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Preventing suicide in low to middle-income countries

An international study of almost 2,000 people in Brazil, India, Sri Lanka, Iran and China has shown that a low cost strategy to keep in contact with people who have previously attempted suicide, can reduce the risk of subsequent suicides.

Given that suicide is among the top three causes of deaths in 15 to 34-year-olds, the strategy has the potential to help reduce the economic and societal loss of young people in their most productive years of life.

The study, co-authored by the Australian Institute for Suicide Research and Prevention director Professor Diego De Leo, said subsequent suicide deaths reduced from 2.2 per cent in people treated with usual care to 0.2 per cent in the people given extra contact.

The intervention included a one-hour information session about suicidal behaviours, risk factors, constructive coping strategies and referral options.

It also included nine follow-up phone calls or visits by a health professional for 18 months following the patient’s discharge from an emergency department.

“Many suicidal patients lack good communication and relationships within their family and with other people,” the researchers said.

The intervention not only helped increased the suicide attempters’ feelings of connectedness but also increased their skills in solving crises which may otherwise lead to suicidal behaviour.

“Also, systematic follow-up contacts gave the patient a feeling of being seen and heard by someone,” they said.

The study, published in the Bulletin of the World Health Organization (WHO), said one of the advantages of the intervention was that it required minimal training or extra resources and was therefore suitable for implementation in low and middle-income countries.

The WHO estimates that about 85 per cent of suicides occur in low and middle-income countries. In 2002, some 877,000 deaths were attributed to suicide.

Vitamin B and folate fight migraine

Griffith University researchers have recently concluded a clinical trial showing inexpensive supplements help migraine sufferers.

Griffith’s Genomics Research Centre (GRC) Director Professor Lyn Griffiths said the trial had shown that folate and vitamin B helped to significantly reduce frequency, severity and disability of the disorder.

“The trial provided vitamin B supplements and folic acid to more than 50 long-term migraine sufferers for six months,” Professor Griffiths said.

“Results showed a drastic improvement in headache frequency, pain severity and associated disability for those treated.”

Previous studies by the GRC identified a gene, known as MTHFR, which makes people susceptible to migraine attacks when there is a mutation or dysfunction in the gene.

The dysfunction causes people to have higher levels of the amino acid homocysteine, which is known to cause an increased risk of stroke and other coronary diseases.

“The recent trial was founded on the theory that vitamin B supplements and folic acid will reduce the homocysteine and in turn, improve migraine symptoms.

“The success of our trial — supported by the Brain Foundation, Janssens and Blackmores — has shown that safe, inexpensive vitamin supplements can treat migraine patients.

“We are now going to undertake a more extensive trial and further studies to find out the best dosage of vitamin supplements for individuals as this may vary depending on a patient’s genetic profile.”

A migraine attack causes severe headache with associated nausea and vomiting. It is a devastating disorder that affects approximately 12 per cent of the Australian population.
Professor Griffiths said there was a real need to develop effective treatments to help those afflicted with migraine.

“Current treatments for migraine are not always effective and can be expensive and cause adverse effects,” she said.
Professor Griffiths’ work is at the forefront of personalised medicine, tailoring medical care to an individual’s genetic profile, which is a far safer and more efficient method of prescribing treatment.

Professor Griffiths’ team is a world leader in identifying genes associated with migraine disorders and was the first to show that variations in hormonal-pathway and blood-flow related genes are linked with the disorder. 

The Genomics Research Centre has established a significant bank of population genomic resources, including the world’s largest collection of DNA samples from migraine patients, multi-generational pedigrees and samples from the unique isolated founder-population from South Pacific’s Norfolk Island.

Take-off time for travellers to test popular herbal remedy

Long-haul travellers are invited to help determine whether the herbal medicine Echinacea can prevent respiratory and other symptoms associated with international air travel.

Echinacea is currently the most widely used herb for the prevention of the common cold and to reduce the duration and severity of its symptoms.

Dr Evelin Tiralongo, a senior lecturer in Griffith’s School of Pharmacy, said there was considerable scientific evidence for its use as an early treatment of the symptoms of the common cold. However further research was necessary for the product to extend its claims.

Dr Tiralongo, who has a particular clinical and research interest in complementary and alternative medicines, said international travel was known to put extra stress on people’s physical and psychological health.

“Nasal dryness following long-haul flights has been investigated as a risk factor for developing upper respiratory infections and other disorders such as allergic rhinitis. There is also the risk of cross-infection from other passengers,” she said.

Times changes leading to jet lag and rapid adjustment to different climates following intercontinental flights can also affect the body’s immune system. 

Dr Tiralongo is encouraging healthy adults between 18 and 60 years of age who are planning to travel on long-haul, economy class flights to Europe or North America to consider participation in the study.

“Given that more than half of the population already uses herbal medicines, vitamins and minerals, we need more evidence for complementary and alternative medicines,” she said.

“Participants will complete a diary while they are travelling and a questionnaire on their return to evaluate upper respiratory symptoms, duration of jet lag, quality of life, occurrence of viral infections, headache and sleep patterns.”

The project is sponsored by Queensland-based herbal products company MediHerb.

For further information or to register your interest, please contact project coordinator Shirley Wee 07 5552 9773, [email protected]

Flexibility can reduce career concerns

Personal attributes such as adaptability and flexibility can help protect young people from worrying excessively about their future career success.

Griffith University psychologist Professor Peter Creed said while focus and goal setting were critical factors in career planning and success, strategies to monitor those goals and fully investigate career options were also important.

A study of some 250 first year university students found career adaptability strategies, including the ability to explore aspects of both career and self, were associated with fewer career concerns.

“University students have concerns about whether or not they will succeed in their uni courses, whether they will get a job in their chosen career, do well and survive long-term in that career,” Professor Creed said.

”The more adaptable and flexible they are, and the more self regulation skills they have such as managing their emotions, then the fewer career concerns they have.”

He said career adaptability was heavily influenced by the student’s perceived level of social support.

“The support of family and friends helps young people feel safe and secure enough to pursue career information and consider aspects of themselves such as their likes and dislikes, and strengths and weaknesses.”

Professor Creed said young people should resist making early career decisions that effectively close off options.

“Our education system forces young people to make career choices very early and for those going to university, to select just one of many vocationally orientated degrees.”

“However an important message to young people is to keep their options open as much as possible and to recognise that there are multiple pathways to most goals and multiple outcomes from most pathways.”

He said an engineering degree for example could lead to a traditional career in a big city firm or to development work in a third world country.

The study on career adaptability and career concerns was presented recently at the International Congress of Psychology in Berlin.

Jumping for joy … and stronger bones

High impact activities such as jumping and skipping that can easily be incorporated into warm-ups before sports and physical education classes, have been shown to benefit bone health in adolescents.

The 10 minute school-based intervention, provided twice a week for about eight months, significantly improved bone and muscle strength in healthy teenagers compared to regular warm-ups.

Physiotherapist Ben Weeks said the warm-up which included tuck jumps, star jumps, side lunges and skipping with gradually increasing complexity and repetitions, was specifically designed to apply a bone-stimulating mechanical load on the skeleton. 
Students worked up to about 300 jumps per session by the end of the study.

“Eighty per cent of bone mass is accrued in the first 20 years and especially around puberty due to the circulating hormones. This study targets a window of opportunity in adolescence to maximise peak bone mass with high-intensity, weight-bearing activity.”

The study of 99 adolescents with a mean age of almost 14 years found boys in the intervention group improved whole body bone mass while the girls’ bone mass specifically improved at the hip and spine.

Boys in the bone-friendly warm-up group also lost significantly more fat mass than the other boys.

Mr Weeks said the gender-specific response to the exercise program may be related to the different rates of physical development with girls reaching maturity at an earlier age than boys.

“Peak height velocity is at different ages in boys and girls. Most boys in the group were right at that stage while most girls in the study were past puberty.”

He said the improved bone strength at the hip and spine in girls was promising as those were the typical sites for osteoporotic fractures in the elderly.

While the study showed that a simple, practical exercise intervention can result in worthwhile skeletal benefits in adolescents, Mr Weeks said larger, longitudinal studies were required to determine whether the beneficial effects could persist into adulthood and reduce the risk of future bone fractures.

Mr Weeks is a member of the Bone, Muscle and Movement Group within the Griffith Institute of Health and Medical Research.

Journal of Bone and Mineral Research 2008; 23 (7) 1002-11.


Fulbright scholarship to advance trauma research

Brisbane nurse researcher Professor Leanne Aitken has been awarded a prestigious Fulbright Senior Scholarship to develop collaborative research with US colleagues in the area of trauma care.

Professor Aitken, Chair in Critical Care Nursing at Griffith University and Princess Alexandra Hospital, said the research will focus on improving pain relief and the management of sedation in intensive care and trauma patients.

“Severe, penetrating trauma such as gun shot injuries are much more common in the US, and as a result they have very experienced trauma networks and a well developed understanding of what systems make for effective trauma care.

“This is an opportunity to grow research on a multinational basis and find solutions which are potentially applicable to both health care systems,” she said.

Professor Aitken said effective management of trauma patients relied on multidisciplinary teams of medical, nursing and allied health professionals working together across the acute care continuum.

“Trauma care cannot be limited to one particular area such as the emergency department or intensive care unit.”

She said while technological advances had improved survival for many critically ill patients, there was room for improvement in long-term outcomes and quality of life.

“There is some evidence that the management of pain and sedation can affect patients’ psychological recovery. However if we can improve clinical care during the acute phase of treatment, hopefully we can also improve their long term recovery.”

Professor Aitken will visit the University of Pennsylvania for four months next year where she is looking forward to working with Associate Professor Therese Richmond, who is recognised internationally for her expertise in the field of trauma nursing.

“As the number of trauma patients in Australia is low compared to many other countries and trauma nursing is a relatively new specialty here, access to an extensive team of trauma advanced practice nurses will provide me with new insights and perspective.”

The Fulbright program is the largest educational scholarship of its kind and aims to promote mutual understanding through educational exchange. Professor Aitken is one of only four Australians to be recognised as a Fulbright Senior Scholar in 2009.

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