Method Of Suicide Research Articles

Examining the Spread of Charcoal-Burning Suicide in Taiwan.

Background: Charcoal-burning has become a predominant method of suicide in many East-Asian countries since the 1990s. Aims: To explore charcoal-burning suicide trends from 1996 to 2020 in Taiwan. Methods: Joinpoint regression models were applied to identify suicide trends over the study period. Decompositional analyses quantified the contributions of age, sex, suicide method, and area of residence to suicide rate trends, accounting for age and geographical distribution of the general population, with a focus on charcoal-burning suicide. Results: There were three stages of suicide rate trends: increasing (1996-2006), descending (2006-2011), and levelling-off (2011-2020). Suicide by charcoal-burning accounted for 70% of the increasing suicide rates between 1996 and 2006 and 50% of the decreasing rates in the descending stage (2011-2020). During the levelling-off stage, suicide by charcoal-burning continued to decrease, albeit slowly. During the descending stage, there was a partial "substitution" of jumping for charcoal-burning. During the levelling-off stage, suicide by hanging partially "substituted" for suicide by charcoal-burning. Limitations: The variables included were limited by data availability. Conclusions: Charcoal-burning remains the second most common method of suicide in Taiwan today. Charcoal-burning has been partially replaced in the last 10 years by jumping and hanging. Monitoring suicide methods and trends is essential for suicide prevention interventions.

The short-term effect of ambient particulate matter on suicide death

BackgroundAir pollution can cause various respiratory and neurological diseases and continuous exposure can lead to death. Previous studies have reported that particulate matter (PM) exposure increases the risk of depression, suicidal thoughts, and suicidal death; however, the results are inconsistent and limited. This study aimed to examine the relationship between short-term PM exposure and suicide deaths, as well as investigate the short-term effects of PM on suicide death within vulnerable groups based on factors such as sex, age group, suicide-related information (note, method, and cause), psychiatric disorders, and physical diseases.MethodsData on a total of 28,670 suicide deaths from 2013 to 2017, provided by the Korea Foundation for Suicide Prevention, were analyzed. The study design employed a time-series analysis with a two-stage approach. In the first step, a generalized additive model combined with a distributed lag nonlinear model was used to estimate the short-term effect of PM exposure on suicide risk specific to each city. In the second step, the estimated results from each city were pooled through a meta-analysis to derive the overall effect. We determined the effects of single lag, cumulative lag, and moving average PM concentrations from days 0–7 before suicide.ResultsWe confirmed an association between exposure to PM10 (≤ 10 μm in diameter) and deaths due to suicide. In particular, among individuals with psychiatric disorders and those who employed non-violent suicide methods, increased exposure to PM10 was associated with a higher risk of death by suicide, with percentage changes of 5.92 (95% confidence interval [CI]: 3.95–7.92) and 11.47 (95% CI: 7.95–15.11), respectively. Furthermore, in the group with psychiatric disorders, there was an observed tendency of increasing suicide risk as PM10 levels increased up to 120 µg/m3, whereas in the group with non-violent suicide deaths, there was a pronounced trend of rapid increase in suicide risk with an increase in PM10 up to 100 µg/m3.ConclusionsThese results show an association between short-term exposure to PM and suicide. Our study adds evidence for the benefits of reducing PM in preventing diseases and improving mental health.

Supplemental Material for Comparing the Interactions of Risk Factors by Method of Suicide Among Veterans: A Moderated Network Analysis Approach

Supplemental Material for Comparing the Interactions of Risk Factors by Method of Suicide Among Veterans: A Moderated Network Analysis Approach

Mortality trends and years of potential life lost due to suicide in adolescents.

To assess the trend in mortality rates and years of potential life lost (YPLL) due to suicide among adolescents in Northeast Brazil. This is an ecological time series study, with secondary data from 2011 to 2020 from the Mortality Information System for adolescents aged 10 to 19 years in the Northeast region of Brazil. Groups of causes from the 10th Revision of the International Classification of Diseases were included: X60-X84 (intentionally self-inflicted injuries), Y10-Y19 (poisoning of undetermined intent), and Y87 (sequelae of intentional self-harm). Mortality coefficients and frequency distribution by sociodemographic variables, place of occurrence, and method of suicide were estimates. YPLL were estimated by gender and age. Joinpoint regression analysis was used, and the annual percentage change (APC) was determined with 95% confidence intervals. A total of 2,410 deaths were recorded, with a predominance of adolescents aged between 15 and 19, males, of mixed-race, low schooling, and home was the main place of occurrence. The trend in the death rate was increasing in the Northeast (APC: 3.6%; p = 0.001), in girls aged 10 to 14 (APC: 8.7%; p = 0.003), in boys aged 15 to 19 (APC: 4.6%; p = 0.002) and in Bahia (APC: 8.1%; p = 0.012). Hanging/strangulation was the main method adopted by both sexes. The YPLL due to suicide were 11,110 in 2011 and 14,960 in 2020. The precociousness of suicide committed by girls and the increase in mortality among older adolescents are noteworthy, and specific preventive measures need to be adopted for these groups in order to reduce this preventable cause of death.

Suicide Attempt by Hanging - A Study on Patients Admitted in Tertiary Care Hospital in Eastern India.

Suicide is defined as a fatal self-injurious act with some evidence of intent to die. Despite the evolution of sophisticated methods to commit suicide, hanging remains one of the commonest methods to commit suicide across the world. To evaluate the individuals using hanging as a method of suicide and identify the contributing factors for this behaviour. The study was carried out in a tertiary care hospital, over a period of 1 year on the suicide attempters using the method of hanging. Semi-structured in-depth interviews were conducted with all the 46 attempters. The questions focused on the precipitating events present before the attempt. After the in interview the risk factors of the conversations were identified, tabulated and categorized using descriptive analysis. Findings from descriptive analysis reveals that significant age group using this method was below 19 years followed by 20-29 age group, female attempters were more compared to male. Psychiatric diagnosis was present in 8 attempters and 4 attempters had alcohol/substance dependence. The most common personality component in attempters was impulsivity. The most common immediate stressor found were financial stress, conflict with family, spouse, humiliation, substance abuse, exam stress and domestic violence. This study demonstrates that the reasons for suicide attempt by hanging is multifactorial. which includes, psychiatric diagnosis, personality factors, immediate stressors, ease of use, and accessibility, Overall, our study adds to understanding the intricates of this method and will help in developing effective suicide prevention strategies.

Suicidal behaviour among the university students in the UK: A systematic review

IntroductionIdentifying risk factors would help consider suicide prevention in any specific population. We aimed to assess suicidal behaviour among university students in the UK. MethodsAn extensive keyword search was conducted through PubMed, Cochrane, CINHAL Plus, PubMed Central, Web of Science, Trip database, and Science Direct, following the PRISMA guidelines to identify different publications. The search strategy for the literature review was based on the Population Exposure Outcome framework. Critical appraisal utilised the CASP tool for cohort studies and the AXIS tool for cross-sectional studies, resulting in 14 included studies. A narrative synthesis was performed. ResultsPostgraduate and undergraduate students used different suicidal methods such as poisoning, jumping, hanging, drowning, and suffocating, with jumping most preferred by male students. The predisposing factors of suicide among university students included: mental health problems (depression, psychological stress, psychosis, mania, neuroticism, financial anxiety, imperfect parents’ connection with students), sexual orientation with risk of suicide among non-heterosexual students due to lowered self-esteem from feeling disregarded, disrespected and insufficient attention from the surrounding. Suicidal behaviour was high among unmarried students, male and unemployed female students, and students with childhood experiences such as physical abuse, family violence, emotional abuse, neglect, and physical punishment—gender, with females seeking more services from general hospitals with more suicide attempts in older females. High risk was also noted in males, with increased risk in white students compared to black students. ConclusionThe review highlighted that students with previous mental health problems, a history of experiencing sexual abuse in childhood, bad relationships with their mother, disrespect and disregard in the community due to sexual identity are the major contributing factors for suicide among university students in the UK.

Reflections on the trends of suicide in Sri Lanka, 1997-2022: The need for continued vigilance.

Despite reductions in suicide rates in Sri Lanka during the past decades, largely by introduction of national bans on highly hazardous pesticides, the country continues to record a higher than global average rate of suicide. With the changing availability of methods of suicide over time, we aimed to examine the age-standardized suicide rates in Sri Lanka by sex, age, and method between 1997 to 2022 using national police suicide data to identify trends. The rate of suicide in Sri Lanka in 2022 was 27/100,000 and 5/100,000, in males and females respectively, with an overall suicide rate of 15/100,000 population. When considering the previous decades, the overall rate of suicide has declined from 1997 until about 2015, in both sexes, driven by a drop in the numbers of suicides due to pesticide ingestion. In females the overall rates of suicide plateaued around 2015, but in males there has been an upward trend in overall suicide that started in 2016, mostly due to an increase in rates of hanging. Since 2016 rates of suicide by hanging have increased among older males, and young females (17-25 years). Whilst the current suicide rate in Sri Lanka is substantially lower than it was during the 1990s, the upward trend in hanging seen in the last few years, particularly among older men and young women, is of concern. Ongoing monitoring of suicide rates should be a priority during the next few years, to detect and respond to changes as soon as possible. There is an urgent need to address current risk factors for suicide in Sri Lanka, such as significant financial insecurity, unemployment, depression, alcohol misuse, and domestic violence, and to minimize media glamourization of hanging by suicide.

Analysis of suicide cases in post-mortem examination files of the Department of Forensic Medicine at the Medical University of Białystok in the years 2016-2021.

The aim of the study is the analysis of suicides based on forensic autopsies and case files from the Department of Forensic Medicine at the Medical University of Białystok. The number of forensic autopsies conducted at the Department of Forensic Medicine in Białystok in the years 2016-2021 equaled 2365. On the basis of post-mortem examinations and circumstances of deaths contained in the case files, 391 cases were qualified as suicides. The analysis accounted for gender, age, time, the dynamics of changes in the number of suicides over the years, the place of suicide, the method of committing suicide, and the state of sobriety. The data were subjected to statistical analysis using the following tests: Chi-square test of independence, Shapiro-Wilk test, Mann-Whitney U test, non-parametric Kruskal-Wallis ANOVA by ranks with post hoc multiple comparisons of mean ranks for all samples. A p-value of less than 0.05 was considered statistically significant. The calculations were performed using the Statistica 13.3 package from StatSoft. In the studied years, suicides accounted for 16.54% of all autopsies. In 82.09% of cases, the suicides were committed by men, and in 17.91% by women. It was found that individuals who chose suicide by poisoning were statistically significantly younger than those who chose suicide by jumping from a height (p=0.0035). A statistically significant correlation was found between gender and the preferred location for committing suicide (p=0.033). A statistically significant correlation was also found between gender and sobriety or the state after alcohol consumption (p=0.00008). The study shows that the main group of suicides still consists of men (82.09%). The age of women and men committing suicide did not differ significantly. Women were more likely to commit suicide in urban areas than men. Women were statistically significantly more likely to be sober or in a state after alcohol consumption at the time of committing suicide. The most commonly chosen method of suicide was death by hanging.

Demographic analysis of the suicide method by gender and age of the deceased between 2001 and 2010.

AAnalysis of the choice of suicide method by gender and age of the deceased. The study presented here was based on a retrospective analysis of autopsy reports from the years 2001-2010 in the Department of Forensic Medicine of the Jagiellonian University Collegium Medicum in Kraków. The basis of the research work conducted was the collection and extensive analysis of cases of suicide deaths. Subsequently, a preference analysis of the choice of suicide method was conducted, taking into account the age and gender of the deceased. The statistical analysis performed used logistic regression in Excel's XLSTAT as an analysis tool. A total of 2,073 suicide cases were collected from the time frame under discussion. The predominant method of suicide was hanging (1524 cases, 1329 men and 195 women), the second most common method was jumping from the roof or window of a high floor of a building (jumping from heights; 171 cases, 100 men, 71 women). A statistically significant correlation of suicide method with gender was found for: hanging [odds ratio (OR) male (M) vs. female (F) = 3. 4; confidence interval (CI) = 2.7-4.3; p0.001]; drowning [OR: M/F =4.1; CI = 2.6-6.4; p0.001]; jumping from heights [OR: M/F=4.1; CI=2.9-5.7; p0.001] and poisoning [OR: M/F=3.2; CI = 2.1-4.9]. Suicide with the use of firearms occurred exclusively in the case of men (40 cases). The age of the victims correlated with the method of committing suicide by jumping from heights [0R=0.98; CI=0.97-0.99; p0.001] and rail suicide [OR=0.98; CI=0.96-0.99; p0.001]. The study revealed that both age and gender have a significant impact on the choice of suicide method. According to available epidemiological data and the authors' predictions, a predominance of male over female sex was observed in the case of hanging, while jumping from heights was relatively more often chosen by women. The elderly were less likely to choose jumping from heights and rail suicide.

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

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. 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. 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. 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.

Suicidal Death Due to Helium Inhalation: A Case Report

Helium inhalation has been used as a method of suicide due to its rapid onset and perceived painlessness. However, little is known about the specific circumstances and forensic aspects surrounding helium-induced deaths, particularly when combined with other substances such as alcohol and antidepressants. We report a case of an adult male who was found deceased in his home, with evidence suggesting helium inhalation as the cause of death. Toxicological analysis also revealed the presence of ethyl alcohol and the antidepressant Citalopram in various body tissues. The combination of these substances raises questions about their potential contribution to the fatal outcome. This case highlights the importance of thorough forensic investigations in cases of unusual or unexpected deaths, particularly when multiple substances are involved. Understanding the interactions between these substances and their effects on the body is crucial for accurate cause of death determination and prevention strategies.

Farmer Suicides and Alcohol Consumption: An Autopsy Based Medicolegal Study of Suicide Methods and Risk Factors

The term "suicide" refers to the planned and intentional death of oneself. It is distinctly human, and homicide and suicide are the next three 1 most common causes of unnatural deaths after accidents. Farmer's suicide is mainly attributed to crushing financial pressures on farmers, farm product prices being too low, environmental problems, inadequate irrigation, increased use of chemical fertilizers, crop failure, etc. The current study was conducted at the Medical College in a rural region of central India, where most cases are brought from rural areas. The current study concluded that the majority of incidents affected young adults (20–40 years) who committed suicide by poisoning 72 cases (36.7%). In 16.32% (n=32) of the cases, the farmers had consumed alcohol at the time of the incident. Although 18.88% (n = 37) of the farmers' cases were addicted to alcohol.

Patterns of self-harm/suicide attempters who visited emergency department over the past 10 years and changes in poisoning as a major method (2011–2020)

Purpose: Suicide ranks among the top causes of death among youth in South Korea. This study aimed to identify the characteristics of suicidal individuals treated at emergency departments between 2011 and 2020.Methods: A retrospective analysis was conducted using data from January 2011 to December 2020 in the Injury Surveillance Cohort, a prospective registry. Patients’ sex, age, mortality, methods of self-harm, and previous suicide attempts were analyzed. The methods of self-harm were categorized into falls, asphyxiation, blunt injuries, penetrating injuries, poisoning, and others. Sub-groups with and without poisoning were compared.Results: The proportion of self-harm/suicide attempts increased from 2.3% (2011) to 5.0% (2020). The mortality rate decreased from 10.8% (2011) to 6.3% (2020). Poisoning was the most common method (61.7%). Mortality rates ranged from 42.0% for asphyxiation to 0.2% for blunt injuries. Individuals in their 20s showed a marked increase in suicide/self-harm attempts, especially in the last three years. A large proportion of decedents in their 70s or older (52.6%) used poisoning as a method of suicide. The percentage of individuals with two or more previous attempts rose from 7.1% (2011) to 19.7% (2020). The death rates by poisoning decreased from 7.7% (2011) to 2.5% (2020).Conclusion: Our findings underscore the urgent need for targeted interventions and suicide prevention policies. Managing and reducing suicide and self-harm in emergency settings will require a focus on poisoning, the 10–29 age group, and the elderly. This paper will be valuable for future policies aiming to reduce the societal burden of suicide and self-harm.

Suicides of famous chefs of today: stories and reasons

Suicide and suicidal behavior are one of the key issues for public policy and health care. Well-known American psychiatrist Somya Abubucker states that according to the WHO, a death by suicide occurs every 40 seconds in the world and “there are indications that for every adult person who died by suicide, there could be more than twenty others who attempted to commit it”. Restaurants remain a highly stressful environment, with the chef profession ranking among the top 10 most nerve-racking jobs in the world. The aim of the article is to present the life story and professional activity of the world’s most famous chefs and restaurateurs who committed suicide over the past 30 years, as well as the analysis of the probable reasons for their actions. To achieve the declared goal, the following research methods were used: historical, descriptive, comparative, systematization and generalization. The chefs in question used to work in the best restaurants in the United States, Canada, France, Italy, Switzerland, Great Britain and Australia. They made a significant contribution to the development of world gastronomy, their establishments have been transformed into truly cult locations, awarded stars from «Michelin» and evaluations from «Gault & Millau», which have been operating for several decades and offering the most exquisite dishes. It was established that the reasons for their suicides were mostly depression, emotional exhaustion and burnout, economic crisis, a drop in profits and lower ratings, loss of a loved one / close person, influence of reality shows, constant pressure, irregular work schedule, unjustified accusations. It was found that among the methods of suicide, it is, in particular, hanging, use of firearms, drowning and suffocation, medicine and drug overdose. The motives of the actions of some of them remained a mystery, since not even suicide notes were found. Priorities for suicide prevention include increasing specialized mental health programs, restricting access to weapons, and strengthening surveillance to detect signals / reports / information that a person is exhibiting suicidal intent. The obtained results make it possible to supplement and expand specialized training courses in higher education institutions of Ukraine, where personnel are trained for the field of tourism, hotel and restaurant industry, as well as medicine (in particular, psychology, psychiatry, addictionology and rehabilitation).

The characteristics of elderly suicidal attempters in the emergency department in Korea: a retrospective study.

Although Korea ranks first in the suicide rate of elderly individuals, there is limited research on those who attempt suicide, with preventive measures largely based on population-based studies. We compared the demographic and clinical characteristics of elderly individuals who attempted suicide with those of younger adults who visited the emergency department after suicide attempts and identified the factors associated with lethality in the former group. Individuals who visited the emergency department after a suicide attempt from April 1, 2017, to January 31, 2020, were included. Participants were classified into two groups according to age (elderly, ≥65 years; adult, 18-64 years). Among the 779 adult patients, 123 were elderly. We conducted a chi-square test to compare the demographic and clinical features between these groups and a logistic regression analysis to identify the risk factors for lethality in the elderly group. Most elderly participants were men, with no prior psychiatric history or suicide attempts, and had a higher prevalence of underlying medical conditions and attributed their attempts to physical illnesses. Being sober and planning suicide occurred more frequently in this group. In the elderly group, factors that increased the mortality rate were biological male sex (p<0.05), being accompanied by family members (p<0.05), and poisoning as a suicide method (p<0.01). Suicide attempts in elderly individuals have different characteristics from those in younger adults and are associated with physical illness. Suicides in the former group are unpredictable, deliberate, and fatal. Therefore, tailored prevention and intervention strategies addressing the characteristics of those who are elderly and attempt suicide are required.

Suicide trends in Denmark-An ecological study exploring suicide methods from 1995 to 2019.

Suicide is a major public health problem and complex phenomenon, affecting many people around the world. However, the incidence of suicide varies by sex and age, which includes differences in the means used. Therefore, to implement effective preventative interventions, it is important to study these differences to design effective, preventative interventions. This study investigates the trends in suicide rates in Denmark from 1995 to 2019 by analysing changes based on sex, age, and the means used for suicide. Data on all suicide deaths in the study period were extracted from the Danish Register of Causes of Death, and data on the background population were obtained from Statistics Denmark. We used negative binomial regression models to analyse the data, and the obtained estimates as a logarithm of the rate ratios allowed us to compare the results across groups and years. An overall decline in Danish suicide rates was observed during the study period, with the exception of young females aged 15-29 years. The demographic composition did not change significantly, and suicide rates are still highest for males and the elderly aged 60+. Hanging, self-poisoning and firearms remain the most prevalent means of suicide. Suicide prevention initiatives are required, especially interventions targeting males and the elderly. Restricting access to the means of suicide for these groups with high fatality rates may help reduce the overall suicide rate. Moreover, more research is needed to understand the factors that lead to suicide and affect the choice of means, which should also include studying the effects of different suicide prevention strategies on males and females from different age groups.

Suicide prevention in Flemish pharmacies

Introduction: In Flanders, the Flemish Pharmacists Network (VAN), in collaboration with the Flemish Centre of Expertise in Suicide Prevention (VLESP), wants to explore how pharmacists and pharmacist assistants in the public pharmacy can play an active role in suicide prevention in collaboration with other health care providers.&#x0D; Background: Mental health is an important area of focus in health care. Numbers from the Care and Health Agency tell us that nearly 1,000 people die of suicide in Flanders every year. By 2030, the Flemish Health objective is to reduce deaths by suicide by 10% compared to 2020. Poisoning is a common method of suicide and medication is used in the majority of suicide attempts. There is strong scientific evidence that when commonly used methods are made less lethal or accessible, the number of suicides using that method as well as other methods decreases. Restricting access to substances for suicide is a very effective prevention method. Pharmacists occupy a crucial role in society regarding the distribution of medication and are among the most trusted professions. Thus, they are pre-eminent key figures who can play a role in suicide prevention. &#x0D; Who is it for? The objective is to assessing and questioning actively the suicide risk of citizens in pharmacy.&#x0D; Who did you involve and engage with? In 2022 VAN launched a project among Flemish pharmacists in collaboration with VLESP and with the support of the Flemish government. &#x0D; What did you do? In the first phase, a literature review was conducted and a large group of experts from different healthcare professions was assembled. A survey was launched and the results are being analyzed by VLESP. These will be used for the further elaboration of the training and the launch of a pilot project in early 2023. &#x0D; Knowledge improvement within the sector is crucial to take an active role in suicide prevention. Pharmacists should be aware of existing help and support possibilities and referral options to other health care providers. Agreements with other health care providers should be made for this purpose. Pharmacists must be taught the tools to recognize and question signs of suicidal behavior so that they can then raise awareness about medication management, provide appropriate advice, make appropriate delivery and referrals.&#x0D; What results did you get? Around 50 pharmacies will start the pilot project in early 2023, which will be evaluated on a regular basis. Conclusions and recommendations will be written out by the end of 2023. &#x0D; What is the learning for the international audience? For the international audience, it is interesting to know how pharmacies can play an active role and what elements are necessary to promote this. The conclusions and recommendations can serve as a guide for application in other countries. This project can be an important step to a more integrated approach around this topic&#x0D; What are the next steps? After the pilot project, the objective is to extend the active role within all Flemish pharmacies and then within Belgium.

Identifying Trends in Firearm Suicide Among American Indian and Alaska Native Young Men, 1999–2020

Identifying Trends in Firearm Suicide Among American Indian and Alaska Native Young Men, 1999–2020

Modern suicide trend from internet

IntroductionThe most common suicide methods vary slightly from country to country, partly related to the availability of effective means. Societal development over the years and especially the advent of the Internet has enabled the sudden spread of new suicide methods. Recently, especially since 2019, intentional sodium nitrite poisoning has appeared on many social networks as an increasingly popular method of suicide. Material and MethodsThere was performed a retrospective-prospective study of the autopsy protocols of the Medico-Legal Departments of the Healthcare Surveillance Authority in Slovakia, in a period of 15 years (2008–2022). We performed the analysis of cases of death due to nitrite poisoning, focusing on cases of intentional self-harm. In all selected cases, we present complete information, including photo documentation from the place of death, as well as the results of the performed autopsy and the results of additional laboratory examinations. ResultsWe did not record any fatal cases of unintentional, accidental consumption of sodium nitrite in Slovakia, nor any fatal cases of homicidal poisoning by this substance. However, there were three cases of intentional self-harm (completed suicide) by sodium nitrite poisoning (in 2019, 2020 and 2022). ConclusionsThe correct diagnosis of the cases of sodium nitrite poisoning deaths is possible only based on evaluating all the information obtained, a thorough examination of the body and the crime scene, and the correct interpretation of the findings found during a subsequent autopsy and the results of the toxicological analysis.

'Whether it's your weapon or not, it's your home': US military spouse perspectives on personal firearm storage.

In the USA, an estimated 45% of veterans personally own firearms. Firearm access increases the risk of suicide, so suicide prevention efforts in the US Department of Defense (DoD) focus on lethal means safety, including reducing firearm access. Spouse input may enhance effective messaging and intervention delivery of lethal means safety. This study used qualitative methods to explore the perspectives of military spouses or partners on personal firearm storage, including at-home decisions, on-base storage and existing messaging from the DoD. Qualitative data were obtained using 1:1 interviews and focus groups with spouses/partners of US military service members (active duty, Reserve, National Guard, recently separated from the military) and representatives from military support organisations. Sessions focused on personal firearm storage (at home or on military installations) and military messaging around secure firearm storage and firearm suicide prevention. Data were analysed using a team-based, mixed deductive-inductive approach. Across 56 participants (August 2022-March 2023), the themes were variability in current home firearm storage and spousal participation in decision-making; uncertainty about firearm storage protocols on military installations; mixed awareness of secure firearm storage messaging from the military; and uncertainty about procedures or protocols for removing firearm access for an at-risk person. US military spouses are important messengers for firearm safety and suicide prevention, but they are currently underutilised. Tailored prevention campaigns should consider spousal dynamics and incorporate education about installation procedures.