Adolescent self-poisoning: a cohort study of subsequent suicide and premature deaths

Previous self-harm has been identified as a risk factor for subsequent suicide by adolescents. The objective of the study was to identify further risk factors for subsequent premature death and suicide in a population of adolescents presenting with self-poisoning. A longitudinal cohort design using data-linkage of consecutive adolescent patients presenting to the Hunter Area Toxicology Service, a regional toxicology service for Newcastle, Australia, with the National Death Index of the Australian Institute of Health and Welfare was used. A total of 441 adolescents aged 10 to 19 years presented with self-poisoning over 5 years from January 1991 to December 1995, with follow-up to March 2001. There were 14 deaths total, eight of which were likely suicides. There was a 22-fold increase in suicide rate for males and a 14-fold increase for females compared with age-normalized population rates. Adjusted hazard ratios (95% CI) forpremature death were male gender 3.77 (1.11-12.78), nonaffective psychotic disorders 16.3 (3.83-69.34) and the mental illnesses of childhood 6.12 (1.68-22.23). There was a similar pattern for suicide: Male gender, nonaffective psychotic disorders, and the mental illnesses of childhood confer greater risk for subsequent suicide or premature death in this population.     

Sex trafficking and the mainstream of market culture

The majority of analyses of the international trade in women focusses on the rôle of organised crime groups in the supply and delivery of women across borders and into the local sex trade. This paper (a) attempts to locate the demand for traded women in a broader analysis of changes in the political economy of developed studies and (b) more specifically situates the trade in women in relation to the new-found centrality of sex in the mainstream of popular culture.     

The State and the Economy: Opinion Formation and Collaboration as Facets of Economic Management

This paper seeks to extend discussion of the areas of state activity that are relevant to economic performance. It does this by linking several literatures that are now usually considered in isolation from each other. These are institutionalist theory, developmental state theory, and comparative and historical institutionalism. The paper focuses particularly on the experience of the east Asian developmental states. The paper suggests a new role for the state as catalyst in the formation of ideas, choice sets and motives concerning economic performance. It can play this role at national and policy community levels and in relation to desired overall outcomes, export or cluster development and innovation. The notion that economic globalization will inexorably drive convergence between states is discounted. On the contrary, this is as likely to nourish miscomprehension or incomprehension between citizens of different states. This is an additional reason for attending to the quality of opinion formation by states.     

Program Strategy and Coalition Building as Facets of New Public Management

This paper explores two issues: first, the strategic and coalition-building tasks that may be routinely associated with New Public Management (NPM); and second, the implications of acknowledging these tasks for the conception of public management. NPM focuses on performance. It invites managers to accept responsibility for whole programs or systems (Kettle, 1997; Dunleavy, 1994; Ridley, 1996; Hood, 1995). This directs attention to basic program frameworks (that is, program strategy), as well as to operations. It involves the purposes of programs. It involves routine attention to such factors as the effectiveness of outcomes, the identification of alternative program configurations, the implications of emerging issues and needs, and the mobilisation of authority for change. In practice, this authority derives both from program stakeholders, as well as from ministers and the broader political system.     

Secrets of the Political Constitution

Book reviewed in this article:
Adam Tomkins, The Constitution after Scott: Government Unwrapped