Suicide: a concept analysis

Background

Suicide is a national and global phenomenon with its rate increasing every year inspite of clinicians, policy makers and researchers grappling with suicide prevention and investing heavily in risk assessment, prevention and reduction. There seems to be a gap in the understanding of suicide and its associated behaviours.

Aim

The aim of this review was to undertake a concept analysis of suicide and behaviour.

Method

The Walker and Avant eight-step method was adopted. Search engines including Academic Search Elite, CINAHL, Ovid Online embracing Embase and Ovid Medline were utilised to access articles published in the last 10 years, written in English, with abstracts and full text.

Results

The concept of suicide require understanding of implicity and explicity of suicidal intent and how these relate to suicide behaviour. Areas of risk assessment such as thwarted belongingness and perceived burdensomeness should be considered. Associated with suicide are internal and external hazards, which tend to create vulnerability leading to suicidal behaviour. Clinicians should differentiate between suicide in the presence of mental illness and when there is a predicament. Risk assessment tools should not be taken as absolute as they do not provide 100 % detection of intent.

Conclusion

Understanding the concept of suicide would help clinicians comprehend their patients and suicidal behaviour and improve intervention methods.

     

Relationship of being threatened or injured with a weapon in school with suicidal ideation and attempt among school students: a school-based study in Zhejiang Province,China

Background

Suicide is the second leading cause of death among 15–29?year old youths globally, and the third most common external cause of death in China. School bullying can cause serious consequences among adolescents, including psychosocial problems, low self-esteem and post-traumatic stress disorder. Most studies examining the associations between being bullied in school and suicide are from Western, developed countries. Moreover, few studies focus on being threatened or injured with a weapon, which may cause serious body injury. Our study aimed to explore the relationship of being threatened or injured with a weapon in school with suicidal ideation and attempt among middle and high school students in Zhejiang Province, China.

Methods

A cross-sectional study of 23,543 students in grades 7–12 from 442 schools was carried out through an anonymous self-administered questionnaire between April and May 2017. Multivariable logistic regression models were used to examine the relationship of being threatened or injured with a weapon in school with suicidal ideation and attempt.

Results

51.3% of participants were boys, and mean (SD) age was 15.6 (1.7) years. The overall prevalence of suicidal ideation and attempt were 16.1% (95%CI: 15.3–16.9) and 3.6% (95%CI: 3.3–4.0), respectively. Prevalence was higher among girls than boys (ideation: 19.1% vs. 13.3%. attempt: 4.4% vs. 2.9%). 13.2% of students reported being threatened or injured with a weapon in school in the past 12?months (95%CI: 11.9–14.5), higher among boys than girls (15.7% vs. 10.5%), and among rural students than urban students (13.9% vs. 11.6%). After adjustment for socio-demographic status, lifestyle factors, academic performance, self-reported health and mental health, the odds ratios for suicidal ideation and attempt among students who reported being threatened or injured with a weapon were 1.46 (1.31–1.61) and 1.68 (1.31–2.13) respectively, as compared with those who did not report being threatened or injured.

Conclusions

Preventive measures for physical bullying in school need to be reinforced in China. Being threatened or injured with a weapon is associated with both suicidal ideation and attempt among middle and high school students. Suicide prevention should be an important component of psychological interventions for threatened or injured students.

     

The benefits of personal strengths in mental health of stressed students: A longitudinal investigation

Objective

This study used a two-wave longitudinal research design to explore the role of individual strengths, including interpersonal strength, intellectual strength, and temperance strength, in affecting the mental health of stressed college students.

Participants

A total of 404 stressed Chinese college students were screened to participate in this 12-month longitudinal study.

Methods

At the beginning of the study (Time 1), students who had not experienced stressful events within the last 12 months were invited to assess their strengths, psychological well-being, and psychological symptoms. After 12 months (Time 2), 404 students who reported stressful experiences completed the scales again and were retained for the final analyses.

Results

Academics-related stressors were the most endorsed life events among college students, whose states of mental health showed downward trends from Time 1 to Time 2. Three strengths had weak to modest correlations to mental health at both Time 1 and Time 2. Although the additional variances of mental health explained by the three strengths were very modest, the mediational roles of the strengths were identified. The perceived stress completely mediated the relationship between the strengths and the psychological symptoms and partly mediated the relationship between the strengths and psychological well-being.

Conclusions

Individual strengths may function as a defense against perceived stress and are protective factors of mental health. These strengths maintain mental health by enhancing the psychological well-being and reducing the psychological symptoms of individuals.

     

Effects of an Afterschool Early Literacy Intervention on the Reading Skills of Children in Public Housing Communities

Background

Afterschool programs (ASPs) in the United States have been implemented in low income neighborhoods to enable at-risk youth to access educational support services to increase academic skills. However, mixed findings about the ASPs positively affecting academic performance suggests a need for additional evaluative studies.

Objective

The current study examines the effects of literacy training on the reading skills of kindergarten to third grade students who were enrolled in a community-based ASP in four public housing neighborhoods. Participants received structured literacy and reading training, individual tutoring, and a choice-based book distribution program.

Method

Assignment to treatment and comparison groups was based on residence in public housing neighborhoods. We implemented a quasi-experimental design to compare improvements in reading proficiency among ASP literacy program participants in four public housing neighborhoods and a comparable group of students residing in two other public housing neighborhoods without this ASP. Participants were enrolled in grades K to 3 (n = 543). The study lasted for 4 years, and an intent-to-treat approach was used to analyze outcomes.

Results

Mixed-effects models indicated that among a full sample and propensity-score matched sample, ASP participants demonstrated significantly better reading proficiency than comparison group participants over time.

Conclusions

Study findings provide preliminary evidence that it is possible to impact reading proficiency for very high-risk students in the early grades of elementary school. ASPs that target literacy among low-income students could play an important role in boosting student achievement, and therefore in narrowing the achievement gap as young people progress through school.

     

„Teachers’ Mental Health Literacy“

Background

According to conservative estimates approximately three million children experience at least one parent with a mental disorder every year. This is about a quarter of all students in Germany. Burden patterns and attempts at coping also become manifest in children’s school lives, mostly with impairments in their learning performance. For teachers this means occupational stress as well.

Objectives

The subproject TEACHER-MHL of the HLCA Consortium will investigate current knowledge of teachers in different types of schools (1st–6th grade), who are dealing with pupils experiencing a critical life-event such as the mental illness of a parent and thus running a higher risk of health disorders. In addition, a program will be developed for the further training of teachers in different types and levels of schools.

Materials and methods

The following steps are planned: systematic literature review, semistructured interviews with teachers, quantitative survey to gather data about specific competences of teachers, and developing and testing a training program for teachers.

Results

By participating in the developed training module, it is expected that specific competencies and the sustainable empowerment of teachers will be promoted, resulting in a significant improvement of school health promotion and support for teachers.

Conclusions

The focus is on a high-risk group that has not yet been sufficiently taken into consideration in professional discussions about school settings. The subproject will determine the current needs of a professional group in dealing with affected students and transfer the results into practice. This paper gives an overview of this research project.

     

Impact assessment of a pay-for-performance program on breast cancer screening in France using micro data

Background

A voluntary-based pay-for-performance (P4P) program (the CAPI) aimed at general practitioners (GPs) was implemented in France in 2009. The program targeted prevention practices, including breast cancer screening, by offering a maximal amount of €245 for achieving a target screening rate among eligible women enrolled with the GP.

Objective

Our objective was to evaluate the impact of the French P4P program (CAPI) on the early detection of breast cancer among women between 50 and 74 years old.

Methods

Based on an administrative database of 50,752 women aged 50–74 years followed between 2007 and 2011, we estimated a difference-in-difference model of breast cancer screening uptake as a function of visit to a CAPI signatory referral GP, while controlling for both supply-side and demand-side determinants (e.g., sociodemographics, health and healthcare use).

Results

Breast cancer screening rates have not changed significantly since the P4P program implementation. Overall, visiting a CAPI signatory referral GP at least once in the pre-CAPI period increased the probability of undergoing breast cancer screening by 1.38 % [95 % CI (0.41–2.35 %)], but the effect was not significantly different following the implementation of the contract.

Conclusion

The French P4P program had a nonsignificant impact on breast cancer screening uptake. This result may reflect the fact that the low-powered incentives implemented in France through the CAPI might not provide sufficient leverage to generate better practices, thus inviting regulators to seek additional tools beyond P4P in the field of prevention and screening.

     

Age and IQ Explained Working Memory Performance in a RCT with Fatty Fish in a Group of Forensic Inpatients

Objectives

To investigate the effect of a long-term fatty fish intervention on a pure cognitive mechanism important for self-regulation and mental health, i.e. working memory (WM), controlling for age and IQ.

Design

A randomized controlled trial.

Setting

A forensic facility.

Participants

Eighty-four young to middle aged male forensic inpatients with psychiatric disorders.

Intervention

Consumption of farmed salmon or control meal (meat) three times a week during 23 weeks.

Measurement

Performance on WM tasks, both accuracy and mean reaction time, were recorded pre and post intervention.

Results

Performance on a cognitive functioning tasks taxing WM seemed to be explained by age and IQ.

Conclusion

Fatty fish consumption did not improve WM performance in a group of young to middle aged adults with mental health problems, as less impressionable factors such as aging and intelligence seemed to be the key components. The present study improves the knowledge concerning the interaction among nutrition, health and the aging process.

     

Drogenkonsum unter Studierenden der Sozialen Arbeit

Background

The study surveyed extent of drug use among students of social work and explored if there was a relationship between drug use and demands of study program.

Methods

Social work students (n = 240) filled in an online questionnaire about their drug use and rated demands of their study program.

Results

A third of the students took cannabis, 10?% tranquilizer or sleeping pills and almost 10?% amphetamines. Students used cannabis und tranquilizers deliberately to obtain recovery times in everyday student life. However, there were only low rates of brain doping observed.

Conclusion

Students should receive coaching on alternative methods of relaxation and strategies for time management and self-care.

     

Barriers to Hepatitis C Screening in a Minority Population: A Comparison of Hepatitis C and Human Immunodeficiency Virus Screening Rates at a Community STD Clinic in Miami,Florida

Methods

357 patients at a free STD clinic in Miami, FL were screened for HCV. Surveys were administered assessing risk factors for infectious disease transmission, and HCV and HIV screening history.

Results

15.1% of participants had been screened for HCV before whereas 83.8% had been screened for HIV (n?=?356). Of the patients previously screened for HCV (n?=?54), 98.2% of these patients had previously been screened for HIV as well.

Conclusion

This data shows the low prevalence of prior HCV screenings in a high-risk population in Miami, FL. Participants who had previously received an HIV screening test were more likely to report receiving a prior HCV screening. Despite the high prevalence of HCV, most HCV infections are undiagnosed. Mortality from HIV has been declining in the United States while mortality from HCV is increasing. To decrease HCV related mortality, we recommend offering HCV screening in conjunction with HIV screening.

     

Cross-sectional observation of the relationship of depressive symptoms with lifestyles and parents’ status among Japanese junior high school students

Objectives

Students’ depressive symptoms might be related to their own risk factors and to their parents’ status. The objective of this cross-sectional study was to examine the relationship of depressive symptoms with lifestyle variables and parents’ psychological and socio-demographic status among Japanese junior high school students.

Methods

Of 477 students and their parents, 409 (85.7 %) students and 314 (65.8 %) parents participated in the study. Students answered self-reported questionnaire on depressive symptoms, their heights and weights, subjective stress, body dissatisfaction, lifestyles including sleep duration and extracurricular physical activity in school and other physical activity outside the school, and nutritional intake. Parents responded to questionnaire on depressive symptoms and socio-demographic status.

Results

The prevalence of depressive symptoms was 24.9 %. Students with depressive symptoms were more likely to have stress. Students in shorter and longer sleep duration groups were more likely to have depressive symptoms. The students with depressive symptoms had smaller amount of energy intake than did those without depressive symptoms. Multiple logistic regression analysis revealed significant relationships between students’ depressive symptoms and some independent variables. Sex, subjective stress, “almost-never”-categorized extracurricular physical activity in school and other physical activity outside the school, and having a parent with depressive symptoms were significantly associated with students’ depressive symptoms.

Conclusion

Reducing mental stress and taking care of lifestyles, especially, “almost-everyday”-categorized extracurricular physical activity in school and other physical activity outside the school, may have benefits for students’ mental health, and having a parent with depressive symptoms may be associated with students’ depressive symptoms.

     

Wie bedeutsam ist Gesundheit für den Studienerfolg von Studierenden?

Background

This narrative review aims to summarize the research findings on students’ health in Germany with special focus on stress and mental health, substance use and the relationship between health factors and academic achievement.

Results

Existing research shows that German students report a high level of self-perceived health. However, certain symptoms and health complaints as well as mental health problems are frequent among students. Students’ health behaviour is characterised by a relatively high level of physical activity. On the other hand students have a high level of substance use.

Conclusion

There is some evidence for a positive association between health and healthy lifestyle and academic achievement of students.

     

School Climate,Academic Achievement and Educational Aspirations in Roma Minority and Bulgarian Majority Adolescents

Background

School climate can promote students’ academic achievement and high educational aspirations. School climate refers to the quality and character of school life, norms, values, social interactions and organizational processes within a school.

Objective

We examined for the present sample whether (a) school climate relates to academic achievement and educational aspirations and (b) such relations vary for Roma minority compared to their majority peers.

Method

Participants in this cross-sectional study were 356 adolescents aged 11–19 years old (159 Roma, 197 Bulgarian majority), 332 mothers (149 Roma, 183 majority), 231 fathers (104 Roma, 127 majority) and 221 majority teachers who completed self-report surveys to address the study goals. Adolescents provided data on educational aspirations and academic achievement, parents on their children’s educational aspirations and teachers reported on school climate. We employed linear mixed models to explore associations of school climate, academic achievement and educational aspirations among Roma and Bulgarian majority youth.

Results

There were negative associations between teacher-reported school climate and students’ academic achievement, as well as adolescent and parental educational aspirations for Roma adolescents only. Roma adolescents and parents reported lower academic achievement and educational aspirations than their majority counterparts.

Conclusions

This study supports the relevance of school climate in relation to academic achievement and aspirations of disadvantaged minority students. Interventions should pay close attention to perceptions and attitudes in a school to successfully promote positive outcomes among students.

     

Academic and Mental Health Outcomes of Youth Placed in Out-of-Home Care: The Role of School Stability and Engagement

Background

Youth placed in out-of-home care are at significant risk of low academic achievement and poor mental health. Few studies have considered the potential effects of school-related factors, such as school placement stability and school engagement, on youth outcomes.

Objective

The current study examined the potential main effects of school placement stability and engagement on academic achievement and mental health. Furthermore, we examined whether school-related factors moderated the association between home placement stability and youth outcomes.

Methods

Participants included 420 youth (age 6–14 at baseline) placed in out-of-home care participating in a national longitudinal study of youth in contact with the child welfare system. Youth, caregivers, and caseworkers provided relevant information at baseline, 18, and 36 months. Hierarchical regression models were constructed to test potential main and moderating effects of school engagement and school placement stability on youth mental health and academic achievement prospectively, while accounting for relevant covariates.

Results

School placement stability was an independent predictor of youth internalizing and externalizing symptoms, but was not significantly associated with academic outcomes. Furthermore, there were no main effects of school engagement or home placement stability on youth outcomes and school-related factors did not moderate the relationship between home placement stability and youth outcomes.

Conclusion

For children and adolescents who do not have the benefit of a stable, safe, or caring home environment, school stability may be contribute to an environment that can foster healthy development.

     

Promotive Factors and Psychosocial Adjustment Among Urban Youth

Background

Urban youth are often exposed to compounded risk factors which make them more vulnerable to negative outcomes. Research examining promotive factors which may reduce vulnerabilities to poor psychosocial adjustment among this population is limited.

Objective

The current study addresses this limitation by examining the impact of self-efficacy and positive expectations about the future, as promotive factors, on levels of depressive and anxious symptomatology, sense of belonging, and friendship among a sample of urban youth.

Methods

Data are from 1202 4th and 5th grade students enrolled at 27 elementary schools in a high poverty, high minority school district in the Southeastern United States.

Results

Using ordinary least squares regression, analyses reveal that promotive factors are significant predictors of psychosocial adjustment and thus have implications for improving negative outcomes among urban minority youth.

Conclusions

The findings suggests that interventions aimed at increasing self-efficacy and positive expectations about the future may reduce child and adolescent vulnerability to negative outcomes associated with poor psychosocial adjustment.

     

Validation of a Chinese version of the stress overload scale-short and its use as a screening tool for mental health status

Purpose

Although stress emerges when environmental demands exceed personal resources, existing measurement methods for stress focus only on one aspect. The newly-developed Short Stress Overload Scale (SOS-S) assesses the extent of stress by assessing both event load (i.e., environmental demands) and personal vulnerability (i.e., personal resources). The present study was designed to evaluate the psychometric properties of the Chinese version of Stress Overload Scale-Short (SOS-SC), and further examine its roles in screening mental health status.

Methods

A total of 1364 participants were recruited from communities and colleges for scale validation.

Results

Reliabilities were good throughout the subsamples (ω?>?0.80). Confirmatory factor analysis indicated the acceptable goodness-of-fit for the two-factor correlated model (Sample 1: 560 community residents). Multi-group confirmatory factor analysis confirmed measurement invariance across community residents (Sample 1) and college students (Sample 2 and Sample 3). Criterion validity and convergent validity were established (Sample 2: 554 college students). Latent moderated structural equations demonstrated that the relationship between SOS-SC and depression is moderated by social support (Sample 2), further validating the SOS-SC. In addition, the SOS-SC effectively screened individuals in a population at different levels of mental health status (i.e., “at risk” vs. “at low risk” for depression symptoms and/or wellbeing).

Conclusion

The SOS-SC exhibits acceptable psychometric properties in the Chinese context. That said, the two aspects of stress can be differentiated by the Chinese context, therefore, the SOS-SC can be used to measure stress and screen mental health status among the Chinese population, and monitor and evaluate health-promoting interventions.

     

Measuring Educational Outcomes for At-Risk Children and Youth: Issues with the Validity of Self-Reported Data

Background

Youth programs often rely on self-reported data without clear evidence as to the accuracy of these reports. Although the validity of self-reporting has been confirmed among some high school and college age students, one area that is absent from extant literature is a serious investigation among younger children. Moreover, there is theoretical evidence suggesting limited generalizability in extending findings on older students to younger populations.

Objective

The purpose of this study is to examine the validity of academic and attendance self-reporting among children and youth.

Method

This study relies on original data collected from 288 children and youth using Big Brothers Big Sisters enrollment and assessment data, paired with school-records from two local school divisions. Initially, we utilized percent agreement, validity coefficients, and average measures ICC scores to assess the response validity of self-reported academic and attendance measures. We then estimated the affects of several moderating factors on reporting agreement (using standardized difference scores). We also accounted for cross-informant associations with child reported GPA using a moderated multiple regression model.

Results

Findings indicate that children and youth report their individual grades and attendance poorly. Particularly, younger and lower performing children are more likely to report falsely. However, there is some evidence that a mean construct measure of major subjects GPA is a slightly more valid indicator of academic achievement.

Conclusion

Findings suggest that researchers and practitioners should exercise caution in using self-reported grades and attendance indicators from young and low-performing students.

     

Exploring the Social-Ecological Determinants of Physical Fighting in U.S. Schools: What about Youth in Immigrant Families?

Background

Despite the growing presence of immigrant families in the US, little is known about physical fighting in school among youth from those families.

Objective

The present study examines the social-ecological determinants of school physical fighting among youth in immigrant families. Implications for practice are also discussed.

Method

Using the Children of Immigrants Longitudinal Study data set, the study sample consisted of 4288 immigrant students in 9th–12th grade. Models were estimated using multivariate logistic regression. Variables in the individual, family, friend/peer, and school contexts were included by fitting four hierarchical logistic models to the data.

Results

Results indicated that youth in immigrant families who are males, in lower grade level, racial/ethnic minorities, and of low family socio-economic status (individual) were likely to engage in physical fights. Youth in immigrant families who feel detached from their parents (family); speak another language with friends (friend/peer); and perceive school discipline to be unfair, feel discriminated against by teachers, and who perceive school crimes to be a problem (school) are also at an elevated risk of physical fights.

Conclusion

Findings from the study contribute to a growing body of research on youth in immigrant families.

     

Rückenfit – unsere Schule macht mit

Background

Back pain is not only a worldwide problem in adults, but also in children and adolescents. The prevalence rates increase with age. Risk factors for back pain in children are among others asymmetries of the spine, too heavy and asymmetrically carried school backpacks, and a sedentary lifestyle.

Objectives

This paper presents a multifactorial school-based intervention program and the corresponding study protocol for a cluster-randomized, controlled evaluation of this program to address these risk factors.

Materials and methods

The intervention program should be tested on pupils aged 10–12 at a German “Gymnasium” (secondary school) over the course of one school year. It contains 5 lessons on back care, 3 exercise posters for the class room, and exercises for physical education classes that strengthen and mobilize core muscles and train body perception. The evaluation instruments are motoric tests, a back-behavior test, a knowledge test, a clinical–orthopedic examination, and several questionnaires.

Results and conclusions

The presented intervention program and evaluation instruments aim to show one way of planning and evaluating an intervention in the daily school environment. There is a need for high-quality studies on prevention of back pain in children and adolescents. This is a topic that has received little attention in Germany.