ABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Bipolar Disorder/diagnosis , Bipolar Disorder/drug therapy , Lithium/metabolism , Lithium/pharmacology , Lithium/therapeutic use , Lithium Compounds/therapeutic use , Antimanic Agents/therapeutic use , Bipolar Disorder/physiopathology , Lithium/pharmacokinetics , Lithium/supply & distribution , Antimanic Agents/metabolism , Antimanic Agents/pharmacology , Antimanic Agents/pharmacokineticsABSTRACT
Minerals and metals are finite resources, and recent evidence suggests that for many, primary production is becoming more difficult and more expensive. Yet these resources are fundamentally important for society--they support many critical services like infrastructure, telecommunications and energy generation. A continued reliance on minerals and metals as service providers in modern society requires dedicated and concerted governance in relation to production, use, reuse and recycling. Lithium provides a good example to explore possible sustainable governance strategies. Lithium is a geochemically scarce metal (being found in a wide range of natural systems, but in low concentrations that are difficult to extract), yet recent studies suggest increasing future demand, particularly to supply the lithium in lithium-ion batteries, which are used in a wide variety of modern personal and commercial technologies. This paper explores interventions for sustainable governance and handling of lithium for two different supply and demand contexts: Australia as a net lithium producer and Switzerland as a net lithium consumer. It focuses particularly on possible nation-specific issues for sustainable governance in these two countries' contexts, and links these to the global lithium supply chain and demand scenarios. The article concludes that innovative business models, like 'servicizing' the lithium value chain, would hold sustainable governance advantages for both producer and consumer countries.
Subject(s)
Commerce/methods , Conservation of Natural Resources/legislation & jurisprudence , Conservation of Natural Resources/methods , Lithium/supply & distribution , Australia , Government Regulation , Lithium/economics , SwitzerlandABSTRACT
CONTEXT: Prior observational studies suggest that treatment with lithium may be associated with reduced risk of suicide in bipolar disorder. However, these studies are biased toward patients with the most severe disorders, and the relation to sex and age has seldom been investigated. OBJECTIVE: To investigate whether treatment with lithium reduces the risk of suicide in a nationwide study. DESIGN: An observational cohort study with linkage of registers of all prescribed lithium and recorded suicides in Denmark during a period from January 1, 1995, to December 31, 1999. SETTING: All patients treated with lithium in Denmark, ie, within community psychiatry, private specialist practice settings, and general practice. PARTICIPANTS: A total of 13 186 patients who purchased at least 1 prescription of lithium and 1.2 million subjects from the general population. MAIN OUTCOME MEASURE: All suicides identified on the basis of death certificates completed by doctors at the time of death. RESULTS: Patients who purchased lithium had a higher rate of suicide than persons who did not purchase lithium. Purchasing lithium at least twice was associated with a 0.44 reduced rate of suicide (95% confidence interval, 0.28-0.70) compared with the rate when purchasing lithium only once. Further, the rate of suicide decreased with the number of prescriptions of lithium. There was no significant interaction between continued lithium treatment and sex and age regarding the suicide rate. CONCLUSION: In a nationwide study including all patients treated with lithium, it was found that continued lithium treatment was associated with reduced suicide risk regardless of sex and age.
