Mortality among homeless people in developed countries is much higher than among the general population (Barrow, Herman, Cordova, & Struening, 1999; Hwang, 2000; Nusselder et al., 2013). Among the causes of this high mortality, deaths due to suicide have rarely been considered, although the data available on suicide attempts suggest that the actual suicide rate among this group may be remarkably high (Barak, Cohen, & Aizenberg, 2004; Barrow et al., 1999; Hwang, 2000). Various studies that have examined suicide attempts among homeless adults in developed countries have found very high percentages of homeless people who have attempted suicide, albeit with important variations: e.g. 48% in Montreal, Canada (Lamontagne, Garceau-Durand, Elie & Blais, 1988); 34.1% in Toronto, Canada (xxxx); 22% in Los Angeles (USA) (Gelberg, Linn & Leake, 1988); and 22% among hostel users in St. Louis (Smith, North, & Spitznagel, 1993). In a large sample of 2,974 homeless people in the USA, Dietz (2011) noted that 6% reported that they had attempted suicide in the previous year.
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While in developed countries there is evidence confirming that suffering from partner violence (Ellsberg et al. 2008) and/or adverse experiences in childhood - sexual abuse, physical punishment/abuse, household dysfunction…- (Dube et al. 2001; Fergusson, Boden, & Horwood, 2008) is associated with suicidal behaviour among women, only a limited number of studies in less developed countries have examined the role of these risk factors in suicidal behaviour (Ahmed et al. 2004; Alem, Kebede, Jacobson, & Kullgren, 1999; Blum et al., 2003; Borges et al., 2008; Maselko & Patel, 2008; Naved & Akhtar, 2008; Pillai, Andrews, & Patel, 2009; Vizcarra et al., 2004), and no study on this subject has been undertaken in Central America. According to Haarr (2010), it is necessary to understand the cultural aspects of suicidal behaviour among women experiencing IPV within a particular society in order to develop culturally appropriate strategies for prevention and support. Various studies have shown that the prevalence of suicide attempts among women is about 1- 8% (Borges et al., 2007; Gureje, Kola, Uwakwe, Wakil, & Afolabi, 2007; Joe, Stein, Seedat, Herman, & Willians, 2008; Kebede & Alem, 1999; Nock et al., 2008; Thanh, Tran, Jiang, Leenaars, & Wasserman, 2006), making it a public health problem of the highest order. However, little is known about the prevalence of suicidal behaviour among women suffering from IPV and potentially modifiable risk factors in low and middle income settings (Vijayakumar, John, Pirkis, & Whiteford, 2005).
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Third, a cross-sectional study was conducted, which failed to consider the temporality and order of occu- rrence of certain events (such as stressful life events or the development of an emotional problem) therefore, that causal associations between risk factors and suici- de attempts should be considered with this limitation. Fourth, the suicide survey questions prevent from analyzing ideation, planning, and attempt as a process but as mutually exclusive events, which may explain why the prevalence of attempting suicide was higher (although not statistically different from the others). Fifth, regarding suicide attempts in Mexico, there is no organization that has truthful information on this problem since it is not mandatory to report it 5 , making
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we are interested in estimating the prevalence of three outcomes, suicide ideation, suicide plans and suicide attempts (suicidal behavior) in the year 2016. Because of limitations in the length of the questionnaire and interview time, we did not include non-suicidal self-in- jury behavior in the Encodat. Respondents were asked about 12-month experiences of suicidal ideation (‘Have you seriously thought about committing suicide?’), suicide plans (‘Have you made a plan for committing suicide?’), and suicide attempts (‘Have you attempted suicide?’). Those positive for a 12-month suicide at- tempt were further asked whether: 1. Whether this attempt led to a hospitalization or medical treatment for the injuries, and 2. To characterize if: (a) if the at- tempt was serious and it was only because of luck that they did not die; (b) if the attempt was serious but they knew the method was not foolproof, and (c) if the at- tempt was a cry for help and they did not want to die. Because self-administered surveys have been shown to yield higher rates of reporting of embarrassing be- haviors than interviewer-administered surveys, 15 these
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multiple methods which seldom require medical attention. In a sequence of suicide attempts mostly one method with a large lethality is chosen, which almost always requires medi- cal intervention. Also the age of onset differs. NSSI tends to start in early adolescence and has an average –usually chron- ic– course of ten to fifteen years, although this can vary from one year to several decades. Suicide attempts usually start at a later age and occur notably less frequently. 26
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In order to improve the prediction of suicide, the selection of adequate variables seems fundamental (Hendin, Al Jurdi, Houck et al., 2010). Different variables have been used as predictors of suicide to date, but none of them is capable of accurately predicting whether or not a particular subject will commit suicide. For instance, sociodemographic predictors of suicide lack specificity (Davis & Schrueder, 1990). Moreover, psychiatric disorders are closely associated with suicide, but most individuals suffering from them do not attempt suicide (Davis & Schrueder, 1990). In addition, a prior suicide attempt is the best predictor of a completed suicide (Coryell & Schlesser, 2001), but only roughly 50% of suicide completers present with a history of suicide attempts (Isometsa & Lonnqvist, 1998; Obafunwa & Busuttil, 1994). Finally, biological tests such as the dexamethasone suppression test have yielded mediocre results (Coryell & Schlesser, 2001; Jokinen, Nordstrom, & Nordstrom, 2008). On the other hand, most suicide attempts and completed suicides are preceded by life events (Blaauw, Arensman, Kraaij et al., 2002; Cavanagh, Owens, & Johnstone, 1999; De Vanna, Paterniti, Milievich et al., 1990) such as interpersonal conflicts, physi- cal illness, and financial problems (Kolves, Varnik, Schneider et al., 2006). Surprisingly, whether or not life events are predictive of suicidal behavior still remains a contro- versial issue (Yen, Pagano, Shea et al., 2005). In view of the aforementioned difficult- ies in the detection of suicide attempters, the present study explores: (1) whether or not the Holmes-Rahe Social Readjustment Rating Scale (SRRS; Holmes & Rahe, 1967) can be used as an instrument capable of accurately identifying suicide attempters
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El riesgo de suicidio fue evaluado con la “Escala de riesgo suicida” (Risk of Suicide, RS; Rubio et al., 1998). Un instrumento autoadministrado de 15 preguntas, con respuesta sí (1) no (0). Su puntuación total se obtiene mediante el sumatorio de las respuestas afirmativas. Las cuestiones están relacionadas con intentos autolíticos previos, la intensidad de la ideación autolítica actual, sentimientos de depresión y desesperanza y otros aspectos asociados a las tentativas. En la validación española, las puntuaciones superiores a 6, se consideran de riesgo, siendo su consistencia interna de =0.90, y su fiabilidad temporal de =0.89 (Rubio et al., 1998).
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In Spain however, the data reveals a grea- ter support by the adult population for eutha- nasia as opposed to physician assisted sui- cide, and not because the profile of those supporting one practice or another are very different, but rather, because the latter ap- pears to generate more doubts: the debate surrounding the same is perhaps less matu- re, less explicit, more influenced by cultural a prioris that are far from any logical reasoning, empirically reflected in the data in the very substantial increase in those that do not know. This appears to be related to a more cultural than rational issue. In fact, in other more liberal societies, it does not operate in the same manner, in which the justification or legalization of one of these practices would support physician assisted suicide, as is the case in the state of Oregon (De Miguel and López, 2006), given that the supra-individual institutions (either the state or religion) adhe- re more to the individual freedoms.
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Modern theorists have given particular atten- tion to how economic factors (particularly income levels, economic fluctuations and employment rates) affect suicide levels. The- re are two major theoretical currents in this regard. On one side there are the “counter- cyclical” theorists (Brenner, 1987; Weyerer and Wiedenmann, 1995; Dos Santos et al., 2016), who argue that suicide rates increase in times of crisis and fall during economic booms, due to the increase in levels of con- sumption and satisfaction. On the other side there are the “pro-cyclical” theorists (Gins- berg, 1966; Lester, 1996; Ruhm, 2000; Gerdtham and Ruhm, 2002; Jungeilges and Kirchgassner, 2003; Neumayer, 2004; Tapia Granados, 2005; Tapia Granados and Ioni- des, 2008; Jalles and Andresen, 2015), who argue – in line with Durkheim’s perspective – that when the economy prospers, indivi- duals’ aspirations increase more rapidly than do the rewards, which causes frustration and leads to an increase in suicides. To some ex- tent, they are arguing that when income le- vels are higher, there are fewer external fac- tors that can be blamed for the failures and suffering of life. In short, mortality (including suicide) behaves pro-cyclically; that is, it mo- ves with the cycles of economic growth.
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Each author, each essay, attempts to bring closer what is seen in film. Bringing it closer allows to create a relationship between what we see, we know and we believe. The effect of this triad is a screen, a different kind of screen: it’s a screen that forms the writing. It’s what gives the book its diversity and interdisciplinary base, not only because the study demands it, but because the authors themselves have taken interest in developing intersectionality within their own fields. Historians, film critics, art critics, professors, curators, philosophers, philologists: interchangeable categorical naming – an attempt to establish a limit to which is considered unquenchable, infinite 1 .
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of 15 items to which the subject may answer “yes” or “no”. It includes questions about previous auto- lytic attempts, current suicidal ideation intensity and feelings of depression and despair. Some of the questions are: “Have you ever thought about en- ding your life?” Scoring is obtained by adding all the points and may go from 0 to 15 points. Authors propose a cutoff point of 6. It has been used to determine risk of suicide in Nursing Staff.
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The participation of the counselors and psychologists who work at the UPR-Cayey was a key element to this project. We were the first ones to meet and participate in formal training on the topic, including the certifi- cation as QPR instructors. The Program covered the cost of the certification. It also paid stipends so that the staff could participate in meetings for brainstorm- ing and strategy development in the areas we wanted to develop to address the issue of suicidal behavior. First, the need to promote services and the process of referral and intervention in at-risk cases was identified as an area to improve. As a product of these meet- ings, this group of colleagues came up with a slogan to promote the Counseling Center (CEDE) within the academic community. This slogan had to be attractive for students, which are our clientele. The slogan was: “Your challenges are not only academic. When it gets tough, let us help you”. It was included in posters and the CEDE promotional materials and this is how the CEDE promotional campaign started. The staff also collaborated in developing the intervention protocol for individuals at risk of suicide and the initial screening of referred students. In addition, the Center started a registry of the suicide risk cases addressed. The expe- rience of pairing the Center’s goals with the goals of the Suicide Prevention Program was a key element in establishing practices that are still being implemented even after federal funding has ended. The fact that the promotional strategies and the intervention protocols were a product of the group working at the CEDE and were not adopted from an external entity contributed to their rapid implementation at the CEDE and contributed to the dissemination and permanence of the campaign at the university.
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Breast cancer is the most commonly occurring cancer diagnosed in women in Western societies, with men also being affected but to a lesser extent. Despite considerable recent progress in the early detection of breast cancer and the improved treatments, such as immunotherapy, chemotherapy, radiotherapy or endocrine therapy available, which have been shown to improve the clinical outcome, the cure rate has not increased and mastectomy is often also required, thus causing significant psychological sequelae in affected patients . Moreover, chemotherapy and radiotherapy treatments are not cancer-specific and also present side effects that often imply a worsened condition and increased patient discomfort. This situation suggests the need to develop new alternative therapeutic approaches, such as gene therapy, that may prove useful alone, or in combination with existing ones, as regards focusing treatment only at the site of action to ensure increased effectiveness, reduce the treatment dose, and decrease adverse systemic side effects [2, 3]. In addition, gene therapy offers the possibility of treatments that eradicate tumors without damaging normal tissue . Different approaches have been developed in gene therapy to treat breast cancer, including the transfer of toxic or pro-apoptotic genes. To date, most research into suicide gene
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Manelli’s point of view is based on the thin ac- count of what is a technically justifiable idea of a good death. This leads to disturbing libertarian relativism. That is, there is little point in medi- cal professionals acting as gatekeepers, preventing non-rational assisted suicides, if rational suicide is merely permission to assist those technically sane individuals who can weigh up the pros and cons of continued life, and then decide in favour of death. This leaves the door open for suicide on demand; a possible choice for anyone who is autonomous, without a mental illness and reaso- nably responsible, but perceives, for one specious reason or another, their life turning out badly. From a psychiatrist like Jerome Motto’s point of view, it is unlikely that Betty’s decision to enter into a suicide pact with her husband George was competent. Motto provides a thicker and richer account as to what constitutes a clinically good reason to entertain rational suicide. From his
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The strength of relational systems is affected by events such as divorce, birth rates, migration, education and population growth and distribution . Among these factors, the likely impact of migration on both total violence and suicide is particularly relevant for this study. In 2013, the number of Salvadorians living in the U.S. was assessed at 1.2 million , equivalent to 19% of El Salvador’s current population. It is estimated that daily, at least 276 Salvadorians try to migrate illegally to the U.S. . Migration causes the separation of families, friends and co-workers, and the weakening of ties in the localities of origin. The families and children left behind by migrants may be initially exposed to stress and other mental pain, which may result in suicide. On the other hand, emigration may improve the quality of life among those left behind in the communities of origin, and might relate to lower suicide rates. Little is known about the impacts of emigration on homicide and suicide in the communities of origin.
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case-crossover analysis, comparing different time periods for the same patients, showed largely the same results as the main analyses and allayed such concerns. For example, smoking is known to be associated with both lung cancer and car- diovascular events. In the case-crossover analy- sis, the relative risk of cardiovascular death during the first 4 weeks after a diagnosis of lung cancer was similar to that in the main analysis (data not shown). Furthermore, although we stratified the analyses according to previous hospitaliza- tions for psychiatric or cardiovascular diseases, we captured only severe conditions for which hospital admission was required. However, if the positive associations were not explained by severe preexisting conditions, it is rather unlikely that they were explained by milder conditions. Our study focused on hard outcomes alone (i.e., com- pleted suicide and cardiovascular death) and thus probably did not capture the full extent of the psychological burden among patients with newly diagnosed cancer. Other potentially relevant out- comes, such as attempted suicide and other severe but nonfatal cardiovascular events, remain to be explored.
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the 10 suicidologists, a number of theoretical proposi- tions/implications (or protocol sentences) have been LGHQWLÀHGWREHREVHUYDEOHLQYDULRXVVDPSOHVRIQRWHV In his model, Leenaars isolated 100 protocol sentences from each of the 10 theorists and reduced them to 35 sentences; 23 protocol sentences were found to be highly predictive (described) for the content of suicide notes (i.e., one standard deviation above the mean of REVHUYDWLRQV DQG SURWRFRO VHQWHQFHV VLJQLÀFDQWO\ discriminated genuine suicide notes from simulated notes (i.e., control data) (with five sentences being both). 25,27,1 2QHXQLTXHÀQGLQJRIWKHVHVWXGLHVLVWKDW
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