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Risk of suicide-related behaviors is elevated among military personnel transitioning to civilian life. An earlier report showed that high-risk U.S. Army soldiers could be identified shortly before this transition with a machine learning model that included predictors from administrative systems, self-report surveys, and geospatial data. Based on this result, a Veterans Affairs and Army initiative was launched to evaluate a suicide-prevention intervention for high-risk transitioning soldiers. To make targeting practical, though, a streamlined model and risk calculator were needed that used only a short series of self-report survey questions.
Methods
We revised the original model in a sample of n = 8335 observations from the Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study (STARRS-LS) who participated in one of three Army STARRS 2011–2014 baseline surveys while in service and in one or more subsequent panel surveys (LS1: 2016–2018, LS2: 2018–2019) after leaving service. We trained ensemble machine learning models with constrained numbers of item-level survey predictors in a 70% training sample. The outcome was self-reported post-transition suicide attempts (SA). The models were validated in the 30% test sample.
Results
Twelve-month post-transition SA prevalence was 1.0% (s.e. = 0.1). The best constrained model, with only 17 predictors, had a test sample ROC-AUC of 0.85 (s.e. = 0.03). The 10–30% of respondents with the highest predicted risk included 44.9–92.5% of 12-month SAs.
Conclusions
An accurate SA risk calculator based on a short self-report survey can target transitioning soldiers shortly before leaving service for intervention to prevent post-transition SA.
The transition from military service to civilian life is a high-risk period for suicide attempts (SAs). Although stressful life events (SLEs) faced by transitioning soldiers are thought to be implicated, systematic prospective evidence is lacking.
Methods
Participants in the Army Study to Assess Risk and Resilience in Servicemembers (STARRS) completed baseline self-report surveys while on active duty in 2011–2014. Two self-report follow-up Longitudinal Surveys (LS1: 2016–2018; LS2: 2018–2019) were subsequently administered to probability subsamples of these baseline respondents. As detailed in a previous report, a SA risk index based on survey, administrative, and geospatial data collected before separation/deactivation identified 15% of the LS respondents who had separated/deactivated as being high-risk for self-reported post-separation/deactivation SAs. The current report presents an investigation of the extent to which self-reported SLEs occurring in the 12 months before each LS survey might have mediated/modified the association between this SA risk index and post-separation/deactivation SAs.
Results
The 15% of respondents identified as high-risk had a significantly elevated prevalence of some post-separation/deactivation SLEs. In addition, the associations of some SLEs with SAs were significantly stronger among predicted high-risk than lower-risk respondents. Demographic rate decomposition showed that 59.5% (s.e. = 10.2) of the overall association between the predicted high-risk index and subsequent SAs was linked to these SLEs.
Conclusions
It might be possible to prevent a substantial proportion of post-separation/deactivation SAs by providing high-risk soldiers with targeted preventive interventions for exposure/vulnerability to commonly occurring SLEs.
The Yellow Chat Epthianura crocea is comprised of three disjunct subspecies. Subspecies E. c. macgregori (Capricorn Yellow Chat) is listed as Critically Endangered under the EPBC Act and has a distribution that also appears to be disjunct, with a limited geographic area of less than 7,000 ha. Some populations are threatened by rapid industrial development, and it is important for conservation of the subspecies to determine the extent to which the putative populations are connected. We used 14 microsatellite markers to measure genetic diversity and to determine the extent of gene flow between two disjunct populations at the northern and southern extremes of the subspecies’ range. No significant differences in genetic diversity (number of alleles and heterozygosity) were observed, but clear population structuring was apparent, with obvious differentiation between the northern and southern populations. The most likely explanation for reduced gene flow between the two populations is either the development of a geographic barrier as a consequence of shrinkage of the marine plains associated with the rise in sea levels following the last glacial maxima, or reduced connectivity across the largely unsuitable pasture and forest habitat that now separates the two populations, exacerbated by declining population size and fewer potential emigrants. Regardless of the mechanism, restricted gene flow between these two populations has important consequences for their ongoing conservation. The relative isolation of the smaller southern groups (the Fitzroy River delta and Curtis Island) from the much larger northern group (both sides of the Broad Sound) makes the southern population more vulnerable to local extinction. Conservation efforts should focus on nature refuge agreements with land owners agreeing to maintain favourable grazing management practices in perpetuity, particularly in the northern area where most chats occur. Supplemental exchanges of individuals from northern and southern populations should be explored as a way of increasing genetic diversity and reducing inbreeding.
Introduced accidentally from South America, deeproot sedge is rapidly expanding in a variety of habitats throughout the southeastern United States. Of particular concern is its rapid expansion, naturalization, and formation of monocultures in Texas coastal prairie, one of the most imperiled temperate ecoregions in North America. The objective of this research was to examine how deeproot sedge responds to prescribed fire, to the herbicide imazapic, and to treatment combinations of both. Combinations of prescribed fire and imazapic treatments and imazapic-only treatments effectively reduced deeproot sedge cover and frequency. However, plots exposed to dormant season fires (with no imazapic) had greater deeproot sedge cover after burn treatments were applied, indicating that coastal prairie management using only dormant season prescribed fire will not work toward reduction or management of this exotic invasive species. Although deeproot sedge cover was often reduced in fire–imazapic treatment combinations, it was still present in treatment plots. Moreover, desirable functional plant groups (i.e., native bunchgrasses) did not respond positively to the fire–imazapic treatments, but in some instances, woody plant coverage increased. Repeated, long-term approaches using integrated and coordinated efforts with multiple treatment options will be necessary to restore community structure to desired compositional levels. Such integrated approaches should be effective in reducing deeproot sedge frequency, cover, and extent to more manageable levels throughout its introduced geographic range.
A crucial aspect of behavioural assessment and intervention is the initial interview with the client. Although the interview is the most frequently employed method of assessment, very few published behavioural interview schedules are available to clinicians. The authors present an interview schedule for the behavioural assessment of children's problems. Hopefully, such devices will improve the reliability and validity of problem identification and facilitate effective case management.
Edited by
Alex S. Evers, Washington University School of Medicine, St Louis,Mervyn Maze, University of California, San Francisco,Evan D. Kharasch, Washington University School of Medicine, St Louis
There are tantalizing glimpses of the intrinsic ability of the human immune system to control emerging cancer cells. This is seen most clearly in EBV-associated B-cell tumours which emerge in patients undergoing immunosuppression following organ transplantation. Humoral immune responses against tumour antigens of melanoma and of epithelial malignancies have also been detected in patients. However, when patients have cancer, the tumour cells have obviously evaded any immunological weapons. Vaccination as a treatment has to be able to activate a defeated immune system, in a situation where tumour antigens may still be present, and where the patient may be debilitated by disease or treatment.
Tumours of B lymphocytes are attractive for study because of the availability of cells, and because of an increasing understanding of the array of potential target molecules expressed at the cell surface. There is also a clinical need to develop new treatments for the many categories for which chemotherapy has not improved survival. However, these tumours exist despite exposure to the full power of the immune system. If we can succeed in activating an antitumour response against B-cell tumours, therefore, we should be in a strong position to attack other cancers which are less exposed. Molecular technology is facilitating vaccine development in three ways: first, by revealing novel tumour antigens; second, by aiding our understanding of immune mechanisms; and third, by facilitating new delivery systems to mobilize those mechanisms.
This review will focus on malignancies arising from B lymphocytes.
Soil temperature can influence the functioning of roots in many ways. If soil moisture and nutrient availability are adequate, rates of root length extension and root mortality increase with increasing soil temperature, at least up to an optimal temperature for root growth, which seems to vary among taxa. Root growth and root mortality are highly seasonal in perennial plants, with a flush of growth in spring and significant mortality in the fall. At present we do not understand whether root growth phenology responds to the same temperature cues that are known to control shoot growth. We also do not understand whether the flush of root growth in the spring depends on the utilization of stored nonstructural carbohydrates, or if it is fueled by current photosynthate. Root respiration increases exponentially with temperature, but Q10 values range widely from c. 1.5 to > 3.0. Significant questions yet to be resolved are: whether rates of root respiration acclimate to soil temperature, and what mechanisms control acclimation if it occurs. Limited data suggest that fine roots depend heavily on the import of new carbon (C) from the canopy during the growing season. We hypothesize that root growth and root respiration are tightly linked to whole-canopy assimilation through complex source–sink relationships within the plant. Our understanding of how the whole plant responds to dynamic changes in soil temperature, moisture and nutrient availability is poor, even though it is well known that multiple growth-limiting resources change simultaneously through time during a typical growing season. We review the interactions between soil temperature and other growth-limiting factors to illustrate how simple generalizations about temperature and root functioning can be misleading.
A systematic relationship between the acoustic structure and phonemic content of speech raises the possibility that processing strategies similar to those described in animals with highly specialized hearing may also operate in the human brain. This idea could be tested by analyzing animal communication calls into locus equations and using those as stimulus tools in neurophysiological studies of auditory neurons.
It might seem odd to suggest that the study of bird song needs a social agenda. Isn't it obvious that birds sing to attract or to repel one another? Isn't it now clear that birds need social experience to develop species-typical repertoires? Although the answer to these questions is “yes,” we are convinced that only the surface structure of social influence has been uncovered – the deep structure remains to be explored. The purpose of the chapter is to defend this position by examining some of our own efforts to study social influences. We begin with an account of some of the formative experiences that shaped the directions of our research. We follow with some of the historical themes that guided us and others studying songbirds. Then, we describe some of our most recent efforts to examine new themes relevant to avian communication, themes quite familiar to those studying primates. In particular, we focus on the difference between communicative form and communicative competence. We wish to draw a greater distinction between the processes involved in developing a potentially communicative signal and the processes involved in learning how to use those signals effectively (Seyfarth & Cheney 1986 and see Chapter 13; Snowdon et al., Chapter 12). We conclude that analyses restricted only to the structural nature of vocal signals are inadequate to capture the developmental processes leading to vocal communication. We must go beyond studies of songs and focus on the singers, listeners, and the contexts framing communication.
FLASHBULB MEMORIES: A BIOASSAY OF SONG, A BIOASSAY OF SINGERS
In May of 1973, we witnessed an event that led to a series of studies spanning the next two decades.
High resolution optical spectroscopy of V795 Herculis shows complex time- and phase-dependent behaviour of the disk emission. Separate low- and high-velocity fluctuations phased on the 2.6 hr orbital period are observed in the wings of the Balmer lines, prompting a gas stream overflow model.