Can we predict agitation in patients with suicide attempts in the emergency department?

Background: The agitation in patients presenting to the emergency department (ED) after suicide attempts is common and an important problem. Objective: To establish whether we can predict agitated patients among suicide attempt patients in ED. Methods: This is a cross-sectional observational study of adult suicide attempt events in ED. Information was collected prospectively on a specially designed data-collection form. Patients aged 16 years old and above who presented to the ED for care due to suicide attempts were included in the study. Suicide attempts were grouped as aggressive and non-aggressive attempts. Results: A total of 533 patients were included. Forty-three of these patients had agitation in ED (8%). Non-aggressive suicide attempts were referred to psychiatry services more than aggressive ones (73.6%, n=345 vs 32.8%, n=21, P<0.0001). Agitation in ED and being male increased aggressive suicide attempt risk 3.5 (95% CI:1.6-7.6) and 3.2 times (95% CI:1.8-5.5), respectively. Agitation was statistically more frequent among these patients: those on antidepressant overdose, with previous suicide attempt; with aggressive suicide attempt; and those with confusion; and unconsciousness (P<0.05). Conclusion: Patients who attempted suicide and whose risk of harm to others included those with: antidepressant overdose, aggressive suicide attempt and the unconscious. Response teams should be prepared for these subgroups.

Emergency and Transitional Shelters [Literature Review]

Over the past two decades the number of recorded disasters has doubled from approximately 200 to over 400 disasters per year. Such an increase in the frequency of disasters has not been without consequence, producing ever-greater waves of population displacements throughout the developing world. The United Nation’s Inter-Agency Standing Committee (IASC) responsible for the coordination of international humanitarian responses states unequivocally that populations displaced by disaster have a right to protection and the provision of basic necessities such as adequate food, water, clothing, sanitation, and essential health services (IASC, 2006 and The Sphere Project, 2011). Shelter responses are often a vital node around which many of these humanitarian concerns are addressed. This document is a review of 3 case studies, 6 field reports, 1 concept paper, 16 guidelines, 1 call for proposals, and 4 strategic framework documents prepared by organizations active in the humanitarian shelter sector on emergency and transitional shelters. While emergency shelter response is focused primarily on protection and relief during and immediately after a disaster has occurred, the transitional shelter approach emphasizes integrating disaster response into an immediate transition towards reconstruction, recovery, and sustainable development.

How do customers of a financial services institution judge its communications

Communications are important for relationships within a marketing channel from both a theoretical and managerial perspective. Yet it is a problematic area for scholars. Thus, this research addresses the problem of how do customers of a financial services institution perceive communications with an ideal institution? This study's case research methodology used in-depth interviews with 34 carefully selected customers of a building society. The factors that make up customers' attitudes about corporate communications for an ideal financial services institution were identified and actual perceptions were compared against that ideal. The findings confirmed the importance of communications for customers in a relationship with a financial services provider and suggested communication priorities for customers in this context. In addition, the findings suggested sources of communication dissatisfaction for customers. These findings build upon the literature that speculates about customer perceptions of communications with organizations but provides little evidence to support hypotheses. The contributions arose from the emphasis on the customers' own attitudes and the patterns found within them.