Differences between younger and older adults in the structure of suicidal intent and its correlates

OBJECTIVE: To analyze differences in the variables associated with severity of suicidal intent and in the main factors associated with intent when comparing younger and older adults. DESIGN: Observational, descriptive cross-sectional study. SETTING: Four general hospitals in Madrid, Spain. PARTICIPANTS: Eight hundred seventy suicide attempts by 793 subjects split into two groups: 18-54 year olds and subjects older than 55 years. MEASUREMENTS: The authors tested the factorial latent structure of suicidal intent through multigroup confirmatory factor analysis for categorical outcomes and performed statistical tests of invariance across age groups using the DIFFTEST procedure. Then, they tested a multiple indicators-multiple causes (MIMIC) model including different covariates regressed on the latent factor "intent" and performed two separate MIMIC models for younger and older adults to test for differential patterns. RESULTS: Older adults had higher suicidal intent than younger adults (z = 2.63, p = 0.009). The final model for the whole sample showed a relationship of intent with previous attempts, support, mood disorder, personality disorder, substance-related disorder, and schizophrenia and other psychotic disorders. The model showed an adequate fit (chi²[12] = 22.23, p = 0.035; comparative fit index = 0.986; Tucker-Lewis index = 0.980; root mean square error of approximation = 0.031; weighted root mean square residual = 0.727). All covariates had significant weights in the younger group, but in the older group, only previous attempts and mood disorders were significantly related to intent severity. CONCLUSIONS: The pattern of variables associated with suicidal intent varies with age. Recognition, and treatment of geriatric depression may be the most effective measure to prevent suicidal behavior in older adults.

Survey of General Optical Council disciplinary and fitness to practise hearings:2001-2011

The aim of this survey was to review 187 transcripts from the United Kingdom’s General Optical Council (GOC) Disciplinary and Fitness To Practise (FTP) Committee hearings from 2001 to 2011 in order to identify common themes and thereby help practitioners to avoid the more frequently occurring pitfalls that were recorded during this period. The study covered changes in GOC FTP regulations in 2005, which involved a change from a disciplinary to a fitness to practise process. The number of cases was very small compared to the total number of optometrist and dispensing optician registrants, which was 13709 in 2001-02 rising to 18582 in 2010-11. The main findings indicated that between 2001 and 2011 there was a three times greater likelihood that male registrants versus female registrants would be brought in front of a GOC Disciplinary or FTP Committee. In terms of erasures from the GOC registers between 2001 and 2011, male registrants were also more likely to be erased than females. The male: female split for erasures between 2001 and 2011 was five: one, increasing to seven: one when considering the situation post the 2005 GOC FTP rule change. Of the cases brought before the Disciplinary and FTP Committees between 2001 and 2011, it was noted that cases implicating theft and fraud were most frequent representing 27% of hearings examined (17% involving NHS fraud and 10% theft or fraud from an employer). The examination of transcripts revealed other hearings were more complex. These hearings often had a primary reason for the investigation that highlighted further secondary concerns that also required investigation.

Resource endowment and opportunity cost effects along the stages of entrepreneurship

In this paper, the start-up process is split conceptually into four stages: considering entrepreneurship, intending to start a new business in the next 3 years, nascent entrepreneurship and owning-managing a newly established business. We investigate the determinants of all of these jointly, using a multinomial logit model; it allows for the effects of resources and capabilities to vary across these stages. We employ the Global Entrepreneurship Monitor database for the years 2006–2009, containing 8269 usable observations from respondents drawn from the Lower Layer Super Output Areas in the East Midlands (UK) so that individual observations are linked to space. Our results show that the role of education, experience, and availability of ‘entrepreneurial capital’ in the local neighbourhood varies along the different stages of the entrepreneurial process. In the early stages, the negative (opportunity cost) effect of resources endowment dominates, yet it tends to reverse in the advanced stages, where the positive effect of resources becomes stronger.