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Search Results: 1 - 10 of 4921 matches for " Vishal Ajit Shah "
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A replication of the relationship between elderly suicides rates and elderly defendency ratios: cross-national study
Ajit Shah
Journal of Injury and Violence Research , 2010,
Abstract: BACKGROUND: A positive correlation between elderly dependency ratios and elderly suicide rates has been observed using one-year cross-sectional data on elderly suicide rates. METHODS: A cross-national study designed to replicate this positive correlation between elderly dependency ratios and elderly suicide rates was undertaken by: (i) using one-year average of five years data on suicide rates; and (ii) using more recent data on both elderly suicide rates and elderly dependency ratios. Data on elderly suicide rates, and the total number of elderly and young people was ascertained from the World Health Organisation website. RESULTS: The main findings were of significant positive correlations between elderly dependency ratios and suicide rates in both sexes in both the elderly age-bands (65-74 years and 75+ years). CONCLUSIONS: The replication of the positive correlations between elderly dependency ratios and elderly suicide rates by using one-year average of five years data on suicide rates suggests that this relationship is robust and accurate.
Further evidence for epidemiological transition hypothesis for elderly suicides
Ajit Shah
Journal of Injury and Violence Research , 2011,
Abstract: BACKGROUND: A developmental model of epidemiological transition for elderly suicide rates with four sequential stages has been developed to simultaneously explain cross-national variations in elderly suicide rates, trends over time for elderly suicide rates and age-associated trends in suicides rates reported in the literature. This model was supported by demonstration of a curvilinear (inverted U-shaped curve) relationship between elderly suicide rates and socio-economic status fitting the quadratic equation Y = A + BX - CX2 (where Y is the suicide rate, X is the socio-economic status and A,B, and C are constants) in both sexes. However, this relationship was derived from a cross-sectional study and, therefore, only an association can be inferred. One way to substantiate this further would be to examine the above curvilinear relationship between suicide rates and socio-economic status in a series of younger age-bands because a large part of the epidemiological transition hypothesis was contingent upon the impact of socio-economic status, through a series of mechanisms, on life expectancy. It was hypothesized that the curvilinear (inverted U-shaped curve) relationship between suicide rates and socio-economic status would be absent in younger age-bands and may be present in the younger age-bands closer to the older age-bands (i.e. 45-54 years and 55-64 years). METHODS: The curvilinear relationship between suicide rates in five age-bands 15-24 years to 55-64 years in both sexes and gross national domestic product (GDP), a measure of socio-economic status, fitting the above quadratic equation was examined with curve estimation regression model using data from the World Health Organization. RESULTS: In males in the age-bands 35-44 years, 45-54 years and 55-64 years there was a statistically significant curvilinear (inverted U-shaped curve) relationship with GDP and fitted the quadratic equation Y = A + BX - CX2; this relationship was absent in males in the age-bands 15-24 years and 25-34 years. In females in the age-bands 45-54 years and 55-64 years there was a statistically significant curvilinear with GDP (inverted U-shaped curve) and fitted the quadratic equation Y = A + BX - CX2; this relationship was absent in females in the age-bands 15-24 years, 25-34 years and 35-44 years. CONCLUSIONS: Although caution should be exercised in accepting the model of the epidemiological transition hypothesis for elderly suicide rates because it had been generated from cross-sectional data using an ecological design, the findings of the current study of suicide rates in
A replication of a possible relationship between elderly suicide rates and smoking using five-year data on suicide rates? A cross-national study
Ajit Shah
Journal of Injury and Violence Research , 2010,
Abstract: BACKGROUND: There is a paucity of studies examining the relationship between smoking and elderly suicides. A recent cross-national study, using one-year cross-sectional data on suicide rates, reported an absence of an independent relationship between elderly suicide rates and the national prevalence of smoking. National aggregates of suicide rates can randomly fluctuate year on year and may lead to erroneous findings in cross-sectional ecological studies when only data from a single year are utilised. METHODS: The relationship between the national prevalence of smoking and suicide rates in both sexes in the age-bands 65-74 and 75+ years was examined using a one-year average of five years data on suicide rates using data from the World Health Organisation and United Nations Development Programme. RESULTS: On univariate analysis, the national prevalence of smoking in males was positively correlated with suicide rates in males aged 65-74 and 75+ years, but this relationship was absent in females. On multivariate analysis there was no independent relationship between the national prevalence of smoking in males and suicide rates in males in both the elderly age-bands. CONCLUSION: The findings of this study, using a one-year average of five years data on suicide rates and a more recent data set, suggests that the absence of an independent relationship between the national prevalence of smoking and elderly suicide rates was accurate and robust.
The relationship between elderly suicide rates and different components of education: a cross-national study
Ajit Shah
Journal of Injury and Violence Research , 2012,
Abstract: BACKGROUND: Two recent studies reported a curvilinear (U-shaped) between elderly suicide rates and educational attainment measured by the United Nation’s Education Index. A study examining the curvilinear (U-shaped) relationship between elderly suicide rates and the individual components of the Education Index (adult literacy rate, percentage of children of relevant age group enrolled in primary schools and percentage of children of relevant age group enrolled for secondary schools) and one other measure of educational attainment (youth literacy rate) was undertaken to partial out the effects of the individual components of Education Index on elderly suicides. METHODS: A cross-national study examining the relationship between elderly suicide rates (Y-axis) and different measures of educational attainment (X-axis) was undertaken using data from the World Health Organization and the United Nations data banks using Curve estimation regression models. RESULTS: The relationship between elderly suicide rates with the adult literacy rate, the percentage of children of relevant age group enrolled for secondary schools and the youth literacy rate was curvilinear (U-shaped curve). This relationship was absent with the percentage of children of relevant age group enrolled in primary schools. CONCLUSIONS: Given the cross-sectional study design, a causal relationship between elderly suicide rates and measures of educational attainment, including the adult literacy rate, the percentage of children of relevant age group enrolled for secondary schools and the youth literacy rate, cannot be assumed. However, the findings suggest that future studies of elderly suicide rates and educational attainment should focus on the adult literacy rate, the percentage of children of relevant age group enrolled for secondary schools and the youth literacy rate as measures of educational attainment.
A replication of the relationship between adversity earlier in life and elderly suicide rates using five years cross-national data
Ajit Shah
Journal of Injury and Violence Research , 2012,
Abstract: BACKGROUND: Although life-long adversity has been suggested as a protective factor for elderly suicides, studies examining protective factors for elderly suicides are scarse. A cross-national study examining the relationship between elderly suicide rates and several proxy measures of adversity earlier in life was undertaken to replicate earlier findings by using five consecutive years data on elderly suicide rates from a more recent data set and by adding two more proxy measures of adversity early in life. METHODS: The relationship between elderly suicide rates and five proxy measures of adversity earlier in life was examined using data from the World Health Organization and the United Nations data banks with Spearman’s correlation coefficient. The five proxy measures of adversity early in life were: the percentage of children under the age of 5 years who were under weight, the percentage of children under the age of 5 years who were under height, the percentage of infants with low birth weight babies, the percentage of the general population with sustainable access to improved sanitation and the percentage of the general population with sustainable access to an improved water source. RESULTS: Generally, elderly suicide rates were lower in countries with higher adversity early in life. The only exceptions were in females aged 75+ years where this association only approached statistical significance for the percentage of children under the age of 5 years who were under weight and the percentage of children under the age of 5 years who were under height. CONCLUSIONS: The current study using a more recent data set and a five years data on elderly suicide rates along with two additional proxy measures of adversity early in life was able to replicate the findings of the earlier study. This suggests that the findings of the earlier study were accurate and robust.
The relationship between obesity and elderly suicide rates: a cross-national study
Ajit Shah
Journal of Injury and Violence Research , 2010,
Abstract: BACKGROUND: An inverse relationship between obesity and suicide has been observed in younger adults, but this has not been examined in the elderly. METHODS: A cross-national ecological study examined the independent relationship between the prevalence of obesity and elderly suicide rates, by controlling for potentially confounding variables, using data from the World Health Organization and the United Nations. RESULTS: Elderly suicide rates in females were independently associated with the prevalence of obesity. CONCLUSIONS: Caution should be exercised in attributing a causal relationship from this cross-sectional ecological study due to ecological fallacy and requires confirmation in individual-level case-control or cohort studies.
Elderly suicide rates: a replication of cross-national comparisons and association with sex and elderly age-bands using five year suicide data
Ajit Shah
Journal of Injury and Violence Research , 2012,
Abstract: BACKGROUND: Suicide rates generally increase with age. A recent cross-national study, using one-year cross-sectional data on suicide rates identified regional and cross-national patterns for elderly suicide rates. However, findings from studies using one-year cross-sectional data on suicide rates may be open to bias because of random year on year fluctuations in elderly suicide rates. METHODS: One-year average of suicide rates for both sexes in the age-bands 65-74 and 75+ years were calculated from data on suicide rates for five consecutive years ascertained from the World Health Organization. Cross-national variations were examined by segregating different countries into four quartiles of suicide rates. RESULTS: There was wide cross-national variation in elderly suicide rates. Elderly suicide rates were the lowest in Caribbean and Arabic/Islamic countries, and the highest in central and eastern European, countries emerging from the former Soviet Union, some oriental and some west European countries. CONCLUSIONS: The regional and cross-national patterns for elderly suicide rates observed in this study were almost identical to a similar earlier study using one-year cross-sectional data on suicide rates. This suggests that the findings of both studies were accurate and robust, and potential explanations for the observed cross-national variations in elderly suicide rates requires further study.
Suicide rates: age-associated trends and their correlates
Ajit Shah
Journal of Injury and Violence Research , 2012,
Abstract: BACKGROUND: Suicide rates traditionally increased with ageing. There is a paucity of studies examining factors associated with age-associated trends in suicide rates. METHODS: The relationship between suicide rates and ageing was examined by ascertaining suicide rates in the seven age-bands 16-24 years to 75+ years from the World Health Organization for 97 countries. The relationship between socio-economic status, income inequality, healthcare expenditure, child mortality rates and life expectancy and countries with an increase, a decline and no change in suicide rates with ageing was examined using data from the United Nations. RESULTS: In males and females there was a decline in 5 and 10 countries, an increase in 33 and 37 countries and no change in 59 and 50 countries respectively in suicide rates with ageing. Age-associated trends in suicide rates were significantly associated with socio-economic status (males) or income inequality (females), per capita expenditure in healthcare, the proportion of gross-national domestic product spent on healthcare, child mortality rates and life expectancy. CONCLUSIONS: The current study, of factors associated with age-associated trends in suicide rates, confirmed a previously developed five sequential stage model to explain the relationship between elderly suicide rates and socio-economic status and income inequality, quality and quantity of healthcare services, child mortality rates and life expectancy.
The relationship between the use of mental health act and general population suicide rates in England and Wales
Ajit Shah
Journal of Injury and Violence Research , 2012,
Abstract: BACKGROUND: The relationship between suicide and involuntary admissions has been mainly examined in younger and mixed age groups. These studies provide mixed results with some demonstrating no relationship and others reporting increased rates of suicides in involuntarily admitted patients. However, the association between the utility of the Mental Health Act with general population suicide rates in England and Wales has not been formally studied. METHODS: Thus, an ecological study, over the 19-year period, to examine the relationship between rates of involuntary admissions and general population suicide rates in England and Wales was undertaken using nationally collected data. Data on general population suicide rates for both sexes were ascertained from the World Health Organization (WHO) website. Data on the number of detentions under the Mental Health Act were ascertained from the Office of National Statistics website. Data on the population size for the elderly age-bands were ascertained from the WHO website. Spearman's correlation coefficient was used to examine the relationship between suicide rates and rates of detention under the Mental Health Act. RESULTS: There were negative correlations between rates of involuntary admissions and general population suicide rates in both sexes. CONCLUSIONS: A causal relationship and the direction of causality cannot be assumed because this was an ecological study. There is a need for sufficiently powered study to compare the number of suicide occurring in involuntarily and voluntarily admitted patients using a case-control or cohort design and survival analysis. If an inverse association can be demonstrated between suicide and involuntary admissions then it has important implications for the development of mental health legislation as an adjunct to national suicide prevention strategies.
Some critical methodological issues in secondary analysis of world health organization data on elderly suicide rates
Ajit Shah
Journal of Injury and Violence Research , 2009,
Abstract: Background: Suicides may be misclassified as accidental deaths in countries with strict legal definitions of suicide, with cultural and religious factors leading to poor registration of suicide and stigma attached to suicide. Methods: The concordance between four different definitions of suicides was evaluated by examining the relationship between pure suicide and accidental death rates, gender differences, age-associated trends and potential distil risk and protective factors by conducting secondary analysis of the latest World Health Organisation data on elderly death rates. The four definitions of suicide were: (i) one-year pure suicides rates; one-year combined suicide rates (pure suicide rates combined with accidental death rates); (iii) five-year average pure suicide rates; and (iv) five-year average combined suicides rates (pure suicides rates combined with accidental death rates). Results: The predicted negative correlation between pure suicide and accidental death rates was not observed. Gender differences were similar for all four definitions of suicide. There was a highly significant concordance for the findings of age-associated trends between one-year pure and combined suicide rates, one-year and five-year average pure suicide rates, and five-year average pure and combined suicide rates. There was poor concordance between pure and combined suicide rates for both one-year and five-year average data for the 14 potential distil risk and protective factors, but this concordance between one-year and five-year average pure suicide rates was highly significant. Conclusions: The use of one-year pure suicide rates in cross-national ecological studies examining gender differences, age-associated trends and potential distil risk and protective factors is likely to be practical, pragmatic and resource-efficient.
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