1,721,079 research outputs found
Factors associated with increased suicidal intent among deliberate self-harm patients treated in the emergency room of an urban hospital in South Africa
Full text linkBackground: Suicide is the second leading cause of death among 15 to 29 year olds and 79% of global suicides occur in low- to-middle income countries. South Africa has the eight highest rate of suicide in the world, evidence that suicide is a serious public health concern. Identifying socio-demographic and clinical factors associated with high risk of serious self-harm or suicide, may be useful for improving patient care and strengthening appropriate referral pathways. Aim: To determine the sociodemographic and clinical factors associated with elevated levels of suicidal intent among self-harm patients who presented for treatment in the emergency room of an urban hospital in Cape Town, South Africa. Setting: A retrospective folder review of all patients who presented for treatment of deliberate self-harm to Groote Schuur Hospital. Methods: During the time period, 238 consecutive presentations for deliberate self-harm were identified and recorded on a data capture form.which obtained information about demographics, clinical characteristics and suicidal intent. The data was analysed using bivariate and multivariate analyses. Results: In our sample of 238 patients, 128 (54%) self-reported an elevated level of suicidal intent. Being of male gender, higher levels of education and having multiple reasons for selfharm were significant predictors of an elevated level of suicidal intent. Conclusion: Suicide is increasingly recognised as a serious public health problem globally, and in South Africa. Determining the socio demographic and clinical correlates for those at increased risk of suicidal behaviours, provides useful information on identifying vulnerable patients. This allows clinicians to improve patient risk assessment and public health awareness interventions may be closer targeted to at risk group
Motives for deliberate self-harm in a South African tertiary hospital
Full text linkBackground: Although there is a growing body of literature on the epidemiology of deliberate self-harm (DSH) in South Africa, comparatively few studies have investigated the motives for self-harm. No studies have investigated the motives for DSH in Cape Town. Aim: To identify the range of motives for DSH in Cape Town, and how these motives are associated with different sociodemographic factors, the severity of self-injury, and levels of suicidal intent. Methods: Data were collected for 238 consecutive patients presenting with DSH to the emergency department of Groote Schuur Hospital in Cape Town, South Africa. The data were analysed using bivariate and multivariate analyses. Results: Patients engaged in DSH for a range of motives. Interpersonal issues was the most common motive (70%), followed by financial concerns (22%). Male patients were twice as likely as female patients to report interpersonal motives for their self-harm. Patients who reported interpersonal issues were more likely to engage in methods of DSH that involved damage to body tissue. Patients without tertiary education were more likely to report academic concerns as a motive, and patients who reported psychiatric illness as motive for DSH were more likely to require medical interventions than those who did not. Conclusion: This study contributes novel insights into the motives for DSH in the Cape Town context and provides the foundation for continued research on the subject. The study also gives impetus to the development of therapeutic interventions focused on the motives for self-harm
Common mental disorders and psychological adjustment among individuals seeking HIV testing : a study protocol to explore implications for mental health care systems
Full text linkCITATION: Bantjes, Jason & Kagee, Ashraf. 2018. Common mental disorders and psychological adjustment among individuals seeking HIV testing : a study protocol to explore implications for mental health care systems. International Journal of Mental Health Systems, 12:16, doi:10.1186/s13033-018-0196-0.The original publication is available at https://ijmhs.biomedcentral.comPublication of this article was funded by the Stellenbosch University Open Access Fund.Background: In an effort to promote greater access to voluntary counseling and testing for HIV, it has become
practice in many countries, including South Africa, to establish non-medical testing sites and to de-couple HIV testing
from other medical and mental health care services. While it is well established that HIV infection is associated with
a range of psychopathology, much of the literature has assumed that it is receipt of an HIV positive diagnosis that
causes people to become depressed, traumatized, or develop other psychiatric symptoms. Empirical data about the
baseline psychiatric condition and mental health care needs of persons seeking HIV testing is scarce. Understanding
the psychological health of persons seeking HIV testing and documenting how psychiatric symptoms develop over
time following receipt of an HIV positive diagnosis, has important implications for mental health care systems.
Methods: We describe a study protocol to investigate: (1) the level of psychological distress and the prevalence of common
mental disorders among persons seeking HIV testing; (2) the longitudinal development of psychiatric symptoms
among persons diagnosed with HIV; and (3) the recommendations that can be made for mental health care systems
to support persons seeking HIV testing and those newly diagnosed with HIV. In this longitudinal study quantitative and
qualitative data are collected to document participants’ psychiatric symptoms, to determine whether they meet diagnostic
criteria for a common mental disorder, and to explore the lived experiences of persons receiving an HIV positive test
result. Data are collected at three time points; before HIV testing, and then again at 6 and 12 months post-testing.
Discussion: Documenting the prevalence of common mental disorders among persons seeking HIV testing, and
tracking the psychosocial support needs, psychological adjustment and psychosocial experiences of persons newly
diagnosed with HIV, has important implications for the delivery of mental health care services and the design of integrated
mental health care systems.https://ijmhs.biomedcentral.com/articles/10.1186/s13033-018-0196-0Publisher's versio
Patient factors that predict admission to an emergency psychiatric unit following deliberate self-harm in an urban hospital in South Africa
Full text linkBackground: Suicidal behaviour is increasingly widespread in South Africa and constitutes a significant burden of disease, often within resource-constrained hospital settings. Little is known about the factors associated with psychiatric admission following an act of deliberate self-harm (DSH) in South Africa. Aim: The aim of this study was to investigate the sociodemographic and clinical factors which differentiated DSH patients who were admitted to an emergency psychiatric unit compared to those who were treated in the emergency department and discharged. Setting: Data were collected for 272 consecutive patients presenting to the emergency department of a tertiary, public, urban hospital in South Africa, as a result of self harm, between 16 June 2014 and 29 March 2015, for an initial epidemiological study of DSH at the hospital. This study had a data subset of 174 of those patients (84 admitted to the emergency psychiatric unit and 90 treated in the emergency department and discharged). Methods: This study was a retrospective cross-sectional analysis, and it analysed existing data from the epidemiological study, using bivariate and multivariate logistic regression analysis. Results: Of the patients admitted to the emergency psychiatric unit, a greater proportion of patients were female (61,9%), were not in a relationship (83,3%), had no dependents (60,7%), were unemployed (73,8%), and had a low socioeconomic status (59,5%). Having dependants was associated with an increased likelihood of admission to the emergency psychiatric unit in bivariate analysis; however, when controlling for other sociodemographic variables, this was no longer significant. None of the clinical variables were significantly associated with admission to the emergency psychiatric unit. Conclusion: The lack of significant findings in the sociodemographic and clinical factors associated with an admission to the emergency psychiatric unit (compared to being treated in the emergency department and discharged) is surprising. At face value, it suggests that there are no obvious differences between the two groups. The use of a validated screening tool or more accurate measure of the clinical correlates (e.g. screening tool for substance-related 6 disorders) could have better highlighted, perhaps subtle, differences between the two groups. It is perhaps more important to question whether the perceived risk factors in DSH patients are associated with suicidal behaviour and whether emergency psychiatric unit admission, based on these factors, is more effective at treating DSH short-term, and reducing suicidal behaviour long-term, than say outpatient-based treatment interventions. Clinician-related factors that influence psychiatric admission decisions following DSH is also an important area for future research
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Epidemiology of substance use among service users admitted to hospital following a medically serious act of deliberate self-harm: a feasibility study
No full textBackground: Suicidal behaviour is increasing internationally and in South Africa and is considered a national public health problem (1). Literature has shown that substance use is a potentially modifiable risk factor for both fatal and non-fatal suicidal behavior (2- 6). In South Africa, 43 percent of patients who present to emergency departments with intentional or unintentional injuries meet the criteria for a substance use disorder (SUD) (7). The association between substance use and suicidal behavior has been well established, however, the exact nature of this relationship awaits further investigation and clarification. Aims: The proposed study’s aims are; (i)to determine the patterns of substance abuse and the prevalence of SUDs (past and current) among patients admitted following an act of DSH, (ii) to compare patterns of substance use and the prevalence of SUDs (past and current) among those admitted following an episode of DSH, those admitted to the emergency psychiatric unit for reasons other than DSH and medical patients admitted for reasons other than DSH, (iii) to determine if patterns of substance use or the diagnosis of substance use or the diagnosis of SUDs predicts hospital admission for DSH. It concurrently analyzed preliminary data in order to determine if outcomes of the larger study would be meaningful and significant. Methods: Seventy-six patients were recruited over a period of 19 weeks. Twenty-seven consecutive patients with a medically serious act of DSH were recruited and were matched with a control group based on age range and gender. Demographic data and substance use history were collected using; (i) a self reported questionnaire, (ii) Alcohol Use Disorders Identification Tests (AUDIT), (iii) Drug Use Disorders Identification Test (DUDIT) and (iv) SUD module of the structured clinical interview of the DSM. Results: Findings of the feasibility study indicated low recruitment numbers and data collection challenges. Causes of low recruitment number were multifactorial, including low base rates for self-harm, length of recruitment time, consenting capacity, tight control criteria, exclusion of manic and psychotic patients and declining of patients to participate. Data collection faced challenges including difficult navigation of hospital premises, long data collection times, limited understanding of questions, language barriers and lack of privacy. Formal suicide risk assessment was a challenge for some data collectors. Preliminary data confirmed that substance use is a significant risk factor for DSH. Conclusions: This feasibility study demonstrated the existing protocol can be used to generate meaningful data and identified specific steps to be altered in a scaled-up study. These steps included; expansion of study sites to more institutions to increase recruitment numbers, a wider range in matching criteria for control groups and improved orientation and training of data collectors regarding use of the data collection tool, navigation of the hospital premises, maintaining confidentiality and formal suicide risk assessments. Formal translation of the research tool into other languages was recommended. Despite low recruitment numbers, data collected from this study was meaningful
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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