Alcohol Consumption and Nearly Lethal Suicide Attempts

W e conducted a case‐control study of the association between nearly lethal suicide attempts and facets of alcohol consumption; namely, drinking frequency, drinking quantity, binge drinking, alcoholism, drinking within 3 hours of suicide attempt, and age began drinking. Subjects were 13–34 years of age. In bivariable analyses, all measures were associated with nearly lethal suicide attempts. Odds ratios ranged from 2.4 for alcoholism to 7.0 for drinking within 3 hours of attempt. All exposure variables except age began drinking exhibited a J‐shaped relationship between alcohol exposure and nearly lethal suicide attempt. After controlling for potential confounders and other measures of alcohol exposure, drinking within 3 hours of attempt remained most strongly (odds ratios > 6) associated. Alcoholism remained significantly associated in most models, but at lower strength.     

The Development of a Standardized Assessment Framework for Animal Exhibits

Science centers, zoos, and aquariums share the common goal of engaging visitors in learning about the physical and natural world. Exhibits in zoos and aquariums, however, focus primarily on living organisms. Interactive exhibits are less common in these institutions and this differentiates the way visitors engage with exhibits from that of a typical science center visit. Based on the usefulness of the Visitor-Based Learning Framework (Barriault &; Pearson, 2010 Barriault, C. L., &; Pearson, D. (2010). Assessing exhibits for learning in science centres: A practical tool. Visitor Studies, 13(1), 90–106. doi:10.1080/10645571003618824[Taylor &; Francis Online] , [Google Scholar]) as an exhibit assessment tool in science centers, the purpose of this research was to develop a similar tool that assesses the potential learning impact of live animal exhibits in zoos and aquariums. A comprehensive framework of learning-related behaviors was developed and field-tested with a total of 900 visitors. The resulting Visitor-Based Assessment Framework for Animal Exhibits provides zoo and aquarium researchers and practitioners with a valuable tool to assess exhibits through observable behavioral indicators.     

Suicide Prevention from a Public Health Perspective

The public health approach to health problems provides a strong framework and rationale for developing and implementing suicide prevention programs. This approach consists of health-event surveillance to describe the problem, epidemiologic analysis to identify risk factors, the design and evaluation of interventions, and the implementation of prevention programs. The application of each of these components to suicide prevention is reviewed. Suggestions for improving surveillance include encouraging the use of appropriate coding, reviewing suicide statistics at the local level, collecting more etiologically useful information, and placing greater emphasis on analysis of morbidity data. For epidemiologic analysis, greater use could be made of observational studies, and uniform definitions and measures should be developed and adopted. Efforts to develop interventions must include evaluating both the process and the outcome. Finally, community suicide prevention programs should include more than one strategy and, where appropriate, should be strongly linked with the community's mental health resources. With adequate planning, coordination, and resources, and the public health approach can help reduce the emotional and economic costs imposed on society by suicide and suicidal behavior.     

Medical Conditions and Nearly Lethal Suicide Attempts

P hysical illness has been studied as a risk factor for suicidal behavior, but little is known about this relationship among younger persons. We conducted a population‐based, case‐control study in Houston, Texas, from November 1992 through September 1995. The final sample consisted of 153 case‐ and 513 control‐subjects aged 13 to 34 years. Case patients were identified at hospital emergency departments and met criteria for a nearly lethal suicide attempt. Control subjects were recruited via a random‐digit‐dial telephone survey. Case patients were more likely than controls to report having any serious medical conditions (crude OR = 3.23; 95% CI = 2.12–4.91). After controlling for age, race/ethnicity, alcoholism, depression, and hopelessness, the adjusted odds ratio for men was 4.76 (95% CI = 1.87–12.17), whereas the adjusted odds ratio for women was 1.60 (95% CI‐0.62–4.17), suggesting that young men with medical conditions are at increased risk for nearly lethal suicide attempts. Increased efforts to identify and appropriately refer these patients are needed.     

Identification of Nearly Fatal Suicide Attempts: Self-Inflicted Injury Severity Form

The Self-inflicted Injury Severity Form (SIISF) was developed as an epidemiological research tool for identifying individuals in hospital emergency departments who have life-threatening self-inflicted injuries. Data were collected from 715 patients with self-inflicted injuries in two large hospitals. In 295 of these cases, a second set of data was independently collected for assessment of interrater reliability. Validity was assessed by comparing the SIISF results with simultaneously collected Risk—Rescue Ratings. Assessment of interrater reliability found that only 2.4% of physicians disagreed on the suicide method used. The kappa statistic for method used was .94, indicating excellent agreement. The SIISF was found to distinguish between severe and less severe injuries. Thus, it appears to provide a simple method to distinguish patients who have life-threatening self-inflicted injuries.