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- Beckman, K., et al.
(författare)
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Impulsive suicide attempts among young people-A prospective multicentre cohort study in Sweden
- 2019
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 243, s. 421-426
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to compare the prevalence of impulsive suicide attempts (ISA) among young adults and those over 25 who present at hospital in connection with attempted suicide. We also aimed to identify factors associated with ISA in young adults and to assess medical severity as well as the probability of repeated suicide attempts in this age group. Method: A prospective multicentre cohort study included hospital known cases of suicide attempt (N = 666). The prevalence of ISA was compared between young adults (18-25) and adults aged > 26. We used logistic regression models to identify factors associated with ISA, associations of ISA with high medical severity and prediction of new fatal or non-fatal suicide attempts within 6 months. Results: 43.7% of the young patients had made an ISA, and 30.2% among those aged > 26 (p = 0.001). Among the young, substance use disorder was associated with ISA; crude odds ratio (OR) 2.0 (1.0-4.2), and adjusted OR 2.1 (0.99-4.4). Affective disorder and unemployment/sickness absence implied lower odds of ISA. ISA resulted in injuries of high medical severity as often as more planned attempts and non-fatal or fatal repetition within 6 months was equally common (30%) in both groups. Limitations: The study was set in psychiatric emergency services, which limits the generalizability. Conclusions: Clinicians should acknowledge that suicide attempts among youth often occur without previous planning and may result in medically severe injuries. The probability of new fatal or non-fatal suicide attempts should be kept in mind also after an impulsive suicide attempt.
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- Eneh, Lynda, et al.
(författare)
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Anopheles arabiensis oviposition site selection in response to habitat persistence and associated physicochemical parameters, bacteria and volatile profiles
- 2019
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Ingår i: Medical and Veterinary Entomology. - : WILEY. - 0269-283X .- 1365-2915. ; 33:1, s. 56-67
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Tidskriftsartikel (refereegranskat)abstract
- A better understanding of the oviposition behaviour of malaria vectors might facilitate the development of new vector control tools. However, the factors that guide the aquatic habitat selection of gravid females are poorly understood. The present study explored the relative attractiveness of similar artificial ponds (0.8 m(2)) aged at varying lengths prior to opening in such a way that wild Anopheles arabiensis could choose between ponds that were freshly set up, or were aged 4 or 17 days old, to lay eggs. Physicochemical parameters, bacterial profile and volatile organic compounds emitted from ponds were investigated over three experimental rounds. Fresh ponds contained on average twice as many An. arabiensis instar larvae (mean 50, 95% confidence interval (CI) = 29-85) as the ponds that had aged 4 days (mean = 24, 95% CI = 14-42) and 17 days (mean = 20, 95% CI: 12-34). Fresh ponds were associated with a significantly higher turbidity combined with higher water temperature, higher nitrite levels and a lower pH and chlorophyll level than the older ponds. Round by round analyses suggested that bacteria communities differed between age groups and also that 4-heptanone, 2-ethylhexanal and an isomer of octenal were exclusively detected from the fresh ponds. These characteristics may be useful with respect to developing attract and kill strategies for malaria vector control.
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- Haglund, A., et al.
(författare)
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Interpersonal violence and the prediction of short-term risk of repeat suicide attempt
- 2016
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- In this multi-center cohort study, suicide attempters presenting to hospital (N = 355, 63% women) were interviewed using the Karolinska Interpersonal Violence Scale (KIVS) and followed-up by medical record review. Main outcome was non-fatal or fatal repeat suicide attempt within six months. Also, repeat attempt using a violent method was used as an additional outcome in separate analyses. Data were analyzed for the total group and for men and women separately. Repeat attempts were observed within six months in 78 persons (22%) and 21 (6%) of these used a violent method. KIVS total score of 6 or more was associated with repeat suicide attempt within six months (OR = 1.81, CI 1.08-3.02) and predicted new attempts with a sensitivity of 62% and a specificity of 53%. A three-fold increase in odds ratio was observed for repeat attempt using a violent method (OR = 3.40, CI 1.22-9.49). An association between exposure to violence in adulthood and violent reattempt was seen in women (OR = 1.38, CI 1.06-1.82). The overall conclusions are that information about interpersonal violence may help predict short-term risk for repeat suicide attempt, and that structured assessment of interpersonal violence may be of value in risk assessment after attempted suicide.
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- Lindh, A. U., et al.
(författare)
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Short term risk of non-fatal and fatal suicidal behaviours: the predictive validity of the Columbia-Suicide Severity Rating Scale in a Swedish adult psychiatric population with a recent episode of self-harm
- 2018
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Ingår i: Bmc Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Columbia-Suicide Severity Rating Scale (C-SSRS) is a relatively new instrument for the assessment of suicidal ideation and behaviour that is widely used in clinical and research settings. The predictive properties of the C-SSRS have mainly been evaluated in young US populations. We wanted to examine the instrument's predictive validity in a Swedish cohort of adults seeking psychiatric emergency services after an episode of self-harm. Methods: Prospective cohort study of patients (n = 804) presenting for psychiatric emergency assessment after an episode of self-harm with or without suicidal intent. Suicidal ideation and behaviours at baseline were rated with the C-SSRS and subsequent non-fatal and fatal suicide attempts within 6 months were identified by record review. Logistic regression was used to evaluate separate ideation items and total scores as predictors of non-fatal and fatal suicide attempts. Receiver operating characteristics (ROC) curves were constructed for the suicidal ideation (SI) intensity score and the C-SSRS total score. Results: In this cohort, the median age at baseline was 33 years, 67% were women and 68% had made at least one suicide attempt prior to the index attempt. At least one non-fatal or fatal suicide attempt was recorded during follow-up for 165 persons (20.5%). The single C-SSRS items frequency, duration and deterrents were associated with this composite outcome; controllability and reasons were not. In a logistic regression model adjusted for previous history of suicide attempt, SI intensity score was a significant predictor of a non-fatal or fatal suicide attempt (OR 1.08; 95% CI 1.03-1.12). ROC analysis showed that the SI intensity score was somewhat better than chance in correctly classifying the outcome (AUC 0.62, 95% CI 0.57-0.66). The corresponding figures for the C-SSRS total score were 0.65, 95% CI 0.60-0.69. Conclusions: The C-SSRS items frequency, duration and deterrents were associated with elevated short term risk in this adult psychiatric cohort, as were both the SI intensity score and the C-SSRS total score. However, the ability to correctly predict future suicidal behaviour was limited for both scores.
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- Lindh, Jenny M., et al.
(författare)
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Discovery of an oviposition attractant for gravid malaria vectors of the Anopheles gambiae species complex
- 2015
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Ingår i: Malaria Journal. - : Springer Science and Business Media LLC. - 1475-2875. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: New strategies are needed to manage malaria vector populations that resist insecticides and bite outdoors. This study describes a breakthrough in developing 'attract and kill' strategies targeting gravid females by identifying and evaluating an oviposition attractant for Anopheles gambiae s.l. Methods: Previously, the authors found that gravid An. gambiae s.s. females were two times more likely to lay eggs in lake water infused for six days with soil from a natural oviposition site in western Kenya compared to lake water alone or to the same but autoclaved infusion. Here, the volatile chemicals released from these substrates were analysed with a gas-chromatograph coupled to a mass-spectrometer (GC-MS). Furthermore, the behavioural responses of gravid females to one of the compounds identified were evaluated in dual choice egg-count bioassays, in dual-choice semi-field experiments with odour-baited traps and in field bioassays. Results: One of the soil infusion volatiles was readily identified as the sesquiterpene alcohol cedrol. Its widespread presence in natural aquatic habitats in the study area was confirmed by analysing the chemical headspace of 116 water samples collected from different aquatic sites in the field and was therefore selected for evaluation in oviposition bioassays. Twice as many gravid females were attracted to cedrol-treated water than to water alone in two choice cage bioassays (odds ratio (OR) 1.84; 95% confidence interval (CI) 1.16-2.91) and in experiments conducted in large-screened cages with free-flying mosquitoes (OR 1.92; 95% CI 1.63-2.27). When tested in the field, wild malaria vector females were three times more likely to be collected in the traps baited with cedrol than in the traps containing water alone (OR 3.3; 95% CI 1.4-7.9). Conclusion: Cedrol is the first compound confirmed as an oviposition attractant for gravid An. gambiae s.l. This finding paves the way for developing new 'attract and kill strategies' for malaria vector control.
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- Lindh, Magnus, 1960, et al.
(författare)
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Clinical Effectiveness of Liraglutide vs Sitagliptin on Glycemic Control and Body Weight in Patients with Type 2 Diabetes: A Retrospective Assessment in Sweden
- 2016
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Ingår i: Diabetes Therapy. - : Springer Science and Business Media LLC. - 1869-6953 .- 1869-6961. ; 7:2, s. 321-333
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aim of the present study was to use real-world data from Swedish primary-care and national registries to understand clinical outcomes in patients with Type 2 diabetes (T2D) treated with liraglutide in clinical practice, and to compare with data from those treated with sitagliptin. Methods: This was a non-interventional, retrospective study conducted between February 2014 and September 2014 using T2D patient data from Swedish primary-care centers and national healthcare registries. The primary objective was to assess the effectiveness of liraglutide in control of glycemia and body weight in clinical practice (stage 1). The secondary objective was to compare the clinical effectiveness of liraglutide with sitagliptin on glycemic control and body weight in clinical practice in a propensity-score-matched population (stage 2). Results: In stage 1 (n = 402), 39.4% of patients treated with liraglutide achieved >= 1.0% (10.9 mmol/mol) reduction in glycated hemoglobin (HbA1c) after 180 days of treatment and 54.9% achieved the target HbA1c of <7.0% (53.0 mmol/mol). Moreover, compared with baseline, 22.5% of patients treated with liraglutide achieved both >= 1.0% reduction in HbA1c and >= 3.0% reduction in body weight. In stage 2, a significantly greater proportion of patients receiving liraglutide (n = 180) than sitagliptin (n = 208) achieved >= 1.0% reduction in HbA1c [52.9% vs 33.5%, respectively (P = 0.0002)]. Mean body-weight loss was also significantly greater in patients receiving liraglutide vs sitagliptin [-3.5 vs -1.3 kg, respectively (P < 0.0001)]. Conclusion: This study provides real-world evidence from Sweden corroborating previous clinical trials that demonstrate greater efficacy of liraglutide over sitagliptin on glycemic control and body-weight reduction in patients with T2D.
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