Incidence and fatality of serious suicide attempts in a predominantly rural population in Shandong, China : a public health surveillance study

Objectives To estimate the incidence of serious suicide attempts (SSAs, defined as suicide attempts resulting in either death or hospitalisation) and to examine factors associated with fatality among these attempters. Design A surveillance study of incidence and mortality. Linked data from two public health surveillance systems were analysed. Setting Three selected counties in Shandong, China. Participants All residents in the three selected counties. Outcome measures Incidence rate ( per 100 000 person-years) and case fatality rate (%). Methods Records of suicide deaths and hospitalisations that occurred among residents in selected counties during 2009–2011 (5 623 323 person-years) were extracted from electronic databases of the Disease Surveillance Points (DSP) system and the Injury Surveillance System (ISS) and were linked by name, sex, residence and time of suicide attempt. A multiple logistic regression model was developed to examine the factors associated with a higher or lower fatality rate. Results The incidence of SSAs was estimated to be 46 (95% CI 44 to 48) per 100 000 person-years, which was 1.5 times higher in rural versus urban areas, slightly higher among females, and increased with age. Among all SSAs, 51% were hospitalised and survived, 9% were hospitalised but later died and 40% died with no hospitalisation. Most suicide deaths (81%) were not hospitalised and most hospitalised SSAs (85%) survived. The fatality rate was 49% overall, but was significantly higher among attempters living in rural areas, who were male, older, with lower education or with a farming occupation. With regard to the method of suicide, fatality was lowest for non-pesticide poisons (7%) and highest for hanging (97%). Conclusions The incidence of serious suicide attempts is substantially higher in rural areas than in urban areas of China. The risk of death is influenced by the attempter’s sex, age, education level, occupation, method used and season of year.

Public health interventions for increasing physical activity in children, adolescents and adults : an overview of systematic reviews

This is the protocol for a review and there is no abstract. The objectives are as follows: This overview intends to: a) summarise the existing evidence on interventions that aim to increase PA; b) explore whether any effects of the intervention are different within and between populations, and whether these differences form an equity gradient such as an effect that differs according the advantage/disadvantage (e.g. low income and ethnic minorities); c) highlight gaps in the present evidence base that may warrant a Cochrane systematic review to be completed; and c) identify 'up to date' Cochrane reviews. .

Supporting the needs of public health decision-makers and review authors in the UK

Introduction Systematic reviews, through the synthesis of multiple primary research studies, can be powerful tools in enabling evidence-informed public health policy debate, development and action. In seeking to optimize the utility of these reviews, it is important to understand the needs of those using them. Previous work has emphasized that researchers should adopt methods that are appropriate to the problems that public health decision-makers are grappling with, as well as to the policy context in which they operate.1,2 Meeting these demands poses significant methodological challenges for review authors and prompts a reconsideration of the resources, training and support structures available to facilitate the efficient and timely production of useful, comprehensive reviews. The Cochrane Public Health Group (CPHG) was formed in 2008 to support reviews of complex, upstream public health topics. The majority of CPHG authors are from the UK, which has historically been at the forefront of efforts to promote the production and use of systematic reviews of research relevant to public health decision-makers. The UK therefore provides a suitably mature national context in which to examine (i) the current and future demands of decision-makers to increase the use, value and impact of evidence syntheses; (ii) the implications this has for the scope and methods of reviews and (iii) the required action to build and support capacity to conduct such reviews.

The Australian prehospital pandemic risk perception study and an examination of new public health roles in pandemic response for ambulance services

This report is one of a series of products resulting from a National Health and Medical Research Council (NHMRC) Urgent Research Grant – Pandemic Influenza [No 409973]. The research targeted two key aspects of planning and preparedness for a human influenza pandemic, namely:

Copycat firesetting : bridging two research areas

Deliberate firesetting costs our community in destruction to property and lives. Public concern heightens when similar fires occur in a series, raising the specter of copycat firesetting. Difficulties associated with researching copycat crimes in general mean that not a lot is known about copycat firesetting. As an initial step toward filling this research gap, we explore connections between research on copycat crime and research into deliberate firesetting. The intention is to extract salient features from what is known about the phenomena of deliberate firesetting and copycat crime, map them together, and point out shared and unique characteristics. It is argued that a “copycat firesetter” is likely to exist as a distinct subgroup and potentially requiring targeted interventions.

Text mining for screening efficiency? Testing within a Cochrane public health review

Background The requirement for dual screening of titles and abstracts to select papers to examine in full text can create a huge workload, not least when the topic is complex and a broad search strategy is required, resulting in a large number of results. An automated system to reduce this burden, while still assuring high accuracy, has the potential to provide huge efficiency savings within the review process. Objectives To undertake a direct comparison of manual screening with a semi‐automated process (priority screening) using a machine classifier. The research is being carried out as part of the current update of a population‐level public health review. Methods Authors have hand selected studies for the review update, in duplicate, using the standard Cochrane Handbook methodology. A retrospective analysis, simulating a quasi‐‘active learning’ process (whereby a classifier is repeatedly trained based on ‘manually’ labelled data) will be completed, using different starting parameters. Tests will be carried out to see how far different training sets, and the size of the training set, affect the classification performance; i.e. what percentage of papers would need to be manually screened to locate 100% of those papers included as a result of the traditional manual method. Results From a search retrieval set of 9555 papers, authors excluded 9494 papers at title/abstract and 52 at full text, leaving 9 papers for inclusion in the review update. The ability of the machine classifier to reduce the percentage of papers that need to be manually screened to identify all the included studies, under different training conditions, will be reported. Conclusions The findings of this study will be presented along with an estimate of any efficiency gains for the author team if the screening process can be semi‐automated using text mining methodology, along with a discussion of the implications for text mining in screening papers within complex health reviews.

A values analysis of attitudes towards the use of law to prevent obesity: How might these values inform public health law theory and practice?

This thesis asks whether values, like government duty, individual responsibility, community and social justice, influence the way that scholars and research participants think about the use of law to prevent obesity. It explores the way participants speak about values when expressing their support for or against a variety of government regulatory interventions, including taxation, food labelling reforms and advertising restrictions. This research contributes to our understanding of theories of public health law and public health ethics. The qualitative findings also have implications for policy development, in advocating for a variety of government interventions to prevent obesity.

Smoke and mirrors in trade disputes will harm public health

The 2014 World Cancer Report, issued by the World Health Organisation (WHO), indicates that the number of new cancer cases has reached an all-time high. On the 19 May 2014, Dr Margaret Chan, the Director-General of the WHO, gave a stirring speech to the 67th Health Assembly on the heavy health burden associated with cancer. Chan was particularly interested in public health measures designed to combat the global tobacco epidemic...

TPP draft reveals surgical strike on public health

On 13 November, WikiLeaks released a secret draft text of the Intellectual Property Chapter of the Trans-Pacific Partnership (TPP). The text reveals substantive proposals for expanded protection in respect of copyright, patent, trade mark and trade secrets law, and intellectual property enforcement.

Access to essential medicines: Public health and international law

Historically, there have been intense conflicts over the ownership and exploitation of pharmaceutical drugs and diagnostic tests dealing with infectious diseases. Throughout the 1980’s, there was much scientific, legal, and ethical debate about which scientific group should be credited with the discovery of the human immunodeficiency virus, and the invention of the blood test devised to detect antibodies to the virus. In May 1983, Luc Montagnier, Françoise Barré-Sinoussi, and other French scientists from the Pasteur Institute in Paris, published a paper in Science, detailing the discovery of a virus called lymphadenopathy (LAV). A scientific rival, Robert Gallo of the National Cancer Institute, identified the AIDS virus and published his findings in the May 1984 issue of Science. In May 1985, the United States Patent and Trademark Office awarded the American patent for the AIDS blood test to Gallo and the Department of Health and Human Services. In December 1985, the Institut Pasteur sued the Department of Health and Human Services, contending that the French were the first to identify the AIDS virus and to invent the antibody test, and that the American test was dependent upon the French research. In March 1987, an agreement was brokered by President Ronald Reagan and French Prime Minister Jacques Chirac, which resulted in the Department of Health and Human Services and the Institut Pasteur sharing the patent rights to the blood test for AIDS. In 1992, the Federal Office of Research Integrity found that Gallo had committed scientific misconduct, by falsely reporting facts in his 1984 scientific paper. A subsequent investigation by the National Institutes of Health, the United States Congress, and the US attorney-general cleared Gallo of any wrongdoing. In 1994, the United States government and French government renegotiated their agreement regarding the AIDS blood test patent, in order to make the distribution of royalties more equitable... The dispute between Luc Montagnier and Robert Gallo was not an isolated case of scientific rivalry and patent races. It foreshadowed further patent conflicts over research in respect of HIV/AIDS. Michael Kirby, former Justice of the High Court of Australia diagnosed a clash between two distinct schools of philosophy - ‘scientists of the old school... working by serendipity with free sharing of knowledge and research’, and ‘those of the new school who saw the hope of progress as lying in huge investments in scientific experimentation.’ Indeed, the patent race between Robert Gallo and Luc Montagnier has been a precursor to broader trade disputes over access to essential medicines in the 1990s and 2000s. The dispute between Robert Gallo and Luc Montagnier captures in microcosm a number of themes of this book: the fierce competition for intellectual property rights; the clash between sovereign states over access to medicines; the pressing need to defend human rights, particularly the right to health; and the need for new incentives for research and development to combat infectious diseases as both an international and domestic issue.

Tobacco's mad men threaten public health

Non-communicable diseases – Matthew Rimmer examines plain packaging as a way to curb tobacco use. Smoking is one of the biggest causes of non-communicable diseases.

Julia Gillard, Big Pharma, patent law and public health

It takes a lot of bravery for governments to stand up to big business. But the Gillard government has shown a lot of guts during its tenure. It stood up to Big Tobacco in the battle over plain packaging of tobacco products and has defended individuals and families affected by asbestos. It took on Big Oil in its Clean Energy Future reforms and stood up to the resource barons with the mining tax. The government is now considering Big Pharma - the pharmaceutical industry and their patents – and has launched several inquiries into patent law and pharmaceutical drugs...

Doctors for divestment: Climate change and public health

On the Global Divestment Day on the 13–14 February 2015, doctors and health professionals were at the forefront of the campaign for fossil fuel divestment. In Australia, medical professionals have pushed for fossil fuel divestment, climate action, and re-investment in renewable energy. Professor Fiona Stanley has been a key leader in the debate over public health and climate change, delivering a Monster Climate Petition to the Australian Parliament. In the United Kingdom, the British Medical Association has led the way, with its decision to divest itself of investments in coal, oil, and gas. The landmark report Unhealthy Investments has provided further impetus for the United Kingdom health and medical community to engage in fossil fuel divestment. In the United States and Canada, there is a burgeoning fossil fuel divestment movement. At an international level, there has been a growing impetus for climate action in order to address public health risks associated with global warming.