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An integrative suicide prevention program was implemented to tackle an outbreak of visitor charcoal burning suicides in Cheung Chau, an island in Hong Kong, in 2002. This study evaluated the effectiveness of the program. The numbers of visitor suicides reduced from 37 deaths in the 51 months prior to program implementation to 6 deaths in the 42 months post-implementation period. The number of visitor suicide pacts decreased from 7 pacts (15 individuals) to 1 pact (2 individuals). No statistically significant differences in the numbers of visitor suicide attempts and resident suicides were observed in the two time periods. No statistically significant changes in visitor suicides during the study period were observed on the comparison islands. The consistency and timing of reduction in visitor suicides correlated with the development and delivery of the integrative program on the intervention island, suggesting a causal association between program delivery and reduction of visitor suicides. The possibility of displacement seems small because there was no increase in visitor suicides on the comparison islands during the study period. This integrative approach in preventing target-specific suicides may serve as an example for other communities to develop suicide prevention programs that make use of the existing local resources.

This paper investigates a model for pricing the demand for a set of goods when suppliers operate discount schedules based on total business value. We formulate the buyers's decision problem as a mixed binary integer program, which is a generalization of the capacitated facility location problem (CFLP). A branch and bound (BnB) procedure using Lagrangean relaxation and subgradient optimization is developed for solving large-scale problems that can arise when suppliers' discount schedules contain multiple price breaks. Results of computer trials on specially adapted large benchmark instances of the CFLP confirm that a sub-gradient optimization procedure based on Shor and Zhurbenko's r-algorithm, which employs a space dilation in the direction of the difference between two successive subgradients, can be used efficiently for solving the dual problem at any node of the BnB tree. [ABSTRACT FROM AUTHOR]