Responding to Suicide in School Communities: An Examination of Postvention Guidance from Expert Recommendations and Empirical Studies

PURPOSE OF REVIEW

We review the published literature on a school's response after a student dies by suicide ("postvention"). We examine published recommendations based on expert guidance and empirical studies that have evaluated postvention measures.

RECENT FINDINGS

Experts recommend careful communication with family, staff, and students that adheres to published suicide reporting guidelines. Experts also emphasize the importance of identifying and supporting high-risk students. Few robust, controlled studies have identified effective postvention measures. Effective measures tended to occur in group settings (e.g., group therapy), focus on improving grief symptoms, and involve mental health professionals. Postvention has not been robustly studied in the school context. Expert recommendations and a few evidence-backed studies provide the frame for a coherent, school-based postvention response. Further research is needed to strengthen and expand our collective understanding of effective postvention measures in the school context as youth suicide attempts continue to rise.

[Critical notes on the results of studies (ACCORD, ADVANCE, VADT) of the efficiency of intensive therapy of type 2 diabetes mellitus]

A brief review of results of prospective randomized studies on the efficacy of reduction of blood glucose levels for the prevention of type 2 diabetes mellitus complications delivered at the 68th Congress of American Diabetic Association (June 2008). They showed that normal glycemia is very difficult to reach and usually at the cost of side effects, in the first place hypoglycemia. Lowering glycemia to the near-normal level prevents development of nephropathy but fails to reduce the frequency of cardiovascular disease. The reduced risk of myocardial infarction was documented only in the ACCORD study. However, this effect was associated with a rise in general mortality that necessitated premature termination of this trial. Causes behind the enhanced mortality are discussed, recommendation are proposed ensuing from the results of the reviewed studies.

The importance of hopelessness among university students seeking psychiatric counseling

Hopelessness is a clinically important state relative to morbidity and suicide risk among university students. We examined its role in relation to presenting concerns, diagnosis, psychopharmacologic treatment and spiritual orientation among students seeking treatment at a university counseling center. The most commonly identified concern was anxiety, followed by stress and depression. Eighty-two percent were given a DSM IV diagnosis. Hopelessness was higher among students dually diagnosed with anxiety and depressive disorders and those who were started on psychiatric medication. Spirituality was inversely correlated with hopelessness and constitutes a personal characteristic warranting further investigation. The concerns bringing students to counseling, the rates of DSM IV diagnosis and the use of psychiatric medication suggest a preponderance of psychopathology over developmental or situational concerns that may be more prominent than has been noted in the counseling literature. In this regard, hopelessness appears to be an important feature even beyond its relationship to suicidality and merits attention and evaluation in student counseling.

Preparation and Comparison of Supported Gold Nanocatalysts on Anatase, Brookite, Rutile, and P25 Polymorphs of TiO2 for Catalytic Oxidation of CO

Nanosized anatase (< or = 10 nm), rutile (< or = 10 nm), and brookite (approximately 70 nm) titania particles have been successfully synthesized via sonication and hydrothermal methods. Gold was deposited with high dispersion onto the surfaces of anatase, rutile, brookite, and commercial titania (P25) supports through a deposition-precipitation (D-P) process. All catalysts were exposed to an identical sequence of treatment and measurements of catalytic CO oxidation activity. The as-synthesized catalysts have high activity with concomitant Au reduction upon exposure to the reactant stream. Mild reduction at 423 K produces comparably high activity catalysts for every support. Deactivation of the four catalysts was observed following a sequence of treatments at temperatures up to 573 K. The brookite-supported gold catalyst sustains the highest catalytic activity after all treatments. XRD and TEM results indicate that the gold particles supported on brookite are smaller than those on the other supports following the reaction and pretreatment sequences.

Memory in patients with cerebellar degeneration

Eleven patients with relatively selective cerebellar degeneration and 11 normal control subjects underwent a comprehensive neurologic and neuropsychological examination. The neuropsychological tests assessed general intellectual ability, different aspects of memory (effortful, automatic, and implicit memory processes), speed of information processing, and verbal fluency (using both category and letter fluency tasks). The results indicated that cerebellar patients were significantly impaired only on tasks requiring the use of executive functions, such as the initiation/perseveration subtest of the Mattis Dementia Rating Scale or the fluency tests, and on memory measures requiring greater processing effort. They performed normally on automatic and implicit measures of memory. Performance on the effortful memory and executive measures was not associated with neurologic variables or mood state. After controlling for the initiation/perseveration deficit, the effortful memory scores of the cerebellar patients were no longer different from those of controls. The present study suggests that memory in patients with relatively pure cerebellar dysfunction is only partially compromised and that the impairment is secondary to a deficit in executive functions.

Analysis of neuropsychological functioning in patients with chronic fatigue syndrome

Memory impairment dominates the cognitive complaints of patients with chronic fatigue syndrome (CFS). Twenty CFS patients were available for studies with a clinical and experimental battery composed of memory and cognitive tests. The results on objective testing indicated that the CFS patients had some mild memory impairment, but only on tasks requiring conceptually driven encoding and retrieval processes. There were no associations between the nature of the precipitating illness, self ratings of fatigue, physical findings, or laboratory determination and objective memory performance or self report of memory functioning. These generally negative results indicate that memory impairment in CFS patients is typically mild and involves memory processes that participate in conceptualising information.

Respite care in a geriatric rehabilitation hospital: a support system for caregivers of disabled elderly

Respite care is one of a wide range of services designed to help maintain the infirm elderly at home by reducing the burden on the caregiver. The availability and results of respite care may alter decisions to institutionalize an elderly relative. Fliman Hospital, a geriatric rehabilitation hospital in Haifa, provides short-term, inpatient care for bedridden frail or disabled elderly persons living in the community with the support of an informal network.

Structure of the malB region in Escherichia coli K12. II. Genetic map of the malE,F,G operon

Starting with a strain containing a malK-lacZ fusion, a series of lambda plaque-forming phages which carry varying amounts of the malE,F operon have been isolated. We have used these phages to construct a deletion map of the malE,F operon. The construction of this deletion map has led to the identification of a new gene, malG. The malG gene is located distal to malF. The malG gene product is a protein required for the active transport of maltose and maltodextrins.

Applications of nuclear medicine in ophthalmology

Diagnostic techniques using radioactive isotopes can be used for the investigation of cerebral, orbital and intraocular tumours and for the dynamic study of tear flow. The value of such techniques in the study of obstruction of the nasolacrymal system (particularly partial and functional obstructions) has been established and the possibility of using Tc99m clearance for the investigation of dry eyes is being investigated.