Factors associated with self-cutting as a method of self-harm: findings from the Irish National Registry of Deliberate Self-Harm

Background: Research suggests that patients presenting to hospital with self-cutting differ from those with intentional overdose in demographic and clinical characteristics. However, large-scale national studies comparing self-cutting patients with those using other self-harm methods are lacking. We aimed to compare hospital-treated self-cutting and intentional overdose, to examine the role of gender in moderating these differences, and examine the characteristics and outcomes of those patients presenting with combined self-cutting and overdose. Methods: Between 2003 and 2010, the Irish National Registry of Deliberate Self-Harm recorded 42,585 self-harm presentations to Irish hospital emergency departments meeting the study inclusion criteria. Data were obtained on demographic and clinical characteristics by independent data registration officers. Results: Compared with overdose only, involvement of self-cutting (with or without overdose) was significantly more common in males than females, with an overrepresentation of males aged <35 years. Independent of gender, involvement of self-cutting (with or without overdose) was significantly associated with younger age, city residence, repetition within 30 days and repetition within a year (females only). Factors associated with self-cutting as the sole method were no fixed abode/living in an institution, presenting outside 9 a.m. to 5 p.m., not consuming alcohol and repetition between 31 days and 1 year (males only). Conclusion: The demographic and clinical differences between self-harm patients underline the presence of different subgroups with implications for service provision and prevention of repeated self-harm. Given the relationship between self-cutting and subsequent repetition, service providers need to ensure that adequate follow-up arrangements and supports are in place for the patient.

Selection of a network of large lakes and reservoirs suitable for global environmental change analysis using Earth Observation

The GloboLakes project, a global observatory of lake responses to environmental change, aims to exploit current satellite missions and long remote-sensing archives to synoptically study multiple lake ecosystems, assess their current condition, reconstruct past trends to system trajectories, and assess lake sensitivity to multiple drivers of change. Here we describe the selection protocol for including lakes in the global observatory based upon remote-sensing techniques and an initial pool of the largest 3721 lakes and reservoirs in the world, as listed in the Global Lakes and Wetlands Database. An 18-year-long archive of satellite data was used to create spatial and temporal filters for the identification of waterbodies that are appropriate for remote-sensing methods. Further criteria were applied and tested to ensure the candidate sites span a wide range of ecological settings and characteristics; a total 960 lakes, lagoons, and reservoirs were selected. The methodology proposed here is applicable to new generation satellites, such as the European Space Agency Sentinel-series.

Treatment of Clostridium difficile infection: a national survey of clinician recommendations and the use of faecal microbiota transplantation

Adherence to Clostridium difficile infection treatment guidelines is associated with lower recurrence rates and mortality as well as cost savings. Our survey of Irish clinicians indicates that patients are managed using a variety of approaches. FMT is potentially underutilised despite its recommendation in national and European guidelines.