On Thu, 15 Jul 2010 10:55:39 -0700, Ken Steele wrote: >I think one of Stephen's concerns was raised in the letter by >Prof. Sakinofsky to the BMJ.
Since Stephen hasn't bothered to explain what his point(s) were, we're left to speculating and playing mindreaders. As I tried to point out in my previous post, Stephen focused on the number of suicides on Bloor St, not on the overall number of suicides in Toronto. Consequently, the finding of suicides going to zero on Bloor St might make one wonder what was Stephen's point about the problem with "naturalistic experimetns". As Sakinofsky says: |...the intent to erect anti-suicide barriers at the bridge was |never to replace a comprehensive program, as the authors |seem to imply, but merely to be one small cog in the whole |wheel of comprehensive suicide prevention. So, did the barrier accomplish its immediate goal? Yes. For reasons that are not clear in the article, some larger impact was expected. Scott points out that there may be research reported in Joiner's book "Myths About Suicide" that would lead one to expect more general effects -- quoting Scott's post: |the finding runs counter to most received wisdom in the suicide |field (again, see Joiner's recent book, "Myths about Suicide," which |is quite unambiguous on this point), which proposes that erecting |barriers on bridges results in a overall decrease in suicide, not |merely a decrease at the targeted location (because most suicides |are ostensibly committed following an activation of short-term impulses). I have not read "Myths About Suicide" so I don't know what research Scott is referrring to but in the article by Sinyor and Levitt there is the following sidebar on page 6, just before the reference list: |WHAT IS ALREADY KNOWN ON THIS TOPIC | |Evidence shows that barriers decrease or eliminate suicides at bridges |commonly used for suicide by jumping | |***No study has shown a statistical drop in overall rates of suicide after |the construction of a barrier on a bridge ****** | |It is unclear whether barriers prevent suicides or simply result in people |substituting one bridge for another or attempting suicide by other means | |WHAT THIS STUDY ADDS | |No suicides occurred at Bloor Street Viaduct in Toronto after the construction |of a barrier Suicide rates by jumping were unchanged owing to a corresponding |increase in jumps from other bridges and buildings in the area | |Therefore barriers may not decrease suicide rates when comparable locations |are available Now, I've used **** to highlight the relvenat text above about the lack of change in overall suicide rates after the construction of a barrier on a bridge. Scott seems to imply that this statement is false. I don't know if Stpehen agrees or disagrees with what was written in the article and/or Scott and/or some other source. I think there is, however, some reason to ask what ther hell are people talking about. >Prof. Sakinofsky pointed out that bridge-jumping suicides >did decrease (from 18 to 14) during that time period but >the difference was not statistically significant. Since the N >is so low, there is a concern about a lack of power in the >comparison. In other words, the lack of significance may >represent a Type II error. I saw this and noted it. I also wondered if there was a randomization or permutation test might produce a significant result. But this is somewhat besides the point (if one can hazard what the point is). Sakinofsky says the following: |The authors point out that "no study of a suicide barrier has |shown a statistically significant drop in overall suicide rates |in the vicinity". This may be true for bridge barriers, because |they protect only small numbers of people, So, Scott seems to be wrong on this point. I haven't any idea what Stephen's opinion is on this point. However, Scott's point appears to be supported by other (non-bridge) interventions: |but certainly it is untrue for suicide methods chosen by larger |demographic groups. This was, for example, shown when Britain |converted from coal gas to carbon monoxide-free natural gas in |the late 1950s. Suicide rates between 1960-71 fell overall as a |result but stayed down only among the elderly demographic group |(where the time-honoured mode of suicide was putting one's head |in the gas oven). This prompted Norman Kreitman to speculate |that for some "it may be that the scenario of suicide specifies the |use of a particular method and that if this is not available actual |suicide is then less likely" (3). Perhaps there has been a lack of clarity in several instances. Perhaps some folks don't realize their lack of clarity until it has been pointed out. Perhaps some folks don't realize their lack of clairy even after it has been pointed out. In closing, giving the seriousness of the topic, I suggest the following website: http://babyanimalz.com/ -Mike Palij New York University [email protected] --- You are currently subscribed to tips as: [email protected]. To unsubscribe click here: http://fsulist.frostburg.edu/u?id=13090.68da6e6e5325aa33287ff385b70df5d5&n=T&l=tips&o=3602 or send a blank email to leave-3602-13090.68da6e6e5325aa33287ff385b70df...@fsulist.frostburg.edu
