Suicide and suicides attempts in Italian prison epidemiological findings from the "Triveneto" area, 2010-2016.

The aim of this observational study was to assess rates of suicide and suicide attempts, in relation to gender, age, place of birth and security levels, in north-eastern Italian prisons during 2010-2016, and investigate associations with prison overcrowding, offence type and prior self-harm and suicide attempts. The study was based on individual data on suicides and suicide attempts from 16 prisons, with an average yearly number of 3900 inmates during the study period, for all prisons combined. Descriptive and binomial regression analyses were performed. Rates of suicide and suicide attempts in Triveneto prisons were 1and 15 per 1000 inmates, respectively. >90% of suicides and suicide attempters were men aged between 21 and 49 years old, and most had committed violent offenses. Only half the prisoners who died by suicide and 30% of those who made a suicide attempt in custody were Italians. 'Cooperative witnesses' had the highest mean suicide attempt rate (30/1000 inmates). Fourteen per cent of suicides and 19% of attempters had a prior history of suicide attempts and self-injury. In binomial regression analyses, predictors of suicidal behaviour were being a male inmate in standard security conditions, with a mean age of 30 years. The study highlighted that there is a need for suicide prevention policies in Triveneto; these should take into account predictors of suicidal behaviours and individual characteristics of suicidal inmates. More research is warranted in order to both evaluate the effectiveness of prevention plans and better assess risk of suicide in specific groups, such as cooperative witnesses.

Are older people willing to give up their place in the queue for cardiac surgery to a younger person?

OBJECTIVES: to measure whether people aged 65 and over living in Britain would be willing to give up their place on the cardiac surgery waiting list for someone younger than them. METHODS: two British surveys, based on random types of people sampled for the Office for National Statistics Omnibus Surveys, identified respondents aged 65 and over for a module on waiting lists. They were asked to imagine they had a heart condition that required surgery, and that they were on an NHS waiting list. They were then asked if they would be prepared to give up their place on the cardiac surgery waiting list to a younger person (aged 45). The study compared responses to one of two relative waiting list time frames (6 and 12 months). SETTING: two national random samples of the British public aged 65 and over. RESULTS: fifty eight per cent and 62% of Omnibus respondents aged 65 and over responded that it was not right to give up their place on the cardiac surgery waiting list for someone younger in relation to a 6 and 12 month wait respectively. Thirty seven per cent and 34% of each group of Omnibus respondents aged 65+ said it was right to give up their place on the cardiac surgery waiting list for someone younger than them, in relation to a 6 and 12 month relative waiting period respectively. Thus the length of the wait had little effect on response among British respondents. The proportions who were willing to cede priority are far less than that reported in a comparable Italian survey. Consistent with the Italian survey, willingness to cede priority increased with age. CONCLUSIONS: most older people in Britain do not wish to cede priority on the waiting list for cardiac surgery to people younger than themselves, although willingness to give up one's place increased with age. The specific time frame did not have an impact on people's responses. The increase in willingness to cede priority with older age could be interpreted as older people valuing themselves less, or that they feel that they have had their 'fair innings' and are willing to give younger people the chance of reaching their age. It could even reflect a cohort effect. It is likely that ageing 'baby boomers' may be even less willing to give up their place in the health service queue and will be more assertive about their right to equity in health care provision.