Structural intervention at one bridge decreases the overall jumping suicide rate in Victoria, Australia.

AIMS: There is clear evidence that installing safety barriers is effective in preventing jumping suicides from high-risk bridges with only moderate displacement to other nearby bridges. However, the impact of barriers on jumping suicides across broader geographical areas is not well understood. We examined patterns in jumping suicides across the state of Victoria, Australia, after a safety barrier was installed at the West Gate Bridge which, before the installation of the barrier, was the site of approximately 40% of Victoria's jumping suicides. METHODS: We used negative binomial regression analyses on Victorian data from 2000 to 2019 to compare rates of jumping suicides at the West Gate Bridge, other bridges and non-bridge jumping locations before, during and after the West Gate Bridge barrier installation. We conducted linear regression analyses to examine whether the distance travelled from the deceased's usual residence to the location of their jumping suicide changed between the before, during and after barrier installation periods. RESULTS: After installation of the barrier, there were no jumping suicides at the West Gate Bridge (rate ratio [RR] = 0.00, 95% credible intervals [95% Cr] = 0.00-0.0001) and there was strong evidence that the rate of jumping suicides at all locations declined by 65% (RR = 0.35, 95% Cr = 0.22-0.54). At other bridges, there was also evidence of a reduction (RR = 0.31, 95% Cr = 0.11-0.70), but there was no evidence of a change at non-bridge locations (RR = 0.74, 95% Cr = 0.39-1.30). CONCLUSION: After installation of the safety barrier at the West Gate Bridge, jumping suicide in Victoria decreased overall and at other bridges, and did not appear to change at non-bridge locations. Our findings show that when barriers are installed at a site responsible for a disproportionately high number of jumping suicides, they are not only highly effective at the site where the barriers are installed but can also have a prevention impact beyond the immediate locale at similar sites.

Bed-Sharing in the First 8 Weeks of Life: An Australian Study.

Background As the evidence continues to emerge about the relationship between sudden unexpected death in infancy (SUDI) and the way an infant sleeps, providing consistent and evidence-informed recommendations on how best to sleep infants is an ongoing challenge. A recent case series study in the state of Victoria, Australia, identified 45.8% of sleep-related infant deaths occurred whilst bed-sharing. This study prompted the need for further exploration of infant sleeping practices, including bed-sharing, in this population. Methods A cross-sectional survey of 2745 mothers attending the Maternal and Child Health (MCH) Service across Victoria, Australia was conducted. Data included the prevalence and circumstances of bed-sharing, family demographics, and SUDI risk and protective factors. Associations between bed-sharing and SUDI risk and protective factors were examined using univariate and multivariate analyses. Results Bed-sharing prevalence was found to be 44.7%, with 21.5% reporting that this was intended. Multivariate analyses showed bed-sharing was less likely amongst those with an annual household income above $AUS104, 000 (OR 0.72; 95% CI 0.54-0.96) and more likely amongst mothers who breastfed (OR 1.71; 95% CI 1.23-2.37). Conclusions Bed-sharing prevalence in this population compares closely with the Victorian case series study and a previous cross-sectional study in the state of Queensland, Australia, in 2002. Noted gaps in how families are implementing current recommendations about reducing the risk of SUDI were identified for sleep position, sleep location and the sleep environment. Further consideration needs to be given to addressing these gaps and applying these findings of current bed-sharing practices to the development of infant safe sleeping policy and programs.