Suicide in developing countries (2): risk factors

The majority of studies on risk factors for suicide have been conducted in developed countries, and less work has been done to systematically profile risk factors in developing countries. The current paper presents a selective review of sociodemographic, clinical, and environmental/situational risk factors in developing countries. Taken together, the evidence suggests that the profiles of risk factors in developing countries demonstrate some differences from those in developed countries. In some developing countries, at least, being female, living in a rural area, and holding religious beliefs that sanction suicide may be of more relevance to suicide risk than these factors are in developed countries. Conversely, being single or having a history of mental illness may be of less relevance. Risk factors that appear to be universal include youth or old age, low socioeconomic standing, substance use, and previous suicide attempts. Recent stressful life events play a role in both developing and developed countries, although their nature may differ (e.g., social change may have more of an influence in the former). Likewise, access to means heightens risk in both, but the specific means may vary (e.g., access to pesticides is of more relevance in developing countries). These findings have clear implications for suicide prevention, suggesting that preventive efforts that have shown promise in developed countries may need to be tailored differently to address the risk factor profile of developing countries.     

Some problems of research on the association between blood types and suicide mortality: comment on Lester (2004)

This is a comment on the ecological finding of a negative association of national suicide rate and national proportion of people with Type O blood (Lester, 2004). Current knowledge on this topic is reviewed and several problems, limitations, and discrepancies within this research line are noted. Specifically, it is suggested that (1) this association appears to have been subject to attenuation recently; (2) available ecological evidence on this association is contradictory to both individual-level findings on the same topic and similar ecological-level findings pertaining to personality-related risk factors and antecedents of suicide; (3) a negative association of one of the four ABO phenotypes with suicide mortality does not help single out phenotypes with possibly increased suicide risk; and (4) genetic suicide risk factors may well be associated with other ABO phenotypes than Type O and may further coincide with other blood polymorphisms than the ABO system.     

Decentralization or deconcentration: struggle for political power in poland (1)

This paper argues that the 1989 commitment to political and administrative decentralization has weakened over five years. As the point that it has become a rhetorical formula voiced by the governing political leadership when convenient, but in reality never realized. Two sets of factors contributed to such a state of affairs: (1) the inability of the center to reform itself, and (2) center's increasing commitment to regain the power lost over the last few years.

The first part of the paper lays a theoretical framework for analysis of pressures and barriers to decentralize. Second, examines the process of implementing in Poland, of local government and public administration reform over the 1989-1995 period. Finally, the third analyzes in detail the three most significant forces that central states utilized to gain control: (1) political; (2) power resources and (3) fiscal. It concludes by asserting that beyond 1990, while much of the program has been achieved in designing legislative and territorial aspects of the public administration and local governments reform, what was lacking was the political commitment to implement both.     

Thermometer or sauna?: Performance measurement and democratic assistance in the United States Agency for International Development (USAID)

This article presents a case study of performance measurement in the United States Agency for International Development's (USAID's) democracy and governance program. Its purpose is to illustrate the juxtaposition (and sometimes contradiction) between the high standards of causal logic and accuracy required of performance measurement, and the untidiness involved in the 'politics of democratization'. Based on USAID experiences in numerous countries, the article concentrates on four specific themes drawn mainly from the literature on re-engineering but also from new public administration. These are: the complexity of politics; the challenge of attribution; the danger of distortive incentives; and the interrelated questions of product and process and quantitative and qualitative measures. Problems of measurement are clearly complicated by the fact that the Agency does not deliver service directly, has limited control over its expenditures, and, in the case of democracy assistance, by the need to operate in a complex and sensitive area, across international borders and diverse political systems and cultures. The article includes a discussion of some innovative qualitatively-oriented USAID responses to these problems.