A survey of characteristics of self-immolation in the northern iran

A Survival Prediction Model of Self-Immolation Based on Machine Learning Techniques

Background

Self-immolation is one of the violent methods of suicide in developing countries. Predicting the survival of self-immolation patients helps develop therapeutic strategies. Today, machine learning is widely used in diagnosing diseases and predicting the survival of patients. This study aims to provide a model to predict the survival of self-immolation patients using machine learning techniques.

Materials and Methods

A retrospective cross-sectional study was conducted on 445 hospitalized self-immolated patients admitted to a burn hospital between March 2008 and 2019. Python programming language version 3.7 was used for this goal. All possible machine-learning algorithms were used. Gradient Boosting, support vector machine (SVM), random forest, multilayer perceptron (MLP), and k-nearest neighbors algorithm (KNN) were selected as the high-performance machine learning technique for survival prediction, and then they were compared by evaluation metrics such as F1 score, accuracy, sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve (AUC). Based on this comparison, the best model was reported.

Results

SVM was the best algorithm. F1 score, accuracy, and AUC for this machine-learning model were 91.8%, 91.9%, and 0.96, respectively. The machine learning model results revealed that surgical procedures, score, length of stay, anatomical region, and gender obtained the most important and had more impact than other factors on patients' survival prediction.

Conclusion

In this paper, machine learning algorithms were used to create a model for survival of self-immolation patients. The results of this study can be used as a model for predicting self-immolation patients' survival, better treatment management, and setting up policies and medical decision-making in burn centers.

Suicide by self-immolation in southern Iran: an epidemiological study

Background

Self-immolation, as a method of suicide, is one of the most violent and extreme ways which is usually attempted by the ignition of inflammable materials, with more than 70% fatality rate. In the literature, Iran has been reported to have a high rate of self-immolation; therefore, this study aimed to evaluate the prevalence and epidemiological features of self-immolated patients.

Methods

In this retrospective cross-sectional multicenter study, data from burn patients from 2007 till 2017 due to self-immolation and suicide were enrolled in our study.

Results

Based on our data, 657 out of 3530 burn patients (18.6%) with a mean age of 31.15 (SD = 0.452) were documented as suicidal attempts; the majority were female (63.2%) and married (66.3%). Most of the patients were from rural areas (58.3%) with an education level of under diploma (63.2%). Of the patients in our study, 22 (8.7%) had comorbid systemic diseases and 115 (50.5%) had psychiatric disorders.

Conclusion

Due to the high prevalence of suicide by self-immolation among the Iranian population, further studies to evaluate the risk factors and clarify the high-risk group for more targeted approaches are recommended.

Socioeconomic Inequality in Self-immolation, between Genders; Oaxaca-Blinder Decomposition, Results of Registration-Based Suicide Data

Objective:

To assess the important socio-demographic inequalities in self-immolation in between genders.

Methods:

A cross-sectional study, 2011 to 2016, was conducted. A total of 540 completed suicides were recruited to the study. Data were collected by systematic registration suicide data (SRSD) and Legal Medicine Organization (LMO). The concentration index (CI) was used to determine the inequality. The inequality line was decomposed to find out the main sources of inequality in self-immolation between genders by Oaxaca-Blinder approach.

Results:

The mean ratio of self-immolation was 21.8% among completed suicides. The decreasing trend was found in self-immolations during 2011-2016 (z = -2.07, p = 0.039), the mean rate in six years, was 2.98 per 100.000 populations. Unemployment −.043 (−.07, −0.01), married subject’s −.016 (−.03, −0.00) and low educational level −.005 (−.01, −0.00) were the main inequality source in females compared to males.

Conclusion:

Our results suggest that despite the incidence decreasing in self-immolation within 6 years of study period, the inequality was detected in self-immolation. The main socio-demographics in inequalities were lower educational level, married persons and unemployment that prevention programs should be more concentrated in females to a decrease of inequality in self-immolation.

Associated factors with self-inflicted burns among women in reproductive age in baghdad, iraq: a case control study

BACKGROUND

Self-inflicted burns are a regular source of admissions to burns unit's worldwide. However, there is limited evidence regarding risk factors that associated with self-inflicted burn.

AIMS

To determine factors that associated with self-inflicted burn (SIB) among women in reproductive age in Baghdad, Iraq.

METHOD

Sex, age and time matched case-control study was conducted among females with the age range 15 to 45 years in Baghdad, Iraq. Each case was individual matched to two controls in the similar age (± 1), sex and time when SIB happened. Controls were selected from the same hospital where the cases have been admitted in the same period. Data was collected on the variables age, occupation, education, marital status, socioeconomic status (SES), etc. Crude and adjusted odds Ratio (OR) were estimated by simple and multiple conditional logistic regression model.

RESULTS

We found a positive association between poor SES (AOR = 3.61; 95% CI (2.04 to 6.11)), family history of SIB (AOR = 1.6; 95% CI (1.14 to 4.18)), homelessness (AOR = 3.9; 95% CI (2.07 to 5.48)), subjected to physical (AOR = 2.0; 95% CI (1.35 to 2.95)) and sexual violence (AOR = 1.1; 95% CI (1.17 to 4.51)), having the history of health problem (AOR = 2.63; 95% CI (1.55 to 6.14)), feeling discrimination (AOR = 3.11; 95% CI (1.10 to 5.03)) and dissatisfaction with unstable living condition (AOR = 3.12; 95% CI (1.90 to 6.41)) with SIB.

CONCLUSIONS

Several and interlinked socioeconomic and behavioral factors were associated with SIB in women. Implementing multifaceted intervention is vital to prevent SIB among women with poor SES, living in temporary accommodation, and subjected to domestic violence.

Reasons and experiences of self-inflicted burns among women in reproductive age in Baghdad, Iraq: a qualitative study

BACKGROUND

Self-inflicted burn (SIB) is an important social and medical problem in the world. However, the evidence is limited to the reasons and experiences of women who committed SIB.

OBJECTIVE

To explore in-depth reasons and experiences of self-inflicted burn among women aged 15-45 years, in Baghdad city, Iraq.

METHODOLOGY

The study was conducted among 30 participants, recruited from six different hospitals where the participants were treated. Maximum variation opportunistic sampling technique was used to select the participants, taking into account participants' variation in age, socioeconomic, and marital status. Data were collected through face to face semi-structured interviews. Each interview session was audio-recorded and supported by field notes. Content analysis was conducted using Max QDA 10 software.

RESULTS

We identified four major categories of problems leading to SIB. These were related to the personal, social, economic and family situation of the study subjects. Of these, the main factors mentioned by all participants' family pressure, unstable environment, and poor mental health.

CONCLUSION

We found that SIB is linked to various socioeconomic problems. Meanwhile, comprehensive SIB prevention, care and support stands worthy of consideration to avert the problem as well as to save the lives of those who committed the problem.

Self-immolation in Iran: Systematic Review and Meta-analysis

OBJECTIVE

To perform a systematic review and meta-analysis of self-immolation epidemiology and characteristics in Iran.

METHODS

This was a systematic review and meta-analysis study. PubMed, Scopus, Web of science and Science Direct were searched for English literature and SID and Magiran for Persian in the time period of 2000 to 2016. The retrieved studies were screened and reviewed then quality assessed. Random Effect model was applied for meta-analysis. The qualitative data were analyzed by content analysis method.

RESULTS

After literature screening, 39 studies included in the analysis. Women were subject to self-immolation more than men. The rate of self-immolation estimated to be 4.5 cases in every 100,000 populations and it was the reason of 16% of hospitalized burns. The average length of hospital stay calculated to be 12.24 (95% CI: 8.85-15.59) days. The total burnt surface area was 65.3% (95% CI: 56.71-73.89). Death due to self-immolation was 62.1%. The major risk factors of self-immolation were having mental health issues, family problems and characteristics and problems in relation/communication with spouses.

CONCLUSION

Despite the low rate of self-immolation in Iran, it comprises one sixth of the hospitalized burns. The mortality rate of self-immolation also is high and this highlights the importance of providing special care. Psychological consultations and mental health screening in the primary health care would help to prevent the self-immolation.

A Cry for Help and Protest: Self-Immolation in Young Kurdish Iraqi Women -A Qualitative Study

BACKGROUND

Suicide is a major psychiatric emergency that has always been a topic of great interest to researchers. Self-immolation is a heinous suicide method that is common in Eastern societies. The present study was conducted to explore probable issues which might lead to self-immolation in young Kurdish Iraqi women.

METHODS

The present qualitative study was conducted in Soran, Erbil Governorate in Iraq, and the surrounding villages of Soran District (March 2015 to May 2016). Using purposive sampling, we conducted 24 in-depth interviews with women who had done self-immolation. The obtained data were analyzed using conventional content analysis.

RESULTS

The analysis of the data obtained from the interviews led to the extraction of five categories which seems to be related to self-immolation attempts, including not having control over personal life, marital conflicts, seeking attention, instilling guilt in the family members, and resentment towards male dominant community.

CONCLUSION

Self-immolation is a multidimensional phenomenon that has not come to exist overnight and is rooted in various factors that join to encourage self-immolation attempts by women in critical situations. Comprehensive preventive strategies, such as cultural changes, along with education are required to help lower the rate of self-immolation.

LA50 in burn injuries

Burn injuries put a huge financial burden on patients and healthcare systems. They are the 8th leading cause of mortality and the 13th most common cause of morbidity in our country. We used data from our Burn Registry Program to evaluate risk factors for mortality and lethal area fifty percent (LA50) in all burn patients admitted over two years. We used multiple logistic regressions to identify risk factors for mortality. LA50 is a reliable aggregate index for hospital care quality and a good measure for comparing results, also with those of other countries. 28,690 burn patients sought medical attention in the Emergency Department, and 1721 of them were admitted. Male to female ratio was 1,75:1. 514 patients were under 15 years old. Median age was 25 (range: 3 months - 93 years). Overall, probability of death was 8.4%. LA50 was 62.31% (CI 95%: 56.57-70.02) for patients aged 15 and over and 72.52% (CI 95%: 61.01-100) for those under 15. In the final model, we found that Adjusted OR was significant for age, female sex, TBSA and inhalation injury (P < 0.05). LA50 values showed that children tolerate more extensive burns. Female sex, burn size, age and inhalation injury were the main risk factors for death. Authorities should pay special attention to these variables, especially in prevention programs, to reduce mortality and improve patient outcome. Children have better outcome than adults given equal burn size. Suicide rates are higher for women than men in our country.