Strategies to Stay Alive: Adaptive Toolboxes for Living Well with Suicidal Behavior

Suicidal behavior constitutes a major global problem. Qualitative research utilizing the first-hand experiences of those who have survived attempts to take their own lives can offer much in the way of understanding how to live well despite ongoing suicidal behavior. Given that suicidal intentions and behaviors occur within the person’s subjective construal, the solutions to living—and preferably living well—despite such inclinations must also be subjective and adaptive. The aim of this study was therefore to understand how individuals live with different aspects of their suicidal behavior and their use of effective strategies to protect themselves from future attempts. Thematic analysis of semi-structured, qualitative interviews with 17 participants with lived experience of suicidal behavior from the USA yielded two main themes: (i) the ‘dynamic relationship with suicidal behavior: living with, and through’, and (ii) ‘the toolbox’. Each of these themes had four subthemes. Participants in this study offered important insights into what helped them not just survive ongoing suicidal behavior, but how they created unique toolboxes to continue living, and to live well. These toolboxes contained personalized solutions to dealing with recurring threats to their subjective wellbeing and included diverse solutions from spirituality, pets, peer-support, participating in the arts, through to traditional therapeutic supports. Some participants also discussed the importance of broader social policy and societal changes that help them live. The findings highlight crucial implications for suicide prevention efforts, especially in terms of encouraging collaborations with the lived experience community and furthering a strengths-based approach to mitigating suicidal behaviors. We encourage the clinical community to work in partnership with service-users to enable them to generate effective solutions to living—and living well—through suicidal behavior

Data Analysis with PLSR models

Land condition monitoring information is required for the strategic management of grazing land and for a better understanding of ecosystem processes. Yet, for policy makers and those land managers whose properties are situated within north-eastern Australia's vast Great Barrier Reef catchments, there has been a general lack of geospatial land condition monitoring information. This paper provides an overview of integrated land monitoring activity in rangeland areas of two major Reef catchments in Queensland: the Burdekin and Fitzroy regions. The project aims were to assemble land condition monitoring datasets that would assist grazing land management and support decision-makers investing public funds; and deliver these data to natural resource management(NRM) community groups, which had been given increased responsibility for delivering local environmental outcomes. We describe the rationale and processes used to produce new land condition monitoring datasets derived from remotely sensed Landsat thematic mapper (TM) and high resolution SPOT 5 satellite imagery and from rapid land condition ground assessment. Specific products include subcatchment groundcover change maps, regional mapping of indicative very poor land condition, and stratified land condition site summaries. Their application, integration, and limitations are discussed. The major innovation is a better understanding of NRM issues with respect to land condition across vast regional areas, and the effective transfer of decision-making capacity to the local level. Likewise, with an increased ability to address policy questions from an evidence-based position, combined with increased cooperation between community, industry and all levels of government, a new era has emerged for decision-makers in rangeland management

Stacking sequence selection for defect-free forming of uni-directional ply laminates

In order to meet demands for increased production rates of laminated composite components, aerospace manufacturing is being forced towards highly automated production processes such as forming. However, such automated processes increase the likelihood of inducing defects that lead to manufacturing cost and time inefficiencies which must be avoided. This paper introduces a new compatibility index, based on comparison of minimum energy (resin dominated) modes of adjacent plies that identifies stacking sequences which minimise defect formation. The index is validated using an experimental process where seven laminates with different stacking sequences are formed onto a complex tool geometry using an industrial double diaphragm former. Experimental results confirm that sequences with a high compatibility index produce defect-free parts at elevated temperature. Specifically, sequences with 90° interface angles (high compatibility indices) promote the most formable solutions and continuous 45° interfaces that spiral (e.g. 45/0/-45/90) which have a low compatibility index, produce the most problematic forming conditions owing to a shear locking behaviour. Laminate stacking sequence is thus shown to be a significant contributor, alongside temperature and vacuum rate, to quality of formed parts. The compatibility index method can therefore be used to increase production rate and quality in laminated composite manufacturing, leading to significant cost and efficiency savings.</p

Creating a novel approach to discourse treatment through coproduction with people with aphasia and speech and language therapists

Background: Although spoken discourse is an outcome prioritised by all stakeholders in aphasia rehabilitation, assessment and treatment of discourse are not routine clinical practice. The small evidence base, varied clinical expertise, multiple barriers in the workplace, and challenges for clients in understanding their altered language abilities all contribute to this situation. These factors need serious consideration when developing a new treatment. Involving intended stakeholders as partners in the development process is recommended. This assists with future implementation by ensuring assessment and treatment are practical, feasible, and acceptable to those who will deliver and undertake it. Aims: This paper reports on the coproduction phase of the Linguistic Underpinnings of Narrative in Aphasia (LUNA) research project and describes the levels of partners’ involvement, the outcomes and impact of coproduction, and the factors that influenced it. Methods and procedures: Four partners with aphasia and four speech and language therapists (SLTs) worked with academic team members across a 6-month period to create the LUNA assessment and treatment. Separate sessions were held with partners with aphasia (monthly) and SLTs (fortnightly). Coproduction methods included open discussion, the Someone Who Isn’t Me (SWIM) technique (thinking from others’ perspectives), low and high fidelity prototypes, flexible brainstorming, card sort, and active experimentation with assessment and treatment tasks. Verbal and written information was presented, shared and documented during each session in supportive formats, and each session summarised as accessible minutes. Outcomes and Results: Partners contributed at consultation, cooperation, and co-learning levels during the coproduction phase. Outcomes included joined-up thinking across assessment-goal setting-treatment-desired outcomes; agreed decisions and content for assessment protocol and treatment manual; clarity on personalised, meaningful, and relevant treatment; therapeutic alliance operationalised in treatment manual; and more. Impacts included increased confidence, self-knowledge, pride, validation, peer support, networking, and benefits to SLTs’ services. Coproduction was positively influenced by consistent session structure and conduct, group dynamics, accessible communication methods, active task experimentation, and SWIM technique. Although the process was time and labour intensive, all partners considered this worthwhile. Conclusions: LUNA has exemplified how an inclusive coproduction process can work well despite the language challenges of aphasia. Authors also believe that coproduction with intended users has resulted in products (assessment protocol, treatment manual) that are more practical, feasible, and acceptable to clinicians and clients than if designed by academics alone. This latter claim now needs testing on a wide scale

Intravenous anakinra can achieve experimentally effective concentrations in the central nervous system within a therapeutic time window: results of a dose-ranging study

The naturally occurring antagonist of interleukin-1, IL-1RA, is highly neuroprotective experimentally, shows few adverse effects, and inhibits the systemic acute phase response to stroke. A single regime pilot study showed slow penetration into cerebrospinal fluid (CSF) at experimentally therapeutic concentrations. Twenty-five patients with subarachnoid hemorrhage (SAH) and external ventricular drains were sequentially allocated to five administration regimes, using intravenous bolus doses of 100 to 500 mg and 4 hours intravenous infusions of IL-1RA ranging from 1 to 10 mg per kg per hour. Choice of regimes and timing of plasma and CSF sampling was informed by pharmacometric analysis of pilot study data. Data were analyzed using nonlinear mixed effects modeling. Plasma and CSF concentrations of IL-1RA in all regimes were within the predicted intervals. A 500-mg bolus followed by an intravenous infusion of IL-1RA at 10 mg per kg per hour achieved experimentally therapeutic CSF concentrations of IL-1RA within 45 minutes. Experimentally, neuroprotective CSF concentrations in patients with SAH can be safely achieved within a therapeutic time window. Pharmacokinetic analysis suggests that IL-1RA transport across the blood–CSF barrier in SAH is passive. Identification of the practicality of this delivery regime allows further studies of efficacy of IL-1RA in acute cerebrovascular disease

Global warming and mass extinctions associated with large igneous province volcanism

The coincidence of large igneous province (LIP) eruptions with at least three, if not all of the “Big Five” biotic crises of the Phanerozoic implies that volcanism is a key driver of mass extinctions. Many LIP-induced extinction scenarios invoke global warming, caused primarily (but not exclusively) by greenhouse gases emitted at the site of LIP emplacement and by contact metamorphism of carbon-rich host rocks. Here we explore a) the climate-changing products of volcanism including sulfur dioxide (SO2), carbon dioxide (CO2) and methane (CH4) from eruptions, contact metamorphism, and melting (dissociation) of gas hydrates; b) their deadly effects, including marine anoxia and thermal stress; c) increasingly sophisticated paleotemperature proxies (e.g. δ18O of shell material) through case studies of the best-known LIP-warming-extinction nexi; and d) global warming through the lens of the putative “Anthropocene” extinction

Association of childhood maltreatment and cortisol with the severity and stability of depression symptoms

BACKGROUND: Little is known about patterns of depression symptoms over time in older adults. This study aims to assess the association of childhood maltreatment and cortisol levels with latent classes of depression symptoms over ten years in older adults. METHODS: A total of 752 participants (mean age 61.7±9.5, female 18%) in the Second Manifestations of ARTerial disease-Memory, depression and aging (SMART-Medea) study provided up to twenty measures of depression symptoms over ten years based on the Patient Health Questionnaire-9 (PHQ-9). At baseline, salivary cortisol was measured, and childhood maltreatment was assessed. Responses to the PHQ-9 were indicators in a latent class analysis. Multinomial regression determined associations between class membership and cortisol and maltreatment, adjusting for age, sex, and education. RESULTS: Four distinct classes were identified; never depressed (n=275, 37%), energy/sleep difficulties (n=237, 32%), mild depression symptoms (n=152, 20%) and fluctuating severe depression (n=88, 12%). Childhood maltreatment was associated with mild depression symptoms (OR=1.95, 95% CI: 1.17-3.25) and fluctuating severe depression (OR=3.50, 95% CI: 1.99-6.15). Blunted morning cortisol was associated with energy/sleep difficulties (OR=0.98, 95% CI: 0.95-1.00) and fluctuating severe depression (OR=0.96, 95% CI: 0.92-0.99). There was no evidence for interaction between maltreatment and cortisol. LIMITATIONS: There is limited generalizability due to the cohort consisting of participants with atherosclerosis and being mostly male. This study utilizes retrospective self-reporting of childhood maltreatment. CONCLUSION: Childhood maltreatment and blunted morning cortisol independently contribute to a worse depression course. Blunted morning cortisol may contribute to sub-clinical depression symptoms, specifically difficulties with energy levels and sleep

Copy Number Variation Affecting the Photoperiod-B1 and Vernalization-A1 Genes Is Associated with Altered Flowering Time in Wheat (Triticum aestivum)

The timing of flowering during the year is an important adaptive character affecting reproductive success in plants and is critical to crop yield. Flowering time has been extensively manipulated in crops such as wheat (Triticum aestivum L.) during domestication, and this enables them to grow productively in a wide range of environments. Several major genes controlling flowering time have been identified in wheat with mutant alleles having sequence changes such as insertions, deletions or point mutations. We investigated genetic variants in commercial varieties of wheat that regulate flowering by altering photoperiod response (Ppd-B1 alleles) or vernalization requirement (Vrn-A1 alleles) and for which no candidate mutation was found within the gene sequence. Genetic and genomic approaches showed that in both cases alleles conferring altered flowering time had an increased copy number of the gene and altered gene expression. Alleles with an increased copy number of Ppd-B1 confer an early flowering day neutral phenotype and have arisen independently at least twice. Plants with an increased copy number of Vrn-A1 have an increased requirement for vernalization so that longer periods of cold are required to potentiate flowering. The results suggest that copy number variation (CNV) plays a significant role in wheat adaptation