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2.
Anaesthesia ; 75(1): 96-108, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31729019

RESUMO

Anaesthetists are thought to be at increased risk of suicide amongst the medical profession. The aims of the following guidelines are: increase awareness of suicide and associated vulnerabilities, risk factors and precipitants; to emphasise safe ways to respond to individuals in distress, both for them and for colleagues working alongside them; and to support individuals, departments and organisations in coping with a suicide.


Assuntos
Anestesistas/psicologia , Anestesistas/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Estresse Psicológico/diagnóstico , Suicídio/prevenção & controle , Suicídio/psicologia , Guias como Assunto , Humanos , Transtornos Mentais/complicações , Transtornos Mentais/psicologia , Fatores de Risco , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Suicídio/estatística & dados numéricos , Reino Unido
4.
RECIIS (Online) ; 13(4): 754-767, out.-dez. 2019. ilus
Artigo em Português | LILACS | ID: biblio-1047537

RESUMO

Este artigo objetiva analisar o fomento do debate público promovido pela cobertura jornalística on-line sobre a questão do suicídio de adolescentes e jovens negros no Brasil. Para isso, foram selecionadas três reportagens de três veículos de comunicação: G1 ­ Ciência e Saúde (ligado às Organizações Globo), Nexo (jornal digital independente) e o Alma Preta (agência de jornalismo especializada na temática étnica do Brasil). Com o uso de teorias sobre prática jornalística, opinião pública e silêncio, além do emprego da hermenêutica de profundidade, este estudo concluiu que a mídia não promove integralmente o debate público sobre a questão. O G1 ­ Ciência e Saúde reproduziu o discurso da mídia hegemônica, não dando voz para os negros; o Nexo foi o jornal que tratou o tema de forma mais completa, com uso de dados e fontes, sendo negra uma delas; e o Alma Preta foi o que menos abriu espaço para identificação do público negro, com a ausência de fontes e falta de representação.


This article aims to analyze the public debate at online journalistic coverage on the issue of suicide among black teenagers and young people in Brazil. For this, three news from three media were selected: G1 Ciência e Saúde (linked to Globo Organizations), Nexo (independent digital newspaper) and Alma Preta (journalism agency specializing in ethnic issues in Brazil). Using theories of journalistic practice, public opinion and silence, as well as the use of deep hermeneutics, this study concluded that the media does not fully promote public debate on the issue. G1 ­ Ciência e Saúde reproduced the hegemonic media discourse, giving no voice to blacks; Nexo was the newspaper that dealt with the theme most completely, using data and sources, one of them being black; and Alma Preta was the least open to the identification of the black public, with the absence of sources and lack of representation.


Este artículo tiene como objetivo analizar el debate público a través de la cobertura periodística online sobre el tema del suicidio entre adolescentes y jóvenes negros en Brasil. Para esto se seleccionaron tres medios: G1 ­ Ciência e Saúde (vinculado a Organizaciones Globo), Nexo (periódico digital independiente) y Alma Preta (agencia de periodismo especializada em temas étnicos en Brasil). Utilizando teorías de práctica periodística, opinión pública y silencio, así como el uso de una hermenéutica profunda, este estudio concluyó que los medios no promueven completamente el debate público sobre el tema. G1 ­ Ciência e Saúde reprodujo el discurso de los medios hegemónicos, sin dar voz a los negros; Nexo fue el periódico que trató el tema más completamente, utilizando datos y fuentes; y Alma Preta fue la menos abierta a la identificación del público negro, con la ausencia de fuentes y la falta de representación.


Assuntos
Humanos , Suicídio/prevenção & controle , Adolescente , Jornalismo , Grupo com Ancestrais do Continente Africano , Saúde das Minorias Étnicas , Política de Saúde , Opinião Pública , Suicídio/estatística & dados numéricos , Brasil , Meios de Comunicação , Morte , Populações Vulneráveis , Prevenção de Doenças , Mídias Sociais , Racismo , Hermenêutica
5.
Nurs Clin North Am ; 54(4): 533-539, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31703778

RESUMO

This article offers an alternative conceptualization from which a health care provider can consider and respond to client-based suicidal ideation and behavior. Pragmatically explored through the prism of locus of control, Rogerian psychotherapy principles, Peplau's theory of interpersonal relations, and the work of Kay Redfield Jamison, the Concordant Actions in Suicide Assessment (CASA) model frames clinical decision making along a continuum defined by concordant and state-based action. Therein, cognitive reframes are offered to illustrate how to apply the CASA model in clinical practice.


Assuntos
Controle Interno-Externo , Modelos Psicológicos , Avaliação em Enfermagem , Suicídio/prevenção & controle , Humanos , Papel do Profissional de Enfermagem , Ideação Suicida
8.
BMC Public Health ; 19(1): 1380, 2019 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-31655571

RESUMO

BACKGROUND: Suicide is a major public health issue worldwide. Those who have made a recent suicide attempt are at high risk for dying by suicide in the future, particularly during the period immediately following departure from a hospital emergency department. As such the transition from hospital-based care to the community is an important area of focus in the attempt to reduce suicide rates. There is a need for evaluation studies to test the effectiveness of interventions directed to this stage (termed 'aftercare' interventions). METHODS: A controlled non-randomised two group (intervention vs treatment-as-usual control) design, using an intention-to-treat model, will evaluate the effectiveness of a suicide prevention aftercare intervention providing follow-up after presentations to a hospital emergency department as a result of a suicide attempt or high risk for suicide. The intervention is a community-based service, utilising two meetings with a mental health clinician and follow-up contacts by peer workers via a combination of face-to-face and telephone for four weeks, with the option of extension to 12 weeks. Seventy-five participants of the intervention service will be recruited to the study and compared to 1265 treatment-as-usual controls. The primary hypotheses are that over 12 months, those who participate in the aftercare follow-up intervention are less likely than controls to present to a hospital emergency department for a repeat suicide attempt or because of high risk for suicide, will have fewer re-presentations during this period and will have lower all-cause mortality. As a secondary aim, the impact of the intervention on suicide risk factors for those who participate in the service will be evaluated using pre- and post-intervention repeated measures of depression, anxiety, stress, hopelessness, belongingness, burdensomeness, and psychological distress. Enrolments into the study commenced on 1 November 2017 and are anticipated to cease in November 2019. DISCUSSION: The study aims to contribute to the understanding of effective interventions for individuals who have presented to a hospital emergency department as a result of a suicide attempt or at high risk for suicide and provide evidence in relation to interventions that incorporate peer-workers. TRIAL REGISTRATION: ACTRN12618001701213 . Registered on 16 October 2018. Retrospectively registered.


Assuntos
Assistência ao Convalescente , Serviços de Saúde Comunitária , Tentativa de Suicídio , Suicídio/prevenção & controle , Adolescente , Adulto , Protocolos Clínicos , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Medição de Risco
9.
Lakartidningen ; 1162019 Sep 27.
Artigo em Sueco | MEDLINE | ID: mdl-31573669

RESUMO

MM-ARG, the Swedish maternal maternity mortality group within SFOG (Swedish Society of Obstetrics and Gynecology) has, since 2008, surveyed and analysed maternal deaths in Sweden with the aim to find and give feedback on lessons learned to the medical professions.  MM-ARG consists of obstetricians, midwives and anesthetists and the strength of the working model is that the profession itself takes responsibility for the scrutiny.  A summary of 67 known maternal deaths from 2007‒2017 is presented. Direct causes of death are dominated by hypertensive disease/preeclampsia, followed by thromboembolic disease, sepsis and obstetric bleeding. Indirect death, where a known or unknown underlying disease is exacerbated by pregnancy, is dominated by cardiovascular disease. This review shows that the diagnostics and clinical management could be improved. Besides obstetrics/gynecology, maternal mortality affects other specialties and thus holds important lessons to many.


Assuntos
Mortalidade Materna , Adolescente , Adulto , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Feminino , Humanos , Morte Materna , Transtornos Mentais/mortalidade , Transtornos Mentais/prevenção & controle , Hemorragia Pós-Parto/mortalidade , Hemorragia Pós-Parto/prevenção & controle , Pré-Eclâmpsia/mortalidade , Pré-Eclâmpsia/prevenção & controle , Gravidez , Complicações na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/mortalidade , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Neoplásicas na Gravidez/mortalidade , Complicações Neoplásicas na Gravidez/prevenção & controle , Qualidade da Assistência à Saúde , Sociedades Médicas , Suicídio/prevenção & controle , Suécia/epidemiologia , Tromboembolia/mortalidade , Tromboembolia/prevenção & controle
10.
West J Emerg Med ; 20(5): 818-821, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31539340

RESUMO

INTRODUCTION: Suicide is the 10th leading cause of death in the United States. An estimated 50% of these deaths are due to firearms. Suicidal ideation (SI) is a common complaint presenting to the emergency department (ED). Despite these facts, provider documentation on access to lethal means is lacking. Our primary aim was to quantify documentation of access to firearms in patients presenting to the ED with a chief complaint of SI. METHODS: This was a cross-sectional study of consecutive patients, nearly all of whom presented to an academic, urban ED with SI during July 2014. We collected data from all provider documentation in the electronic health record. Primary outcome assessed was whether the emergency physician (EP) team documented access to firearms. Secondary outcomes included demographic information, preexisting psychiatric diagnoses, and disposition. RESULTS: We reviewed 100 patient charts. The median age of patients was 38 years. The majority of patients had a psychiatric condition. EPs documented access to firearms in only 3% of patient charts. CONCLUSION: EPs do not adequately document access to firearms in patients with SI. There is a clear need for educational initiatives regarding risk-factor assessment and counseling against lethal means in this patient cohort.


Assuntos
Documentação , Serviço Hospitalar de Emergência/legislação & jurisprudência , Armas de Fogo/legislação & jurisprudência , Médicos/estatística & dados numéricos , Ideação Suicida , Suicídio/prevenção & controle , Adulto , Idoso , Aconselhamento , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Suicídio/legislação & jurisprudência , Estados Unidos , Adulto Jovem
12.
Artigo em Inglês | MEDLINE | ID: mdl-31487801

RESUMO

The purpose of this paper is to explore the conviviality between practices of narrative therapy and the emerging field of critical suicide studies. Bringing together ideas from narrative therapy and critical suicide studies allows us to analyze current suicide prevention practices from a new vantage point and offers us the chance to consider how narrative therapy might be applied in new and different contexts, thus extending narrative therapy's potential and possibilities. We expose some of the thin, singular, biomedical descriptions of the problem of suicide that are currently in circulation and attend to the potential effects on distressed persons, communities, and therapists/practitioners who are all operating under the influence of these dominant understandings. We identify some cracks in the dominant storyline to enable alternative descriptions and subjugated knowledges to emerge in order to bring our suicide prevention practices more into alignment with a de-colonizing, social justice orientation.


Assuntos
Bioética , Comunicação , Política , Suicídio/prevenção & controle , Humanos , Justiça Social , Suicídio/psicologia
13.
Psychiatr Danub ; 31(Suppl 3): 258-260, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488737

RESUMO

Suicidal ideations or attempts in patients with major depressive disorder (MDD) are emergent conditions that require immediate treatment. Numerous therapeutic interventions to reduce suicide risk in psychiatric disorders are effective in long-term suicide prevention, but there is necessity of sufficient, rapid pharmacological treatment of suicidal risk in MDD. Ketamine, an N-methyl-D-aspartate (NMDA) antagonist, has been reported to have rapid antidepressant effect. Depressive symptoms, anxiety, hopelessness, suicidal ideation had decreased within hours after ketamine infusion. Ketamine's rapid symptoms relief and reduction of suicide thoughts has aroused growing interests in psychiatric association.


Assuntos
Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Ketamina/uso terapêutico , Suicídio/prevenção & controle , Depressão/tratamento farmacológico , Depressão/psicologia , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Resistente a Tratamento/psicologia , Humanos , Ideação Suicida , Suicídio/psicologia
14.
Psychiatr Danub ; 31(Suppl 3): 574-578, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488793

RESUMO

Bipolar disorder is associated with the highest risk of completed suicide of all mental disorders. The suicide mortality of people with bipolar disorder is approximately 25 times higher than the general population. No approved pharmacological strategies for suicidality in bipolar disorder have been introduced so far. There is evidence for anti-suicidal effect of clozapine in schizophrenia. Clozapine with its unique pharmacology, anti-aggressive and anti-impulsive properties is potentially an effective strategy for suicidality in bipolar disorder.


Assuntos
Transtorno Bipolar/psicologia , Clozapina/farmacologia , Clozapina/uso terapêutico , Suicídio/prevenção & controle , Suicídio/psicologia , Transtorno Bipolar/mortalidade , Transtorno Bipolar/terapia , Humanos
16.
Psychiatr Hung ; 34(2): 199-213, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31417008

RESUMO

The study deals with the psychiatric treatment of the writer with a tragic fate, Sylvia Plath. Sylvia's treatment began with electroconvulsive therapy for suicidal thoughts at the age of 20 and soon afterended up in hospital for an attempted suicide with sleeping pills to McLean Hospital.Her treatment was trusted on Doctor Ruth Beuscher with whom she's been remaining in touch directlyor indirectly (phone, mail) all her life. At the age of 30 she passed away committing suicide at her flatin London after having been treated with antidepressant for her assumably psychotic depression.In the article we provide an insight to the main therapeutic events of Sylvia's treatment and invitethe colleagues for an imaginary experiment based on modern knowledge and family system approach with a trauma focus (on theory of structural dissociation)- hoping it provides us with a conclusionto use in the treatment of suicidal patients.


Assuntos
Criatividade , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Poesia como Assunto/história , Suicídio/história , Suicídio/psicologia , Eletroconvulsoterapia , Feminino , Pesar , História do Século XX , Humanos , Ideação Suicida , Suicídio/prevenção & controle
18.
BMC Health Serv Res ; 19(1): 588, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429739

RESUMO

BACKGROUND: 'Cascade training' or 'train-the-trainers' has been widely utilised in the dissemination of information and expertise in health and social care, but with little examination of the work required for optimal delivery. National suicide prevention strategies commonly include such training initiatives. METHODS: A qualitative study to characterise the work, according to the concepts of Normalization Process Theory, required to disseminate STORM, a model of suicide prevention training across Scotland, and then implement it within organisations. This utilised a cascade style 'train-the trainers' intervention delivered as part of the Choose Life suicide prevention strategy in Scotland during 2008-11. Semi-structured interviews were carried out with 19 training facilitators, 30 of their group participants within organisations and 11 local managers within health boards in Scotland. RESULTS: Crucial to the process of a cascade training approach to implementing suicide prevention within an organisation was the multi-layered activity of constructing coherence of the intervention at every level in order to prevent dilution of the training. This necessitated collaborative work within and between groups of actors- managers, facilitators and participants. Where facilitators were effectively engaged in their role, confident in their ability to train, supported by supervision and possessed the leadership skills to engage both with participants and their local context to deliver training, there was evidence of both successful delivery and embedding within the organisation. However, there was little systematic evidence of institutional level appraisal- crucial to truly implementing a novel intervention within the system - despite efforts at local managerial engagement. CONCLUSIONS: Successful cascade or train-the-trainer implementation of an intervention requires extensive collaborative work to take place between and within groups of actors at all levels of an organization from those working at policy level to the 'coalface'. A priori application of Normalization Process Theory, to specify aims and goals for the necessary work to be carried out between different groups of actors, would assist in embedding a novel working practice at all levels. Future national training strategies for suicide prevention should address what is required to establish a flourishing culture of high-quality skills acquisition and development within healthcare organisations.


Assuntos
Pessoal de Saúde/educação , Suicídio/prevenção & controle , Atitude do Pessoal de Saúde , Competência Clínica/normas , Pessoal de Educação/educação , Humanos , Capacitação em Serviço/métodos , Papel Profissional , Pesquisa Qualitativa , Escócia
19.
Artigo em Inglês | MEDLINE | ID: mdl-31430939

RESUMO

The Mates in Construction (MATES) program was developed to address the issue of high suicide rates among males in the Australian construction industry. The program delivers early intervention training and support to construction workers. This mixed-methods study aimed to (1) examine the effectiveness of training for MATES connectors and (2) examine the barriers, motivations and pathways to help-seeking and help-offering for both MATES connectors and clients. A total of 104 volunteers completed a short survey before and after connector training sessions. Quantitative data analysis showed significant increases in connectors' self-reported suicide awareness, and willingness to offer help to workmates and seek help themselves. For the qualitative component, 27 connectors and clients participated in focus groups and individual interviews. Thematic analysis identified six themes from the connectors' data: awareness, skills and confidence; removing stigma; making a difference; simplicity of the model; understanding the industry; and visibility, camaraderie and passion. For clients, three key themes emerged: barriers and pathways to help-seeking; speaking the same language; and flow-on effects. The results provide evidence for the effectiveness of connector training and indicate that MATES's peer support model is enabling workers to overcome traditional barriers and attitudes to seeking and offering help.


Assuntos
Indústria da Construção , Comportamento de Busca de Ajuda , Comportamento de Ajuda , Relações Interpessoais , Saúde do Trabalhador , Apoio Social , Suicídio/prevenção & controle , Austrália , Grupos Focais , Humanos , Masculino , Saúde do Homem , Pesquisa Qualitativa , Estigma Social , Suicídio/psicologia , Inquéritos e Questionários
20.
Artigo em Inglês | MEDLINE | ID: mdl-31426302

RESUMO

Disproportionate rates of suicide in rural Australia in comparison to metropolitan areas pose a significant public health challenge. The dynamic interrelationship between mental and physical health, social determinants, and suicide in rural Australia is widely acknowledged. Advancement of this knowledge, however, remains hampered by a lack of adequate theory and methods to understand how these factors interact, and the translation of this knowledge into constructive strategies and solutions. This paper presents a protocol for generating a comprehensive dataset of suicide deaths and factors related to suicide in rural Australia, and for building a program of research to improve suicide prevention policy and practice to better address the social determinants of suicide in non-indigenous populations. The two-phased study will use a mixed-methods design informed by intersectionality theory. Phase One will extract, code, and analyse quantitative and qualitative data on suicide in regional and remote Australia from the National Coronial Information System (NCIS). Phase Two will analyse suicide prevention at three interrelated domains: policy, practice, and research, to examine alignment with evidence generated in Phase One. Findings from Phase One and Two will then be integrated to identify key points in suicide prevention policy and practice where action can be initiated.


Assuntos
População Rural , Suicídio/psicologia , Austrália , Humanos , Projetos de Pesquisa , Determinantes Sociais da Saúde , Suicídio/prevenção & controle
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