Incidence and fatality of serious suicide attempts in a predominantly rural population in Shandong, China : a public health surveillance study

Objectives To estimate the incidence of serious suicide attempts (SSAs, defined as suicide attempts resulting in either death or hospitalisation) and to examine factors associated with fatality among these attempters. Design A surveillance study of incidence and mortality. Linked data from two public health surveillance systems were analysed. Setting Three selected counties in Shandong, China. Participants All residents in the three selected counties. Outcome measures Incidence rate ( per 100 000 person-years) and case fatality rate (%). Methods Records of suicide deaths and hospitalisations that occurred among residents in selected counties during 2009–2011 (5 623 323 person-years) were extracted from electronic databases of the Disease Surveillance Points (DSP) system and the Injury Surveillance System (ISS) and were linked by name, sex, residence and time of suicide attempt. A multiple logistic regression model was developed to examine the factors associated with a higher or lower fatality rate. Results The incidence of SSAs was estimated to be 46 (95% CI 44 to 48) per 100 000 person-years, which was 1.5 times higher in rural versus urban areas, slightly higher among females, and increased with age. Among all SSAs, 51% were hospitalised and survived, 9% were hospitalised but later died and 40% died with no hospitalisation. Most suicide deaths (81%) were not hospitalised and most hospitalised SSAs (85%) survived. The fatality rate was 49% overall, but was significantly higher among attempters living in rural areas, who were male, older, with lower education or with a farming occupation. With regard to the method of suicide, fatality was lowest for non-pesticide poisons (7%) and highest for hanging (97%). Conclusions The incidence of serious suicide attempts is substantially higher in rural areas than in urban areas of China. The risk of death is influenced by the attempter’s sex, age, education level, occupation, method used and season of year.

Jet and flash imprint defectivity - Assessment and reduction for semiconductor applications

Defectivity has been historically identified as a leading technical roadblock to the implementation of nanoimprint lithography for semiconductor high volume manufacturing. The lack of confidence in nanoimprint's ability to meet defect requirements originates in part from the industry's past experiences with 1 × lithography and the shortage in enduser generated defect data. SEMATECH has therefore initiated a defect assessment aimed at addressing these concerns. The goal is to determine whether nanoimprint, specifically Jet and Flash Imprint Lithography from Molecular Imprints, is capable of meeting semiconductor industry defect requirements. At this time, several cycles of learning have been completed in SEMATECH's defect assessment, with promising results. J-FIL process random defectivity of < 0.1 def/cm2 has been demonstrated using a 120nm half-pitch template, providing proof of concept that a low defect nanoimprint process is possible. Template defectivity has also improved significantly as shown by a pre-production grade template at 80nm pitch. Cycles of learning continue on feature sizes down to 22nm. © 2011 SPIE.

Androgen-targeted therapy-induced epithelial mesenchymal plasticity and neuroendocrine transdifferentiation in prostate cancer : an opportunity for intervention

Androgens regulate biological pathways to promote proliferation, differentiation, and survival of benign and malignant prostate tissue. Androgen receptor (AR) targeted therapies exploit this dependence and are used in advanced prostate cancer to control disease progression. Contemporary treatment regimens involve sequential use of inhibitors of androgen synthesis or AR function. Although targeting the androgen axis has clear therapeutic benefit, its effectiveness is temporary, as prostate tumor cells adapt to survive and grow. The removal of androgens (androgen deprivation) has been shown to activate both epithelial-to-mesenchymal transition (EMT) and neuroendocrine transdifferentiation (NEtD) programs. EMT has established roles in promoting biological phenotypes associated with tumor progression (migration/invasion, tumor cell survival, cancer stem cell-like properties, resistance to radiation and chemotherapy) in multiple human cancer types. NEtD in prostate cancer is associated with resistance to therapy, visceral metastasis, and aggressive disease. Thus, activation of these programs via inhibition of the androgen axis provides a mechanism by which tumor cells can adapt to promote disease recurrence and progression. Brachyury, Axl, MEK, and Aurora kinase A are molecular drivers of these programs, and inhibitors are currently in clinical trials to determine therapeutic applications. Understanding tumor cell plasticity will be important in further defining the rational use of androgen-targeted therapies clinically and provides an opportunity for intervention to prolong survival of men with metastatic prostate cancer.

Managing peripheral intravenous devices in the adults' general surgical setting: a best practice implementation report

AIM The aim of this evidence-based practice (EBP) project was to promote adherence to the current best practice in monitoring and optimal replacement of peripheral intravenous device (PIVD). METHODS This EBP project took place in a 30-bed acute general surgical ward. Twenty in-patients with PIVD in situ for 4 days or more were recruited. There were five stages in the project: identification of EBP topic, criteria, sample and setting; baseline; dissemination of baseline audit results and identification of best practice barriers; identification of barriers to EBP and implementation of strategies promoting EBP; and postimplementation audit. RESULTS There were eight criteria in this project. The first audit showed moderate compliance in PIVD monitoring and optimal replacement. The project identified three barriers: lack of awareness of the current evidence-based guidelines, hospital policy not being aligned with current guidelines and no standard form of documentation. In order to overcome these barriers the following strategies were used: audit and feedback, interactive educational meetings, reminders and hospital policy change. The second audit showed minor improvements in each criterion. Compliance with documentation remained a challenge, possibly because of the lack of standardised documentation. DISCUSSION Although the project did not render us the results we aimed for, it was successful because it highlighted the current EBP in PIVD management. The major challenges of the project were time and the lack of opinion leaders in our project team. We felt that more time was needed to adapt to the practice change and standardised documentation could not be developed in such a short time period. Further, the role of the opinion leader proved to be vital in this project. We felt that had we recruited more than one opinion leader, the results would have been different.

DNA molecules and human therapeutics

Nucleic acid molecules are championing a new generation of reverse engineered biopharmaceuticals. In terms of potential application in gene medicine, plasmid DNA (pDNA) vectors have exceptional therapeutic and immunological profiles as they are free from safety concerns associated with viral vectors, display non-toxicity and are simpler to develop. This review addresses the potential applications of pDNA molecules in vaccine design/development and gene therapy via recombinant DNA technology as well as a staged delivery mechanism for the introduction of plasmid-borne gene to target cells via the nasal route.

Ongoing Adaptation as a Feature of Complexity : Further Thoughts and Possible Ideas for Pedagogy in Physical Activity

This chapter takes as its central premise the human capacity to adapt to changing environments. It is an idea that is central to complexity theory but receives only modest attention in relation to learning. To do this we will draw from a range of fields and then consider some recent research in motor control that may extend the discussion in ways not yet considered, but that will build on advances already made within pedagogy and motor control synergies. Recent work in motor control indicates that humans have far greater capacity to adapt to the ‘product space’ than was previously thought, mainly through fast heuristics and on-line corrections. These are changes that can be made in real (movement) time and are facilitated by what are referred to as ‘feed-forward’ mechanisms that take advantage of ultra-fast ways of recognizing the likely outcomes of our movements and using this as a source of feedback. We conclude by discussing some possible ideas for pedagogy within the sport and physical activity domains, the implications of which would require a rethink on how motor skill learning opportunities might best be facilitated.

Applying for funding is the worst part of my job

That’s what one researcher told us when we asked them about applying for NHMRC Project Grant funding. Others said that applying for funding had made them ill, lost them friends, ruined Christmas and caused arguments with friends and family. What makes applying for funding so bad? We’ve tried to summarise the problems with the system in the diagram above. This is based on our group’s four years of research into the funding process. Some of the arrows are based on evidence from our surveys (Survey 1, Survey 2), others are based on anecdote or experience and so maybe wrong. Please let me know if I’ve missed an arrow or an issue.

Designing with people with disabilities : adapting best practices of DIY and organizational approaches

Individualization of design is often necessary particularly when designing with people with disabilities. Maker communities, with their flexible Do-It-Yourself (DIY) practices, offer potential to support individualized and cost-effective product design. However, efforts to adapt DIY practices in designing with people with disabilities tend to face difficulties with regard to continuous commitment, infrastructure provision and proper guidance. We carried out interviews with diverse stakeholders in the disability services sector and carried out observations of local makerspaces to understand their current practices and potential for future collaborations. We found that makerspace participants face difficulties in terms of infrastructure provision and proper guidance whereas Disability Service Organizations face difficulties in continuous expertise. We suggest that artful infrastructuring to blend the best of both approaches offers potential to create a sustainable community that can design individualized technologies to support people with disabilities.

The 'gourmet' sausage factory: Keeping it human

Whilst tertiary institutions continue to invest heavily in the technological aspects of online Teaching & Learning (T&L), there does not appear to have been a commensurate investment in the “human” aspects of the use of the technology. Despite the broad recognition that teaching and learning materials need to be adapted for and to the onscreen medium, little attention appears to have been paid thus far to the actual people who are delivering it – who equally need to “adapt themselves” to that medium, in order to maximise the benefit of the technology by maximising the human communication skills of those using the online medium – as distinct from the technical skills required to drive and deliver the bits and bytes. The REdelivery Initiative was a direct response to that notion. This paper details – by way of a narrative of one of the workshop participants – that part of the process involving the professional development of academics specifically in and specifically for the digital, online, T&L context, in order to both illuminate and maximise the potential and opportunities afforded by the technology.

Locally weighted learning methods for non-rigid robot control

This thesis develops a novel approach to robot control that learns to account for a robot's dynamic complexities while executing various control tasks using inspiration from biological sensorimotor control and machine learning. A robot that can learn its own control system can account for complex situations and adapt to changes in control conditions to maximise its performance and reliability in the real world. This research has developed two novel learning methods, with the aim of solving issues with learning control of non-rigid robots that incorporate additional dynamic complexities. The new learning control system was evaluated on a real three degree-of-freedom elastic joint robot arm with a number of experiments: initially validating the learning method and testing its ability to generalise to new tasks, then evaluating the system during a learning control task requiring continuous online model adaptation.

Effectiveness of an emergency nurse practitioner service for adults presenting to rural hospitals with chest pain : Protocol for a multicentre, longitudinal nested cohort study

Introduction Chest pain is common in emergency department (ED) patients and represents a considerable burden for rural health services. Health services reforms to improve access to care need appropriately skilled and supported clinicians in the delivery of safe and effective care, including the use of emergency nurse practitioners (ENPs). Despite increasing use of ENPs, little is known about the safety and quality of the service in the rural ED context. The aims of this study are (1) to examine the safety and quality of the ENP service model in the provision of care in the rural environment and (2) to evaluate the effectiveness of the service in the management of patients presenting with undifferentiated chest pain. Methods and analysis This is the protocol for a prospective longitudinal nested cohort study to compare the effectiveness of ENP service with that of standard care. Adults presenting to three rural EDs in Queensland, Australia with a primary presenting complaint of atraumatic chest pain will be eligible for enrolment. We will measure (1) clinician's use of evidence-based guidelines (2) diagnostic accuracy of ECG interpretation for the management of patients with suspected or confirmed ACS (3) service indicators of waiting times, length-of-stay and did-not-wait rates and (4) clinician's diagnostic accuracy as measured by rates of unplanned representation within 7 days (5) satisfaction with care, (6) quality-of-life and (7) functional status. To assess these outcomes we will use a combination of measures collected from routinely collected data, medical record review and questionnaires (with 30-day follow-up). Ethics and dissemination Queensland Health Human Research Ethics Committee (HREC) has approved this protocol. The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences.

Analyzing the impact of learning inputs on near-to-far terrain traversability estimation

With the increasing need to adapt to new environments, data-driven approaches have been developed to estimate terrain traversability by learning the rover’s response on the terrain based on experience. Multiple learning inputs are often used to adequately describe the various aspects of terrain traversability. In a complex learning framework, it can be difficult to identify the relevance of each learning input to the resulting estimate. This paper addresses the suitability of each learning input by systematically analyzing the impact of each input on the estimate. Sensitivity Analysis (SA) methods provide a means to measure the contribution of each learning input to the estimate variability. Using a variance-based SA method, we characterize how the prediction changes as one or more of the input changes, and also quantify the prediction uncertainty as attributed from each of the inputs in the framework of dependent inputs. We propose an approach built on Analysis of Variance (ANOVA) decomposition to examine the prediction made in a near-to-far learning framework based on multi-task GP regression. We demonstrate the approach by analyzing the impact of driving speed and terrain geometry on the prediction of the rover’s attitude and chassis configuration in a Marsanalogue terrain using our prototype rover Mawson.

Second-order quantile methods for experts and combinatorial games

We aim to design strategies for sequential decision making that adjust to the difficulty of the learning problem. We study this question both in the setting of prediction with expert advice, and for more general combinatorial decision tasks. We are not satisfied with just guaranteeing minimax regret rates, but we want our algorithms to perform significantly better on easy data. Two popular ways to formalize such adaptivity are second-order regret bounds and quantile bounds. The underlying notions of 'easy data', which may be paraphrased as "the learning problem has small variance" and "multiple decisions are useful", are synergetic. But even though there are sophisticated algorithms that exploit one of the two, no existing algorithm is able to adapt to both. In this paper we outline a new method for obtaining such adaptive algorithms, based on a potential function that aggregates a range of learning rates (which are essential tuning parameters). By choosing the right prior we construct efficient algorithms and show that they reap both benefits by proving the first bounds that are both second-order and incorporate quantiles.

Reconceptualizing green infrastructure for climate change adaptation: Barriers to adoption and drivers for uptake by spatial planners

Urban green infrastructure can help cities adapt to climate change. Spatial planning can play an important role in utilizing green infrastructure for adaptation. Yet climate change risks represent a different sort of challenge for planning institutions. This paper aims to address two issues arising from this challenge. First, it defines the concept of green infrastructure within the context of climate adaptation. Second, it identifies and puts into perspective institutional barriers to adopting green infrastructure for climate adaptation, including path dependence. We begin by arguing that there is growing confusion among planners and policy makers about what constitutes green infrastructure. Definitional ambiguity may contribute to inaction on climate change adaptation, because it muddies existing programs and initiatives that are to do with green-space more broadly, which in turn feeds path dependency. We then report empirical findings about how planners perceive the institutional challenge arising from climate change and the adoption of green infrastructure as an adaptive response. The paper concludes that spatial planners generally recognize multiple rationales associated with green infrastructure. However they are not particularly keen on institutional innovation and there is a tendency for path dependence. We propose a conceptual model that explicitly recognizes such institutional factors. This paper contributes to the literature by showing that agency and institutional dimensions are a limiting factor in advancing the concept of green infrastructure within the context of climate change adaptation.

The space of make: A topological account of the studio

Approaches to art-practice-as-research tend to draw a distinction between the processes of creative practice and scholarly reflection. According to this template, the two sites of activity – studio/desk, work/writing, body/mind – form the ‘correlative’ entity known as research. Creative research is said to be produced by the navigation of world and thought: spaces that exist in a continual state of tension with one another. Either we have the studio tethered to brute reality while the desk floats free as a site for the fluid cross-pollination of texts and concepts. Or alternatively, the studio is characterized by the amorphous, intuitive play of forms and ideas, while the desk represents its cartography, mapping and fixing its various fluidities. In either case, the research status of art practice is figured as a fundamentally riven space. However, the nascent philosophy of Speculative Realism proposes a different ontology – one in which the space of human activity comprises its own reality, independent of human perception. The challenge it poses to traditional metaphysics is to rethink the world as if it were a real space. When applied to practice-led research, this reconceptualization challenges the creative researcher to consider creative research as a contiguous space – a topology where thinking and making are not dichotomous points but inflections in an amorphous and dynamic field. Instead of being subject to the vertical tension between earth and air, a topology of practice emphasizes its encapsulated, undulating reality – an agentive ‘object’ formed according to properties of connectedness, movement and differentiation. Taking the central ideas of Quentin Meillassoux and Graham Harman as a point of departure, this paper will provide a speculative account of the interplay of spatialities that characterise the author’s studio practice. In so doing, the paper will model the innovative methodological potential produced by the analysis of topological dimensions of the studio and the way they can be said to move beyond the ‘geo-critical’ divide.