Optimizing the assessment of suicidal behavior: the application of curtailment techniques

Background: Given their length, commonly used scales to assess suicide risk, such as the Beck Scale for Suicide Ideation (SSI) are of limited use as screening tools. In the current study we tested whether deterministic and stochastic curtailment can be applied to shorten the 19-item SSI, without compromising its accuracy. Methods: Data from 366 patients, who were seen by a liaison psychiatry service in a general hospital in Scotland after a suicide attempt, were used. Within 24 h of admission, the SSI was administered; 15 months later, it was determined whether a patient was re-admitted to a hospital as the result of another suicide attempt. We fitted a Receiver Operating Characteristic curve to derive the best cut-off value of the SSI for predicting future suicidal behavior. Using this cut-off, both deterministic and stochastic curtailment were simulated on the item score patterns of the SSI. Results: A cut-off value of SSI≥6 provided the best classification accuracy for future suicidal behavior. Using this cut-off, we found that both deterministic and stochastic curtailment reduce the length of the SSI, without reducing the accuracy of the final classification decision. With stochastic curtailment, on average, less than 8 items are needed to assess whether administration of the full-length test will result in an SSI score below or above the cut-off value of 6. Limitations: New studies using other datasets should re-validate the optimal cut-off for risk of repeated suicidal behavior after being treated in a hospital following an attempt. Conclusions: Curtailment can be used to simplify the assessment of suicidal behavior, and should be considered as an alternative to the full scale

Wear behaviour of laser melted an ion implanted materials.

The emphasis in this thesis is on the development of wear resistant materials by laser melting. Furthermore, the principle aim is to search for the dislocation characteristics common to the wear process in heterogeneous materials. ... Zie: Summar

Technology 15+. Integration of technology in science subjects in The Netherlands

This presentation draws from experiences obtained from the project 'Technology 15+'. In 1997 the Dutch government decided to integrate aspects of technology in the science subjects of the upper level secondary education. Under the authority of the Ministry of Education the project group "Technology 15+" developed a didactical framework and curriculum materials for the integration of technology and design activities in Science subjects. The project group "Technology 15+" is a co-operation between educational institutes, teacher training centres and the National Institute for Curriculum Development. Where initially the attention was directed towards teaching contents and curriculum development, now the focus is on a wide and durable implementation at all secondary schools. In co-operation with technical colleges, universities, local industry and secondary schools we organize regional networks for supporting design activities in (and outside!) the schools. This support can have different dimensions, e.g.: in service training for science teachers, technical students coaching pupils working at design activities, pupils from secondary schools doing their practical work at the institutes, internet support and visits to industry, etc. In my presentation I will focus on the issues identified within this project and how they have been resolved

Technology for 15+ – integration of technology in the science curriculum of upper level secondary education in the Netherlands

In The Netherlands, as in other countries, there is a growing interest in technological education as a part of general secondary education (for students aged 12 to 18 years). We have an obligatory subject called ‘technology’ for students aged 12 to 15 in the lower level of secondary education, but no continuation in the upper level (for 15 to 18-year-olds). In 1997 the Dutch government decided to integrate aspects of technology into the science subjects of upper level secondary education. Under the authority of the Ministry of Education, the project group ‘Technology 15+’ developed a didactic framework and curriculum materials for the integration of technology and design activities into science subjects. The project group Technology 15+ is a co-operation between educational institutes, teacher training centres and the national institute for curriculum development. Where initially the attention was directed towards teaching content and curriculum development, now the focus is on a wide and durable implementation in all secondary schools. In co-operation with technical colleges, universities, local industry and secondary schools, we organise regional networks for supporting design activities in (and outside) schools. This support can have different dimensions, for example in-service training for science teachers, technical students coaching pupils working on design activities, pupils from secondary schools doing their practical work at the institutes, internet support, and visits to industry. In this paper I will report on this project

Natural environments and suicide mortality in the Netherlands: a cross-sectional, ecological study

Background: Natural outdoor environments, such as green spaces (ie, grass, forests, or parks), blue spaces (ie, visible bodies of fresh or salt water), and coastal proximity, have been increasingly shown to promote mental health. However, little is known about how and the extent to which these natural environments are associated with suicide mortality. Our aim was to investigate whether the availability of green space and blue space within people's living environments and living next to the coast are protective against suicide mortality. Methods: In this cross-sectional, ecological study, we analysed officially confirmed deaths by suicide between 2005 and 2014 per municipality in the Netherlands. We calculated indexes to measure the proportion of green space and blue space per municipality and the coastal proximity of each municipality using a geographical information system. We fitted Bayesian hierarchical Poisson regressions to assess associations between suicide risk, green space, blue space, and coastal proximity, adjusted for risk and protective factors. Findings: Municipalities with a large proportion of green space (relative risk 0·879, 95% credibility interval 0·779–0·991) or a moderate proportion of green space (0·919, 0·846–0·998) showed a reduced suicide risk compared with municipalities with less green space. Green space did not differ according to urbanicity in relation to suicide. Neither blue space nor coastal proximity was associated with suicide risk. The geographical variation in the residual relative suicide risk was substantial and the south of the Netherlands was at high risk. Interpretation: Our findings support the notion that exposure to natural environments, particularly to greenery, might have a role in reducing suicide mortality. If confirmed by future studies on an individual level, the consideration of environmental exposures might enrich suicide prevention programmes