Assessing suicide ideation among older adults: a systematic review of screening and measurement tools

Objectives: Rates of suicide in older adults may be higher than reported due to poor understandings of presentation of suicide ideation in this group. The objectives of this paper were to (i) review current measurement tools designed for older adults to detect suicide ideation and (ii) assess their psychometric properties. Design: We used a systematic review approach to identify measurement tools developed specifically for older adults without cognitive decline or impairment. Results: Ten articles that reported on a total of seven different measurement tools were identified. These included tools that focused on resiliency to suicide and those that measured risk of suicide behavior. There was wide variation across the articles: some were adaptations of existing scales to suit older populations, others were developed by authors; they varied in length from four to 69 items; a range of settings was used, and there was a mix of self-report and clinician-administered measures. Most displayed good psychometric properties, with both approaches showing similar quality. Limitations in terms of samples, settings, and measurement design are discussed. Conclusion: The case for specific measures for older adults is clear from this review. There appear to be unique factors that should be considered in understanding suicide ideation and behavior among older adults that may not be directly assessed in non-specific measurements. However, there is a need to expand the diversity of individuals included in measurement development to ensure they are appropriate across gender, culture and minority status, and for the views of professionals to be considered

Advanced modulation technology development for earth station demodulator applications

The purpose of this contract was to develop a high rate (200 Mbps), bandwidth efficient, modulation format using low cost hardware, in 1990's technology. The modulation format chosen is 16-ary continuous phase frequency shift keying (CPFSK). The implementation of the modulation format uses a unique combination of a limiter/discriminator followed by an accumulator to determine transmitted phase. An important feature of the modulation scheme is the way coding is applied to efficiently gain back the performance lost by the close spacing of the phase points

Mixed-method study of a conceptual model of evidence-based intervention sustainment across multiple public-sector service settings.

BackgroundThis study examines sustainment of an EBI implemented in 11 United States service systems across two states, and delivered in 87 counties. The aims are to 1) determine the impact of state and county policies and contracting on EBI provision and sustainment; 2) investigate the role of public, private, and academic relationships and collaboration in long-term EBI sustainment; 3) assess organizational and provider factors that affect EBI reach/penetration, fidelity, and organizational sustainment climate; and 4) integrate findings through a collaborative process involving the investigative team, consultants, and system and community-based organization (CBO) stakeholders in order to further develop and refine a conceptual model of sustainment to guide future research and provide a resource for service systems to prepare for sustainment as the ultimate goal of the implementation process.MethodsA mixed-method prospective and retrospective design will be used. Semi-structured individual and group interviews will be used to collect information regarding influences on EBI sustainment including policies, attitudes, and practices; organizational factors and external policies affecting model implementation; involvement of or collaboration with other stakeholders; and outer- and inner-contextual supports that facilitate ongoing EBI sustainment. Document review (e.g., legislation, executive orders, regulations, monitoring data, annual reports, agendas and meeting minutes) will be used to examine the roles of state, county, and local policies in EBI sustainment. Quantitative measures will be collected via administrative data and web surveys to assess EBI reach/penetration, staff turnover, EBI model fidelity, organizational culture and climate, work attitudes, implementation leadership, sustainment climate, attitudes toward EBIs, program sustainment, and level of institutionalization. Hierarchical linear modeling will be used for quantitative analyses. Qualitative analyses will be tailored to each of the qualitative methods (e.g., document review, interviews). Qualitative and quantitative approaches will be integrated through an inclusive process that values stakeholder perspectives.DiscussionThe study of sustainment is critical to capitalizing on and benefiting from the time and fiscal investments in EBI implementation. Sustainment is also critical to realizing broad public health impact of EBI implementation. The present study takes a comprehensive mixed-method approach to understanding sustainment and refining a conceptual model of sustainment

Understanding demographic limiting factors to species recovery: Nest-site suitability and breeding ecology of Phelsuma guentheri on Round Island, Mauritius

The island of Mauritius in the Mascarenes has already suffered high levels of extinction, and habitat destruction and invasive alien species have pushed many of the remaining endemic species to the brink of extinction. Round Island, a small island northeast of Mauritius, is home to remnant populations of several reptile species that were once distributed across Mauritius. One of the most threatened of these is Günther’s gecko Phelsuma guentheri, where despite extensive management efforts, population size remains small and below expectation. We identify determinants of nest-site suitability across Round Island, and examine whether suitable nest sites are a limiting factor for the abundance of P. guentheri. Over one breeding season, we recorded and monitored a high number (269) of nest sites harbouring a total of 1475 eggs. We used the number of eggs at each nest, and the hatching success as proxies for nest-site suitability. To study the reproductive behaviour of P. guentheri, we installed trail cameras at three nest sites. We did not find the expected high frequency of use of hardwood trees as nest sites, as found on Ile aux Aigrettes to the southeast of Mauritius, probably because hardwood trees are still relatively sparse and small on Round Island. Instead, the endemic palm Latania loddigesii was the most used nest sites, harbouring 78.8% of all nests with 56.3% of all eggs. Hatching success was high for palm nest sites (90.6%), rock surfaces (91.8%), and on the endemic screw pine Pandanus vandermeeschii (96%), rates that are similar to that reported from hardwood trees on Ile aux Aigrettes (~90%). Communal nesting occurred on all substrates, with up to five individuals using the same nest site. Egg-laying took place at dusk or at night, lasting around 30 min, whereas hatching occurred mostly during the day, lasting 2–107 min. Females laid eggs every 34 days on average, and produced up to four clutches of 1–2 eggs each within the season. We conclude that P. guentheri does not suffer from nest site limitation on Round Island, and that reproductive success is high in terms of both numbers of eggs laid and hatching success, likely due to ongoing habitat restoration. Further research is needed to investigate the factors inhibiting abundance and distribution of P. guentheri on Round Island

Acceptance and Commitment Therapy in a Low-Income Country in Sub-Saharan Africa: A Call for Further Research

A worsening trend of critical shortages in senior health care workers across low- and middle-income countries (LMICs) in sub-Saharan Africa has been documented for decades. This is especially the case in Ethiopia that has severe shortage of mental health professionals. Consistent with the WHO recommended approach of task sharing for mental health care in LMICs, Acceptance and Commitment Therapy (ACT), which is an empirically validated psychological intervention aimed at increasing psychological flexibility, may be delivered by trained laypersons who have a grassroots presence. In this paper, we discuss the need for and potential role of ACT to be delivered by health extension workers (HEWs) to address mental health care needs across Ethiopia. To this end, we also reviewed previous studies that have examined the effectiveness of ACT-based interventions in African countries including in Nigeria, Sierra Leone, Uganda, and South Africa. All studies revealed significant improvements of various mental health-related outcome measures such as decreased psychological distress and depressive symptoms, or increased subjective wellbeing and life satisfaction in the groups that received an ACT-based intervention. However, to date, there is no study that applied ACT in Ethiopia. Thus, more research is warranted to examine the effectiveness and, if proven successful, to scale up a task sharing approach of an ACT-based intervention being delivered by trained HEWs at a grassroots level, possibly paving the way for an innovative, sustainable mental health service in Ethiopia as well as other African LMICs

Association Between Sense of Coherence and Health Outcomes at 10 and 20 Years Follow-Up: A Population-Based Longitudinal Study in Germany

Background: The sense of coherence (SOC) is reported to influence health, but health may also have an impact on SOC. The objective of this study was to examine the longitudinal associations between SOC and selected self-reported and physician-assessed health outcomes over a period of 10 and 20 years and to determine the predominant direction of the associations. Methods: We conducted a population-based, longitudinal study, involving 392 participants (188 females and 204 males; mean age 43.01 years) who were followed for a median of 10 and 18 years. Analyses of variance were carried out to examine the longitudinal associations between SOC at baseline and health outcomes (i.e., self-rated health status, SHS; physical health status assessed by a physician, PHS; self-reported satisfaction with life, SWL) at follow-ups. The direction of associations was examined using a cross-lagged model on correlation coefficients. Results: There were significant group effects for SOC at baseline on SHS at 20-year follow-up (F = 4.09, p = 0.018, ηp(2) = 0.041), as well as on SWL at 10-year (F = 12.67, p < 0.01, ηp(2) = 0.072) and at 20-year follow-up (F = 8.09, p < 0.1, ηp(2) = 0.069). SHS (r = 0.238, p < 0.01), PHS (r = −0.140, p < 0.05) and SWL (r = 0.400, p < 0.01) predicted SOC at 10-year follow-up stronger than vice versa. The direction of associations between SOC and health parameters at 20-year follow-up was less consistent. Conclusions: The long-term associations between SOC and self-reported and physician-assessed health may be reciprocal in community-dwelling adults. More research is needed to examine the predictive power of health on SOC and whether interventions targeted at improving health parameters, may impact SOC

Abstract platforms of computation

Computational formalisms have been pushing the boundaries of the field of computing for the last 80 years and much debate has surrounded what computing entails; what it is, and what it is not. This paper seeks to explore the boundaries of the ideas of computation and provide a framework for enabling a constructive discussion of computational ideas. First, a review of computing is given, ranging from Turing Machines to interactive computing. Then, a variety of natural physical systems are considered for their computational qualities. From this exploration, a framework is presented under which all dynamical systems can be considered as instances of the class of abstract computational platforms. An abstract computational platform is defined by both its intrinsic dynamics and how it allows computation that is meaningful to an external agent through the configuration of constraints upon those dynamics. It is asserted that a platform’s computational expressiveness is directly related to the freedom with which constraints can be placed. Finally, the requirements for a formal constraint description language are considered and it is proposed that Abstract State Machines may provide a reasonable basis for such a language

Recent Studies of the Cosmic-Ray Latitude Effect at High Altitudes

With an improved Geiger counter telescope, having an angular aperture of about ±15° from its axis, a series of balloon flights was made in August and September, 1947, at seven stations extending from San Antonio, Texas, to Saskatoon, Canada. The axis of the telescope in all cases was oriented in a vertical direction. All sets of equipment were compared with a standard to reduce all results to a common basis. The standard sets, in turn, were compared with an accurately constructed telescope which had been used to make an absolute determination of cosmic-ray intensity at the vertical in Pasadena. Two flights were made from each of the seven stations. The agreement between flights made within a few hours of each other at a given station is very good. Results from two flights made at a given station several days apart are not in general as consistent. Likewise, no monotonic increase of the radiation with increase of latitude was observed. Evidence is presented for rather large fluctuations at high altitudes of the lower energy components of cosmic rays. Some of the reasons for these fluctuations are discussed