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

Failed resuscitation of a newborn due to congenital tracheal agenesis: a case report

Tracheal agenesis is a rare congenital condition. It usually presents as an unexpected emergency during resuscitation of a newborn in the delivery room. The condition is almost always fatal in the resuscitation phase, but also when the neonate survives the long term prognosis remains poor. We present a case of tracheal agenesis, discuss its presenting symptoms and possibilities for antenatal diagnosis and review the therapeutic options

Standardized videos in addition to the surgical curriculum in Medical Education for surgical clerkships:a cohort study

BACKGROUND: Medical students are expected to translate the theoretical knowledge gained during their study to practical knowledge during the clerkships. A surgical educational platform with standardized videos may be the solution. However, the effects of a structured online video-based platform in addition to the standard curriculum on students’ self-reported and tested surgical knowledge during the surgical clerkship must be assessed. METHODS: Fourth-year medical students (n = 178) participated in a 6-week course of theoretical and practical training followed by a 10-week in-hospital clerkship in the Erasmus University Medical Center (Erasmus MC), Rotterdam, The Netherlands and 11 affiliated general hospitals. Ninety students followed the usual surgical curriculum (control group), followed by 88 students who were given voluntary access to a video-based surgical educational platform of Incision Academy (video group). At the start (T0) and end (T1) of the clerkship, both groups filled out a surgical knowledge test and a survey regarding their self-reported surgical knowledge and their access to available study sources. Supervisors were blinded and surveyed concerning students’ performance and their acquired knowledge. We analyzed the data using paired and unpaired student t-tests and linear regression. RESULTS: At the end of the clerkship, students in the video group indicated that they had better resources at their disposal than the control group for surgical procedures (p = 0.001). Furthermore, students in the video group showed a greater increase in self-reported surgical knowledge during their clerkship (p = 0.03) and in more objectively tested surgical knowledge (p < 0.001). CONCLUSIONS: An online surgical educational platform with standardized videos is a valuable addition to the current surgical curriculum according to students and their supervisors. It improves their test scores and self-reported surgical knowledge. Students feel better prepared and more able to find the information necessary to complete the clerkship. TRIAL REGISTRATION: Registry not necessary according to ICMJE guidelines. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-022-03314-w

The nature of social work research by Dutch universities of applied sciences:An overview

The knowledge base for Social Work is strengthening. Underpinning of Social Work deriving from scientific research is necessary given the growing complexity of the work and its context. How this research should be conducted and to what type of outcomes it must lead, is part of an ongoing debate. In the Netherlands, practice-based research at Universities of Applied Sciences (UAS) is a relative new approach. Social Work research groups at UAS assert to conduct practice-based research in order to contribute to knowledge and support the objectives of Social Work. The current study was carried out to obtain insight into the characteristics of this research approach. A sample of publications was analysed in terms of knowledge purpose, methodology, and level and type of participation. Results show a strong focus on producing descriptive knowledge and to a lesser extent on control knowledge, using primarily qualitative research methods, and with limited direct participation by stakeholders. In order to practice more what they preach the research can strengthen by doing more empirical research, by diversifying the research in terms of design and methods and increasing the level of participation of stakeholder

Applicability and accuracy of an intraoral scanner for scanning multiple implants in edentulous mandibles:A pilot study

Statement of problem. In the past 5 years, the use of intraoral digitizers has increased. However, data are lacking on the accuracy of scanning implant restorative platforms for prosthodontics with intraoral digitizers. Purpose. The purpose of this clinical pilot study was to assess the applicability and accuracy of intraoral scans by using abutments designed for scanning (scan abutments) in edentulous mandibles. Material and methods. Twenty-five participants with complete mandibular overdentures retained by 2 implants and frameworks were included in this study. Scan abutments were placed on the implants intraorally and scanned with the iTero intraoral scanner. Also, scan abutments were placed on the implant analogs of the definitive casts and scanned with an extraoral laboratory scanner (Lava Scan ST scanner). Two 3-dimensional computer-aided design models of the scan abutments with predetermined center lines were subsequently imported and registered, together with each of the scanned equivalents. The distance between the centers of the top of the scan abutments and the angulations between the scan abutments was assessed. These values were compared with the measurements made on the 3-dimensional scans ofthe definitive casts, which were the participants' original definitive casts used for fabrication of soldered bars. The threshold for distance error was established to be 100 mu m. Results. Four of the 25 intraoral scans were not suitable for research because the intraoral scanner was not able to stitch the separate scans together. Five of the 21 suitable scans demonstrated an interimplant distance error >100 Rm. Three of the 25 intraoral scans showed interimplant angulation errors >0.4 degrees. Only 1 scan showed both an acceptable interimplant distance ( Conclusions. Based on the intraoral scans obtained in this study, distance and angulation errors were too large to fabricate well-fitting frameworks on implants in edentulous mandibles. The main reason for the unreliable scans seemed to be the lack of anatomic landmarks for scanning

Development and evaluation of a novel contamination device that targets multiple life-stages of Aedes aegypti.

BACKGROUND: The increasing global threat of Dengue demands new and easily applicable vector control methods. Ovitraps provide a low-tech and inexpensive means to combat Dengue vectors. Here we describe the development and optimization process of a novel contamination device that targets multiple life-stages of the Aedes aegypti mosquito. Special focus is directed to the diverse array of control agents deployed in this trap, covering adulticidal, larvicidal and autodissemination impacts. METHODS: Different trap prototypes and their parts are described, including a floater to contaminate alighting gravid mosquitoes. The attractiveness of the trap, different odor lures and floater design were studied using fluorescent powder adhering to mosquito legs and via choice tests. We demonstrate the mosquitocidal impacts of the control agents: a combination of the larvicide pyriproxyfen and the adulticidal fungus Beauveria bassiana. The impact of pyriproxyfen was determined in free-flight dissemination experiments. The effect on larval development inside the trap and in surrounding breeding sites was measured, as well as survival impacts on recaptured adults. RESULTS: The developmental process resulted in a design that consists of a black 3 Liter water-filled container with a ring-shaped floater supporting vertically placed gauze dusted with the control agents. On average, 90% of the mosquitoes in the fluorescence experiments made contact with the gauze on the floater. Studies on attractants indicated that a yeast-containing tablet was the most attractive odor lure. Furthermore, the fungus Beauveria bassiana was able to significantly increase mortality of the free-flying adults compared to controls. Dissemination of pyriproxyfen led to >90% larval mortality in alternative breeding sites and 100% larval mortality in the trap itself, against a control mortality of around 5%. CONCLUSION: This ovitrap is a promising new tool in the battle against Dengue. It has proven to be attractive to Aedes aegypti mosquitoes and effective in contaminating these with Beauveria bassiana. Furthermore, we show that the larvicide pyriproxyfen is successfully disseminated to breeding sites close to the trap. Its low production and operating costs enable large scale deployment in Dengue-affected locations

Ga+, In+ and Tl+ Impurities in Alkali Halide Crystals: Distortion Trends

A computational study of the doping of alkali halide crystals (AX: A = Na, K; X = Cl, Br) by ns2 cations (Ga+, In+ and Tl+) is presented. Active clusters of increasing size (from 33 to 177 ions) are considered in order to deal with the large scale distortions induced by the substitutional impurities. Those clusters are embedded in accurate quantum environments representing the surrounding crystalline lattice. The convergence of the distortion results with the size of the active cluster is analyced for some selected impurity systems. The most important conclusion from this study is that distortions along the (100) and (110) crystallographic directions are not independent. Once a reliable cluster model is found, distortion trends as a function of impurity, alkali cation and halide anion are identified and discussed. These trends may be useful when analycing other cation impurities in similar host lattices.Comment: LaTeX file. 7 pages and 2 pictures. Accepted for publication in J. Chem. Phy

Media awards for responsible reporting of suicide: Experiences from Australia, Belgium and Denmark

<p>Abstract</p> <p>Background</p> <p>Media awards to encourage responsible reporting of suicide have been introduced in several countries, including Australia, Belgium and Denmark.</p> <p>Aims</p> <p>This study aimed to examine the experiences of Australian, Belgian and Danish award recipients in preparing stories on suicide, and consider the impacts of the awards for these recipients and for media professionals more broadly.</p> <p>Method</p> <p>We conducted semi-structured telephone interviews with the majority (14 out of 15) of past recipients of the awards in the three countries of interest.</p> <p>Results</p> <p>Media awards appear to show promise as a method of reinforcing national and international media guidelines on reporting suicide. The recipients of awards were proud to have had their achievements recognized in this way, and had developed a heightened awareness of the issues inherent in reporting suicide. Although relatively few had prepared subsequent stories on suicide, a number had been given opportunities to provide advice to other media professionals about how best to approach this sensitive topic. Recipients viewed the awards as an important means by which good quality reporting can be rewarded, and a springboard for raising community awareness about suicide.</p> <p>Conclusion</p> <p>The experience from Australia, Belgium and Denmark suggests that media awards which recognize responsible reporting of suicide are extremely worthwhile.</p

Conservative Management of Patent Ductus Arteriosus in Preterm Infants-A Systematic Review and Meta-Analyses Assessing Differences in Outcome Measures Between Randomized Controlled Trials and Cohort Studies

Objective: This study aims to evaluate outcome after conservative management (no pharmacological/surgical intervention other than fluid restriction, diuretics, or ventilator adjustments) compared with active (pharmacological and/or surgical) treatment for patent ductus arteriosus (PDA) in preterm infants and analyze differences in outcome between randomized controlled trials (RCTs) and cohort studies. Study Design: This is a systematic literature review using PubMed, EMBASE, and Cochrane library. RCTs and cohort studies comparing conservative management with active treatment were included. Meta-analysis was used to compare conservative management with any active (pharmacological and/or surgical), any pharmacological (non-prophylactic and prophylactic), and/or surgical treatment for mortality as primary and major neonatal morbidity as secondary outcome measure. Fixed-effect analysis was used, unless heterogeneity (I2) was >50%. Outcome is presented as relative risk (RR) with 95% confidence interval. Results: Twelve cohort studies and four RCTs were included, encompassing 41,804 and 720 patients, respectively. In cohort studies, conservative management for PDA was associated with a significantly higher risk for mortality (RR, 1.34 [1.12-1.62]) but a significantly lower risk for bronchopulmonary dysplasia (RR, 0.55 [0.46-0.65]), necrotizing enterocolitis (RR, 0.85 [0.77-0.93]), intraventricular hemorrhage (RR, 0.88 [0.83-0.95]), and retinopathy of prematurity (RR, 0.47 [0.28-0.79]) compared with any active PDA treatment. Meta-analysis of the RCTs revealed no significant differences in outcome between conservative management and active treatment. Conclusion: No differences in mortality or morbidity for conservative management compared with active treatment regimens were observed in RCTs. Findings from cohort studies mainly highlight the lack of high-quality evidence for conservative management for PDA in preterm infants