Nonsuicidal self-injury (NSSI) refers to the intentional destruction of one's own body tissue without suicidal intent and for purposes that are not socially sanctioned. While NSSI has been understudied among Veterans, the lifetime prevalence rate of NSSI in Veterans is approximately three times higher than the general population. Moreover, NSSI is associated with increased risk for violence, psychiatric distress, and marked impairment in psychosocial functioning. Even though NSSI is distinct from suicidal behaviors in several important ways, NSSI remains a strong predictor of a future suicide attempt. The primary goal of this project is to evaluate the treatment and acceptability of a brief intervention for NSSI that aims to reduce psychosocial impairment and NSSI behaviors in Veterans.

Start Date01 Mar 2025

Sponsor / Collaborator

VA Office of Research and Development

NCT06019663 / Not yet recruitingNot ApplicableIIT

Exploratory Randomised Controlled Trial of an Artificial Intelligence Self Harm Application

This is a mixed-methods study. The quantitative component will comprise of a multicentre rater-blind, randomized controlled trial to evaluate the feasibility and acceptability of AISHA in addition to treatment as usual (TAU) compared to TAU alone in Pakistan.
In-depth interviews and focus groups with other stakeholders will take place to consider the wider implementation of AISHA in mental health services in Pakistan.

Start Date01 Jun 2024

Sponsor / Collaborator-

IRCT20201009048974N6 / SuspendedNot ApplicableIIT

Investigating the efficacy of a DBT-Based Parenting Intervention for Primary caregivers of Youth With Self-Harm

Start Date21 May 2024

Sponsor / Collaborator

Shahid Beheshti University of Medical Sciences

100 Clinical Results associated with Self-Injurious Behavior

100 Translational Medicine associated with Self-Injurious Behavior

0 Patents (Medical) associated with Self-Injurious Behavior

6,761

Literatures (Medical) associated with Self-Injurious Behavior

01 Mar 2024·SSM - population health

The influence of natural disasters and multiple natural disasters on self-harm and suicidal behaviour: findings from a nationally representative cohort study of Australian adolescents.

Article

Author: Ben Edwards ; Matthew Taylor ; Matthew Gray

Few studies have examined the relationship between exposure to natural hazards and suicide and self-harm in youth. We extend prior research by investigating the association between multiple disasters and the risks of self-harm and suicide longitudinally in a nationally representative longitudinal cohort of adolescents 14 to 15 years to 18-19 years of age. Natural disasters were identified through parental self-reports for the local area. Different types of multiple disaster exposures were investigated including compound disasters (two or more disasters occurring in the last 12 months), cascading disasters (a disaster that leads to another disaster in the subsequent wave) and consecutive disasters (multiple disasters within the last two years or over an eight-year period). Using 8,714 person-waves of data from 2,908 adolescents, findings from random effect models suggest that parental reports of fire or floods increase the risk of self-harm ideation, self-harm, and suicidal ideation. Compound disasters of fire/flood and drought were also associated with increased risk of suicidal thoughts. Cascading disasters of drought followed by fire/flood increased the risks of self-harm but recurrent consecutive droughts were associated with lower risks of suicidal ideation. Australian adolescents are exposed to high rates of natural disasters that increase the risk of self-harm and thoughts of self-harm and suicide. Climate change will increase risk of natural disaster exposure for all countries. Despite these increased risks, there was resilience to disaster exposure particularly in the case of recurrent drought suggesting that youth, families and communities may well develop protective strategies to support mental health.

01 Mar 2024·Pediatric emergency medicine practice

Evaluation and management of suicidal ideation and self-harm in children in the emergency department.

Article

Author: Ashley A Foster ; Bijan Ketabchi ; Jennifer A Hoffmann

Suicide is a leading cause of death among youth, and the emergency department (ED) serves as the primary point of healthcare contact for many with suicidal ideation. As suicide-related presentations to the ED continue to rise, the implementation of time- and cost-effective care pathways becomes ever more critical. Evidence-based tools for the identification and stratification of suicide risk can aid in clinical decision-making and care linkage. This issue reviews best practices for suicide risk assessment of youth to guide evaluation, management, and disposition planning within the ED setting.

01 Mar 2024·Yonsei medical journal

The Prediction Model of Non-Suicidal Self-Injury in Psychiatric Patients Using Decision Tree Analysis.

Article

Author: Kawon Kim ; Sungbum Woo ; Seok Hyeon Kim ; Sungwon Roh ; Sojung Kim

PURPOSE:

The prevalence rate of non-suicidal self-injury (NSSI) in the clinical population is higher than that in the community sample, necessitating the need to investigate the predicting factors of NSSI in this group. The present study aimed to develop a prediction model of NSSI among psychiatric patients in Korea.

MATERIALS AND METHODS:

Decision tree analysis was conducted on a sample of 224 psychiatric patients. Emotion regulation strategies (rumination, cognitive reappraisal, and expressive suppression), impulsivity, problematic alcohol use, working memory, depressive mood, and gender were included in the model as predictors of NSSI.

RESULTS:

Results indicated that rumination, problematic alcohol use, and working memory predicted lifetime NSSI engagement among psychiatric patients. The best predictor of lifetime NSSI engagement was rumination. Specifically, when the level of rumination was high, the level of working memory was lower, and the risk of NSSI was higher. In the case of low levels of rumination, the higher the level of problematic alcohol use, the higher the risk of NSSI. The highest prevalence of lifetime NSSI engagement was found in a subgroup of patients with high levels of rumination and low levels of working memory.

CONCLUSION:

The major contribution of this study is finding a combination of factors to predict the high-risk group of NSSI among psychiatric patients in Korea. This study provides evidence on the effect of rumination, working memory, and problematic alcohol use on NSSI. It is suggested that clinicians and researchers should pay more attention to emotion regulation and related vulnerabilities in preventing and treating NSSI.

News (Medical) associated with Self-Injurious Behavior

29 Feb 2024

·medcitynews.com

Veteran Suicide Statistics Are Horrifying — What Is the VA Doing to Help?

From left to right: Shereef Elnahal, the VA’s under secretary for health; and Arundhati Parmar, MedCity News’ editor-in-chief In the U.S., veterans are 1.5 times more likely to die by suicide than nonveteran adults. Research shows that 44 former service members die each day as a result of suicide or self-injury. Shereef Elnahal, the U.S. Department of Veterans Affairs’ under secretary for health, declared on Tuesday that even one veteran dying by suicide is too many — and promised that the VA is pursuing partnerships aimed at addressing these ghastly statistics. He made these remarks during a fireside chat with Arundhati Parmar, MedCity News’ editor-in-chief, at the ViVE conference in Los Angeles. “We have a clear mandate from President Biden: to reach all veterans with VA programming, especially on top priorities like suicide prevention,” Elnahal said. “We noticed that 50% of veterans who die by suicide have never interacted with the VA at all — and so we knew we would need to leverage partnerships with every institution possible to help us reach all 90 million vets in the U.S.” The VA’s interoperability pledge is an example of one of these efforts, he noted. The pledge, announced in October, involves 13 health systems, including Kaiser Permanente, UPMC, Mass General Brigham, Intermountain Health, Atrium Health and Tufts Medicine. These health systems have vowed to openly exchange information with the VA about care provided to and requested by veterans — using the VA’s open veteran API. This API is “a database of every veteran in the U.S.” whether they’re enrolled in the VA or not, Elnahal explained. The goal of the pledge is to help veterans access care and save money by connecting them to VA benefits and resources, he added. “At Tufts Medicine, which the first institution doing this, every veteran who comes in suicidal crisis is identified as a veteran to their healthcare providers. And so we now push information to those health systems about an exciting new policy that allows us to cover care for free for 30 days for any veteran in an acute suicidal crisis, regardless of whether they’re enrolled in VA or not,” Elnahal declared. The VA has paid for life-saving suicidal crisis care for nearly 1,000 veterans at Tufts, he noted. He added that the VA has plans to scale this program first to the other 12 health systems participants in its interoperability pledge and then later to “every Epic hospital in the country.” Elnahal also highlighted the VA’s partnerships in the area of virtual reality-based peer support care. The organization is working with mental health companies Innerworld and Even Health to offer veterans with VR-based suicide prevention care, he said. “One thing that I noticed early on in my clinical career, but also through my different leadership experiences, is that it’s often a peer who has gone through hardship like substance use disorder, like PTSD and of course military service when it comes to our veterans, who can really be the person that encourages that veteran to come in for care,” Elnahal explained. The VA’s partnerships with Innerworld and Even Health allow it to connect veterans to other veterans across the country for much-needed peer support whenever they need it, he stated. Elnahal also told Parmar that the VA is working to improve its training processes for employees working its veteran crisis line. The organization has a partnership with ReflexAI, a company whose technology allows workers to practice on AI-generated fake patients before they take a real call from a veteran in crisis, he said. In addition to these partnerships, the VA is also conducting clinical trials testing psilocybin and MDMA-assisted psychotherapy. The VA’s funding for these trials exceeds $2 million, Elnahal remarked. He said the trials are seeking to answer key questions about what an effective dosage looks like and how often to combine the psychedelic treatment with talk therapy. Elnahal recalled a conversation he had recently with a veteran named Jonathan Leubecky who had benefited from MDMA treatment. Before receiving MDMA, which is commonly known as ecstasy, Leubecky had been struggling with PTSD and had attempted suicide several times. “He told me he went through psychedelic-assisted psychotherapy with MDMA, and it virtually cured his PTSD. And he never sought MDMA again recreationally. That is a fantastic thing — compare that experience to our experience with opioids, which often leads to addiction and seeking street drugs, even with a short course after an injury. We do not see that phenomenon with psychedelics — they’re inherently nonaddictive,” Elnahal explained. These treatments have yet to be approved by the FDA, but experts predict the first psychedelic approval could arrive sometime this year.

12 Jan 2024

·www.drugs.com

Perinatal Depression Triples Risk for Suicidal Behavior

FRIDAY, Jan. 12, 2024 -- Mothers with clinically diagnosed perinatal depression ( PND ) had a three times higher risk for suicidal behavior than mothers without perinatal depression, according to a study published online Jan. 9 in JAMA Network Open . Hang Yu, from the Karolinska Institutet in Stockholm, and colleagues examined the association between PND and risk for short- and long-term suicidal behavior. The analysis included 86,551 women with PND (2001 to 2017) and 865,510 unaffected women individually matched on age and calendar year at delivery. During a median 6.91 years of follow-up, the researchers found that more events of suicidal behavior (incidence rate [IR], 5.62 per 1,000 person-years) were identified among women with PND compared with unaffected women (IR, 1.01 per 1,000 person-years). Compared with unaffected women, women with PND also had an elevated risk for suicidal behavior (hazard ratio [HR], 3.15). Risk was somewhat attenuated when comparing PND women with their PND-free sisters (HR, 2.75). In a matched analysis, the association was greater for postnatal depression and among women without a history of psychiatric disorders. In the first year after diagnosis, the excess risk was pronounced (HR, 7.20), but remained statistically significant over five to 18 years of follow-up (HR, 2.34). "These findings suggest that vigilant clinical monitoring and interventions are needed for this vulnerable population to prevent such devastating events," the authors write. One author disclosed ties to the pharmaceutical industry. Abstract/Full Text Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions. Posted January 2024 More news resources FDA Medwatch Drug Alerts Daily MedNews News for Health Professionals New Drug Approvals New Drug Applications Drug Shortages Clinical Trial Results Generic Drug Approvals Subscribe to our newsletter Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

Clinical Result

12 Jan 2024

·www.pharmaceutical-technology.com

FDA yet to find link between suicidal risk and GLP-1RA use

The FDA released an update on its investigation of the association between GLP1RA use and suicidal risk. Credit: ormezz via Shutterstock The US Food and Drug Administration (FDA) released an update on its evaluation of suicidal risk related to glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Free Report How is the Biopharmaceutical industry evolving? 2021 was a year of continued innovation and change in the Biopharmaceutical industry. As the COVID-19 pandemic continues to take its toll on businesses worldwide, it’s time to look for new ways to create value, prepare for the future, and remain competitive in the ever-changing landscape. GlobalData’s expansive report examines the business environment and trends that shape the Biopharmaceutical industry. We highlight the most impactful emerging technologies, as well as the industry, regulatory, and macroeconomic factors that influence growth prospects. Access the report to: Benchmark the impact of major themes on the Biopharmaceutical industry. Gain a deeper "on the ground" perspective through exclusive opinions and analysis from industry respondents. Evaluate the effects of COVID-19 on the sector. Download the full report to understand what to expect and how to align your strategies for success. Submit Country Code * UK (+44) USA (+1) Algeria (+213) Andorra (+376) Angola (+244) Anguilla (+1264) Antigua & Barbuda (+1268) Argentina (+54) Armenia (+374) Aruba (+297) Australia (+61) Austria (+43) Azerbaijan (+994) Bahamas (+1242) Bahrain (+973) Bangladesh (+880) Barbados (+1246) Belarus (+375) Belgium (+32) Belize (+501) Benin (+229) Bermuda (+1441) Bhutan (+975) Bolivia (+591) Bosnia Herzegovina (+387) Botswana (+267) Brazil (+55) Brunei (+673) Bulgaria (+359) Burkina Faso (+226) Burundi (+257) Cambodia (+855) Cameroon (+237) Canada (+1) Cape Verde Islands (+238) Cayman Islands (+1345) Central African Republic (+236) Chile (+56) China (+86) Colombia (+57) Comoros (+269) Congo (+242) Cook Islands (+682) Costa Rica (+506) Croatia (+385) Cuba (+53) Cyprus North (+90392) Cyprus South (+357) Czech Republic (+42) Denmark (+45) Djibouti (+253) Dominica (+1809) Dominican Republic (+1809) Ecuador (+593) Egypt (+20) El Salvador (+503) Equatorial Guinea (+240) Eritrea (+291) Estonia (+372) Ethiopia (+251) Falkland Islands (+500) Faroe Islands (+298) Fiji (+679) Finland (+358) France (+33) French Guiana (+594) French Polynesia (+689) Gabon (+241) Gambia (+220) Georgia (+7880) Germany (+49) Ghana (+233) Gibraltar (+350) Greece (+30) Greenland (+299) Grenada (+1473) Guadeloupe (+590) Guam (+671) Guatemala (+502) Guinea (+224) Guinea - 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British (+1284) Virgin Islands - US (+1340) Wallis & Futuna (+681) Yemen (North)(+969) Yemen (South)(+967) Zambia (+260) Zimbabwe (+263) Country * UK USA Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo Democratic Republic of the Congo Cook Islands Costa Rica Côte d"Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Lao Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates US Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Kosovo By downloading this case study, you acknowledge that GlobalData may share your information with GlobalData and that your personal data will be used as described in their Privacy Policy Submit Visit our Privacy Policy for more information about our services, how GlobalData may use, process and share your personal data, including information on your rights in respect of your personal data and how you can unsubscribe from future marketing communications. Our services are intended for corporate subscribers and you warrant that the email address submitted is your corporate email address. Thank you. Please check your email to download the Report. The agency did not find a clear link to suicidal risk through a review of reports of suicidal thoughts or actions received in the FDA Adverse Event Reporting System agency (FAERS) and a meta-analysis of GLP-1 RA clinical trials. Looking at FAERS data, regulators found that reported incidents were often limited in the information provided and did not offer enough evidence to determine a clear relationship with GLP-1 RA use. Furthermore, the large outcome studies and observational studies showed no association between suicidal thoughts or actions and the use of the drug class. Despite this, the agency said that due to the small number of suicidal ideation cases, it would not yet definitively rule out a potential link with GLP-1RA use. The FDA will share its conclusions upon completion of the assessment. The regulator urged patients to continue using GLP-1 RAs, per advice from their healthcare providers. The FDA also reminded healthcare professionals to monitor and advise patients using the drugs, checking, and reporting for “new or worsening depression, suicidal thoughts, or any unusual changes in mood or behaviour”, as per the 11 January update. GLP-1 RAs are a class of drugs that help repair blood glucose control and minimise the risk of heart disease in patients with type 2 diabetes. These therapies are often also used in weight management for obesity. The drugs work by activating GLP-1 receptors in the pancreas, causing an increase in insulin release and reduced glucagon release. In November 2023, the FDA approved Eli Lilly’s Zepbound (tirzepatide) for weight management in obese or overweight patients, making it the 13 th US approval within the drug class. In July 2023, the European Medicines Agency (EMA) discussed its own ongoing review of the relationship between GLP-1RAs and suicidal thoughts. The review began after the Icelandic Medicines Agency flagged reports of suicidal thoughts and self-injury in patients on liraglutide and semaglutide. Drugs using these active ingredients include Novo Nordisk’s Ozempic and Saxenda. At the time of the announcement, the agency was investigating 150 reports of possible cases of self-injury and suicidal thoughts. In the same month, the UK Medicines and Healthcare Products Regulatory Agency (MHRA) announced a similar probe reviewing suicidal risk associated with Ozempic and Saxenda. Free Report How is the Biopharmaceutical industry evolving? 2021 was a year of continued innovation and change in the Biopharmaceutical industry. As the COVID-19 pandemic continues to take its toll on businesses worldwide, it’s time to look for new ways to create value, prepare for the future, and remain competitive in the ever-changing landscape. GlobalData’s expansive report examines the business environment and trends that shape the Biopharmaceutical industry. We highlight the most impactful emerging technologies, as well as the industry, regulatory, and macroeconomic factors that influence growth prospects. Access the report to: Benchmark the impact of major themes on the Biopharmaceutical industry. Gain a deeper "on the ground" perspective through exclusive opinions and analysis from industry respondents. Evaluate the effects of COVID-19 on the sector. Download the full report to understand what to expect and how to align your strategies for success. By GlobalData Submit Country Code * UK (+44) USA (+1) Algeria (+213) Andorra (+376) Angola (+244) Anguilla (+1264) Antigua & Barbuda (+1268) Argentina (+54) Armenia (+374) Aruba (+297) Australia (+61) Austria (+43) Azerbaijan (+994) Bahamas (+1242) Bahrain (+973) Bangladesh (+880) Barbados (+1246) Belarus (+375) Belgium (+32) Belize (+501) Benin (+229) Bermuda (+1441) Bhutan (+975) Bolivia (+591) Bosnia Herzegovina (+387) Botswana (+267) Brazil (+55) Brunei (+673) Bulgaria (+359) Burkina Faso (+226) Burundi (+257) Cambodia (+855) Cameroon (+237) Canada (+1) Cape Verde Islands (+238) Cayman Islands (+1345) Central African Republic (+236) Chile (+56) China (+86) Colombia (+57) Comoros (+269) Congo (+242) Cook Islands (+682) Costa Rica (+506) Croatia (+385) Cuba (+53) Cyprus North (+90392) Cyprus South (+357) Czech Republic (+42) Denmark (+45) Djibouti (+253) Dominica (+1809) Dominican Republic (+1809) Ecuador (+593) Egypt (+20) El Salvador (+503) Equatorial Guinea (+240) Eritrea (+291) Estonia (+372) Ethiopia (+251) Falkland Islands (+500) Faroe Islands (+298) Fiji (+679) Finland (+358) France (+33) French Guiana (+594) French Polynesia (+689) Gabon (+241) Gambia (+220) Georgia (+7880) Germany (+49) Ghana (+233) Gibraltar (+350) Greece (+30) Greenland (+299) Grenada (+1473) Guadeloupe (+590) Guam (+671) Guatemala (+502) Guinea (+224) Guinea - 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British (+1284) Virgin Islands - US (+1340) Wallis & Futuna (+681) Yemen (North)(+969) Yemen (South)(+967) Zambia (+260) Zimbabwe (+263) Country * UK USA Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo Democratic Republic of the Congo Cook Islands Costa Rica Côte d"Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Lao Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates US Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Kosovo By downloading this case study, you acknowledge that GlobalData may share your information with GlobalData and that your personal data will be used as described in their Privacy Policy Submit Visit our Privacy Policy for more information about our services, how GlobalData may use, process and share your personal data, including information on your rights in respect of your personal data and how you can unsubscribe from future marketing communications. Our services are intended for corporate subscribers and you warrant that the email address submitted is your corporate email address. Thank you. Please check your email to download the Report.

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