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Suicide plans and attempts rarely occur without prior suicidal ideation but are hard to predict. Early intervention efforts need to focus on subgroups of the population who are more likely to transition from ideation to suicidal plans and attempts. The current study utilised data from a large nationally representative sample to investigate the time taken to transition and the demographic and mental health correlates of transitioning to suicidal plans and attempts among those with suicidal ideation.
Data were from 1237 Australians aged 16–85 years who reported suicidal thoughts at some point in their life. Discrete time survival analysis was used to retrospectively examine the time in years and correlates of transitioning from suicidal ideation to suicide plans and suicide attempt.
The majority of those who transitioned to suicide plans or attempts typically did so within 2 years of first experiencing suicidal ideation. Several factors were independently associated with increased speed to transition, including alcohol use disorder, drug use disorder, major depressive episode, obsessive compulsive disorder, sexual minority status, and non-urban location. Older age, being male, older age of first ideation and greater family support were associated with a slower transition.
The current study suggests that pre-existing mental or substance use disorders, particularly drug use disorder, as well as sexual minority status, sex and greater family support play an important role in the transition from suicidal ideation to plans or attempts. These results highlight the potential importance of suicide prevention programs that aim to improve social connectedness.
Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.
Postprandial glycaemia and insulinaemia are important risk factors for type 2 diabetes. The prevalence of insulin resistance in adolescents is increasing, but it is unknown how adolescent participant characteristics such as BMI, waist circumference, fitness and maturity offset may explain responses to a standard meal. The aim of the present study was to examine how such participant characteristics affect the postprandial glycaemic and insulinaemic responses to an ecologically valid mixed meal. Data from the control trials of three separate randomised, crossover experiments were pooled, resulting in a total of 108 participants (fifty-two boys, fifty-six girls; aged 12·5 (SD 0·6) years; BMI 19·05 (SD 2·66) kg/m2). A fasting blood sample was taken for the calculation of fasting insulin resistance, using the homoeostatic model assessment of insulin resistance (HOMA-IR). Further capillary blood samples were taken before and 30, 60 and 120 min after a standardised lunch, providing 1·5 g/kg body mass of carbohydrate, for the quantification of blood glucose and plasma insulin total AUC (tAUC). Hierarchical multiple linear regression demonstrated significant predictors for plasma insulin tAUC were waist circumference, physical fitness and HOMA-IR (F(3,98) = 36·78, P < 0·001, adjusted R2 = 0·515). The variance in blood glucose tAUC was not significantly explained by the predictors used (F(7,94) = 1·44, P = 0·198). Significant predictors for HOMA-IR were BMI and maturity offset (F(2,102) = 14·06, P < 0·001, adjusted R2 = 0·021). In summary, the key findings of the study are that waist circumference, followed by physical fitness, best explained the insulinaemic response to an ecologically valid standardised meal in adolescents. This has important behavioural consequences because these variables can be modified.
Community forestry has long been regarded as a way to achieve the sustainable management of forest and tree resources while maximizing benefits for those responsible for the custodianship of natural resources. Throughout much of the developing world, forests and the lands they occupy have been increasingly ceded to the management and control of Indigenous peoples and local communities. In the post-conflict environment of Liberia, community forestry has been identified as a means of maximizing the engagement of local communities in forest management initiatives. Liberia’s recent comprehensive National Forestry Policy is an important step forward in this process. The new legislative framework makes it clear that a major reorientation of the forestry sector is required if it is to successfully address the economic challenges facing the country. These challenges concern the need to substantially improve forest governance and to ensure that the forest sector contributes more effectively to the alleviation of poverty and livelihood improvement. While, on paper, the legal framework for community forestry is robust, implementation is falling short due to conflicts over land and resources that have pervaded the Liberian forestry sector for decades. Increased investment in oil palm expansion, artisanal agriculture and broader government-supported logging activities all threaten the implementation of community forestry. Concomitantly, a fundamental lack of capacity at the community level and at the level of the Forestry Department has curtailed early attempts to operationalize community forestry in the country. In this chapter we explore the evolution and development of community forestry in Liberia, and assess prospects for its future implementation. We provide a clear framework of recommendations to address potential constraints to its success.
Vascular cognitive impairment (VCI) post-stroke is frequent but may go undetected, which highlights the need to better screen cognitive functioning following a stroke.
We examined the clinical utility of the Montreal Cognitive Assessment (MoCA) in detecting cognitive impairment against a gold-standard neuropsychological battery.
We assessed cognitive status with a comprehensive battery of neuropsychological tests in 161 individuals who were at least 3-months post-stroke. We used receiver operating characteristic (ROC) curves to identify two cut points for the MoCA to maximize sensitivity and specificity at a minimum 90% threshold. We examined the utility of the Symbol Digit Modalities Test, a processing speed measure, to determine whether this additional metric would improve classification relative to the MoCA total score alone.
Using two cut points, 27% of participants scored ≤ 23 and were classified as high probability of cognitive impairment (sensitivity 92%), and 24% of participants scored ≥ 28 and were classified as low probability of cognitive impairment (specificity 91%). The remaining 48% of participants scored from 24 to 27 and were classified as indeterminate probability of cognitive impairment. The addition of a processing speed measure improved classification for the indeterminate group by correctly identifying 65% of these individuals, for an overall classification accuracy of 79%.
The utility of the MoCA in detecting cognitive impairment post-stroke is improved when using a three-category approach. The addition of a processing speed measure provides a practical and efficient method to increase confidence in the determined outcome while minimally extending the screening routine for VCI.
There is a growing body of evidence highlighting the presence of a single general dimension of psychopathology that can account for multiple associations across mental and substance use disorders. However, relatively little evidence has emerged regarding the validity of this model with respect to a range of factors that have been previously implicated across multiple disorders. The current study utilized a cross-sectional population survey of adolescents (n = 2,003) to examine the extent to which broad psychopathology factors account for specific associations between psychopathology and key validators: poor sleep, self-harm, suicidality, risky sexual behavior, and low self-esteem. Confirmatory factor models, latent class models, and factor mixture models were estimated to identify the best structure of psychopathology. Structural equation models were then estimated to examine the broad and specific associations between each psychopathology indicator and the validators. A confirmatory factor model with three lower-order factors, representing internalizing, externalizing, and psychotic-like experiences, and a single higher-order factor evidenced the best fit. The associations between manifest indicators of psychopathology and validators were largely nonspecific. However, significant and large direct effects were found between several pairwise associations. These findings have implications for the identification of potential targets for intervention and/or tailoring of prevention programs.
There are few very brief measures that accurately identify multiple common mental disorders.
The aim of this study was to develop and assess the psychometric properties of a new composite measure to screen for five common mental disorders.
Two cross-sectional psychometric surveys were used to develop (n = 3175) and validate (n = 3620) the new measure, the Rapid Measurement Toolkit-20 (RMT20) against diagnostic criteria. The RMT20 was tested against a DSM-5 clinical checklist for major depression, generalised anxiety disorder, panic disorder, social anxiety disorder and post-traumatic stress disorder, with comparison with two measures of general psychological distress: the Kessler-10 and Distress Questionnaire-5.
The area under the curve for the RMT20 was significantly greater than for the distress measures, ranging from 0.86 to 0.92 across the five disorders. Sensitivity and specificity at prescribed cut-points were excellent, with sensitivity ranging from 0.85 to 0.93 and specificity ranging from 0.73 to 0.83 across the five disorders.
The RMT20 outperformed two established scales assessing general psychological distress, is free to use and has low respondent burden. The measure is well-suited to clinical screening, internet-based screening and large-scale epidemiological surveys.
Self-report scales that measure the severity of common mental disorders based on subjective signs and symptoms form a critical component in clinical psychology and psychiatry. There are numerous advantages of self-report scales, including increased efficiency with respect to costs and administration time as well as being amenable to electronic administration. However, there are several disadvantages, including susceptibility to nonoptimal response strategies and cross-cultural bias. The current chapter provides an overview of some of the more widely used self-report scales for depression and anxiety in research and clinical settings, with a specific focus on their psychometric properties and cross-cultural applicability. In addition, this chapter discusses the application of modern test theory to self-report scales for common mental disorders, with the aim of improving the reliability, validity, comparability, and efficiency of self-report data.
Pressure to increase food production grows with population growth. Agriculture dominates the global landscape, and more food is being produced than ever before. Yet, a large part of the population is undernourished. Concomitantly, much of the agricultural expansion related to achieving global food security is at the expense of forests ecosystems, critical for biodiversity and the provision of ecosystem services. SDG 2: Zero Hunger seeks to ‘End hunger, achieve food security and nutrition and promote sustainable agriculture’. This chapter explores the potential impacts of achieving SDG 2 on forests and forest-dependent people. It focuses on five of the SDG 2 targets that are closely entwined with forests and forest related livelihoods. It discusses how the current food system polarises food production and forest conservation, when in fact they should, and can, be harmonised. We conclude with observations on the potential trade-offs and synergies between SDG 2 and the other SDGs, emphasizing the need for integrated land use management.
Debating was an important part of schoolgirls’ political education in late Victorian and Edwardian England that has been overlooked in the scholarship on female education and civics instruction. Debates offered middle- and working-class schoolgirls an embodied and interactive education for citizenship. Considering both the content of discussions and the process of debating, this article argues that school debates provided a unique opportunity for girls to discuss political ideas and develop political skills. Debates became intertwined with girls’ peer cultures, challenging contemporary and historiographical assumptions of girlhood apoliticism. Positioning girls as political subjects sheds new light on political change in modern Britain. Schoolgirl debates show how gendered political boundaries were shifting in this period. Within the unique space of the school debating chamber, girls were free to appropriate and subvert ‘masculine’ political subjects and ways of speaking. In mock parliaments, schoolgirls re-created the archetypal male political space of the House of Commons, demonstrating their familiarity with parliamentary politics. Schoolgirl debates therefore foreshadowed initiatives that promoted women's citizenship after partial suffrage was achieved in 1918, and they help to explain how the first women voters were assimilated easily into existing party and constitutional politics.
Community-based screening for mental health problems may increase service
use through feedback to individuals about their severity of symptoms and
provision of contacts for appropriate services.
The effect of symptom feedback on service use was assessed. Secondary
outcomes included symptom change and study attrition.
Using online recruitment, 2773 participants completed a comprehensive
survey including screening for depression (n=1366) or
social anxiety (n=1407). Across these two versions,
approximately half (n=1342) of the participants were
then randomly allocated to receive tailored feedback. Participants were
reassessed after 3 months (Australian New Zealand Clinical Trials
A negative effect of providing social anxiety feedback to individuals was
observed, with significant reductions in professional service use.
Greater attrition and lower intentions to seek help were also observed
Online mental health screening with feedback is not effective for
promoting professional service use. Alternative models of online
screening require further investigation.
Many measures are available for measuring psychological distress in the community. Limited research has compared these scales to identify the best performing tools. A common metric for distress measures would enable researchers and clinicians to equate scores across different measures. The current study evaluated eight psychological distress scales and developed crosswalks (tables/figures presenting multiple scales on a common metric) to enable scores on these scales to be equated.
An Australian online adult sample (N = 3620, 80% female) was administered eight psychological distress measures: Patient Health Questionnaire-4, Kessler-10/Kessler-6, Distress Questionnaire-5 (DQ5), Mental Health Inventory-5, Hopkins Symptom Checklist-25 (HSCL-25), Self-Report Questionnaire-20 (SRQ-20) and Distress Thermometer. The performance of each measure in identifying DSM-5 criteria for a range of mental disorders was tested. Scale fit to a unidimensional latent construct was assessed using Confirmatory Factor Analysis (CFA). Finally, crosswalks were developed using Item Response Theory.
The DQ5 had optimal performance in identifying individuals meeting DSM-5 criteria, with adequate fit to a unidimensional construct. The HSCL-25 and SRQ-20 also had adequate fit but poorer specificity and/or sensitivity than the DQ5 in identifying caseness. The unidimensional CFA of the combined item bank for the eight scales showed acceptable fit, enabling the creation of crosswalk tables.
The DQ5 had optimal performance in identifying risk of mental health problems. The crosswalk tables developed in this study will enable rapid conversion between distress measures, providing more efficient means of data aggregation and a resource to facilitate interpretation of scores from multiple distress scales.
Patterns in above-ground biomass of tropical forests over short altitudinal gradients are poorly known. The aim of this study was to investigate the variation of above-ground biomass with altitude in old-growth forests and determine the importance of changes in floristic composition as a cause of this variation. We used a dataset from 15 1-ha permanent plots established from lowland (200 m asl) to submontane forests (900 m asl) in the Ngovayang Massif, south-western Cameroon. We analysed variation over altitude in two specific functional traits, the potential maximum tree height and the wood density. Forest above-ground biomass decreased from 500–600 Mg ha−1 in lowland plots to around 260 Mg ha−1 at the highest altitudes. The contribution to above-ground biomass of large-tree species (dbh ≥ 70 cm) decreased with altitude, while the contribution of smaller trees was constant. Contribution of the Fabaceae subfamily Caesalpinioideae decreased with altitude, while those of Clusiaceae, Phyllanthaceae and Burseraceae increased. While potential maximum tree height significantly decreased, wood specific gravity displayed no trend along the gradient. Finally, the decrease in above-ground biomass along the short altitudinal gradient can be at least partially explained by a shift in species composition, with large-tree species being filtered out at the highest altitudes. These results suggest that global change could lead to significant shifts in the properties of montane forests over time.
The orang-utan Pongo spp. is protected by national and international legislation, yet populations continue to decline. Many reports implicate local people in the poaching and illegal trade in orang-utans, yet community participation has been promoted as an alternative conservation strategy. To explore how community-based orang-utan conservation could be developed, we conducted a study to understand informal institutions, particularly local people's perceptions, traditional beliefs, taboos, norms and knowledge, related to orang-utan conservation within and around the wetlands of Danau Sentarum. The majority of Dayak communities interviewed practised traditional taboos, which supported the protection of orang-utans and their habitat. Statistical analysis using generalized linear modelling indicated that more orang-utan nests were found in areas with both good habitat condition and strong informal institutions. Despite applying traditional systems that are similar to conservation, local people have negative perceptions about the term ‘conservation’. We describe the underlying causes of these negative perceptions and highlight their implications for conservation programmes and policies. We conclude that conservation of orang-utans and other species should not focus on single species but on maintaining social and natural capital, cultural diversity and ecological functions at various institutional levels and across geographical scales.