Future Attempts Research Articles

Analyzing Failed Institutional Change Attempts

Theoretical advances in the study of institutional change center around a productive paradox. While change agents can take strategic action to change institutions, institutions display a remarkable level of formal stability. From this paradox, we expect that attempts to change institutions are an empirical regularity and that many formal change attempts will fail. This article contributes to historical institutionalism by analyzing the political effects of failed formal institutional change attempts on institutional sequences. Failed institutional change attempts could be mere blips, having little effect on subsequent institutional trajectories, or even inoculate against future attempts. Failed attempts could also lay the ideational groundwork, aid in coalition building, and garner concessions for subsequent institutional change, or convince change agents to alter their strategy. The article suggests analytical strategies to assess the effects of failed institutional change attempts, drawing on examples from comparative politics and two extended case illustrations from Italian party politics and the Affordable Care Act in the United States.

Psychological characteristics of suicide attempters among undergraduate college students in China: a cross-sectional study

BackgroundThere is a need to understand the psychological characteristics of suicide attempters to prevent future suicide attempts. This study aims to examine potential differences between individuals who have attempted suicide and those who have not done so, on several risk and protective measures.MethodParticipants were 11,806 undergraduate students from seven provinces in China, of which 237 reported a non-fatal suicide attempt. We used the random numbers generator function within the SPSS to randomly select a control subset of 1185 participants to be used as the comparison group based on a 1:5 case-control ratio. Scores on three commonly used risk measures (depression, hopelessness, and psychache) and three protective measures (social support, self-esteem, and purpose in life) for suicidality were adopted to compare the responses of the two groups.ResultsSuicide attempters had indicated higher Median scores for all three risk factor measurements. Suicide attempters also reported significantly lower Median scores for all three protective factor measurements compared to non-suicide attempters. The results suggest that the suicide attempters’ group had higher risks of suicidality compared to the non-attempter group.ConclusionsSuicide attempters continued to report higher scores of risk factors and lower scores of protective factors, indicating that they may continue to be at a higher likelihood of a suicide attempt. Key protective factors should be identified for each individual in order to deliver appropriate clinical interventions to reduce their risk of reattempting.

Taking Implementation Seriously in the Evaluation of Urban Growth Management Strategies: “Safeguarding the Future” of the Antwerp City-Region

Contemporary evaluations of urban growth management (UGM) strategies often take the shape of quantitative measurements of land values and housing prices. In this paper, we argue that it is of key importance that these evaluations also analyse the policy formulation and implementation phases of growth management strategies. It is in these phases that the institutions and discourses are (trans)formed in which UGM strategies are embedded. This will enable us to better understand the conditions for growth management policies’ success or failure. We illustrate this point empirically with the case of demarcating urban areas in the region of Flanders, Belgium. Using the Policy Arrangement Approach, the institutional dynamics and discursive meanings in this growth instrument’s formulation and implementation phase are unravelled. More specifically, we explain how the Flemish strategic spatial planning vision of restraining sprawl was transformed into one of accommodating growth in the demarcation of the Antwerp Metropolitan Area, epitomised by two different meanings of the phrase “safeguarding the future.” In conclusion, we argue that, in Antwerp, the demarcation never solidified into a stable policy arrangement, rendering it largely ineffective. We end by formulating three recommendations to contribute to future attempts at managing urban growth in Flanders.

Correlation Analysis between GDM and Gut Microbial Composition in Late Pregnancy.

The prevalence of GDM is very high worldwide. The specific pathogenesis of GDM is currently not very clear. Recent research suggests that changes in the intestinal flora during pregnancy play a key role in it. Therefore, this study is aimed at exploring the characteristics of the intestinal flora of patients with gestational diabetes in the third trimester of pregnancy and at finding the intestinal flora with significant differences in healthy pregnant women to provide a basis for future clinical attempts of using intestinal microecological agents to treat gestational diabetes mellitus (GDM). We sequenced the V3-V4 regions of the 16S ribosomal ribonucleic acid (rRNA) gene from stool samples of 52 singleton pregnant women at >28 weeks of gestation. Our results showed that there were significant differences between the NOR group vs. GDM group and the G group vs. LG group among Bacteroides, Firmicutes, and Firmicutes/Bacteroides. At the species level, there were significant differences in the abundance of eight species in the NOR and GDM groups. Among them, the relative abundance of Clostridium_spiroforme, Eubacterium_dolichum, and Ruminococcus_gnavus was positively correlated with FBG, and Pyramidobacter_piscolens was negatively correlated with FBG, whereas there were significant differences in the abundance of five species in the G and LG groups. Functional analysis showed that there were differences in the biosynthesis and metabolism of polysaccharides, digestive system, classification, and degradation of the intestinal microbes between the NOR and GDM groups and between the G and LG groups. These results indicated that the gut microbes between GDM patients in the third trimester of pregnancy and healthy controls had essential characteristic changes and might be involved in the regulation of patients' blood glucose levels.

The Incubator Treatment Development Model: The SAFETY Treatment for Suicidal/Self-Harming Youth

Youths who make suicide attempts or engage in repetitive self-harm are at risk for future suicide attempts and death by suicide or self-harm. This treatment development report focuses on the Safe Alternatives for Teens and Youth (SAFETY) treatment. SAFETY is a 12-week outpatient child and family-centered cognitive-behavioral treatment, informed by dialectical-behavior therapy, and designed to promote safety following a suicide attempt or repeated episodes of self-harm. Previous reports have described results of small open and randomized treatment development trials. Here, we describe our “incubator” treatment development model. Combining scientific rigor with attention to the community context in which treatment is delivered, the incubator model emphasizes laboratory-based treatment development trials and quantitative and qualitative data generated through partnerships with community treatment sites and youth and parent consumers of care. Aims of this approach are to: (1) integrate information from our partners throughout the treatment development process; (2) create a more feasible and easily transportable “youth” and “family” centered treatment; and (3) accelerate the pace with which laboratory-based treatment advances can be incorporated into improvements in community care. We describe our incubator treatment development model and how data generated through our treatment development process and interactions between the laboratory and community teams contributed to the development of the SAFETY treatment.

Who is the African Farmer? The Importance of Actor Representations in the Debate About Biotechnology Crops in Africa

The discussion about the impact of agricultural biotechnology on Africa is deeply divided and contains widely diverging claims about the impact of biotechnology on African farmers. Building upon literature on the ‘good farmer’ that highlights that farmers identities are an important factor in explaining the success or failure of agricultural change, we argue that the identity of the farmer is an undervalued yet crucial aspect for understanding the debate about the impact of agricultural biotechnology on African farmers. In this article we therefore investigate what farmers’ identities are implicated in the arguments about the impact of biotechnology on African farmers. We aim to identify the main fault lines in different accounts of the African biotechnology farmer by analysing the identities ascribed to them in two prominent cases of controversy: the debates at the 2002 World Summit on Sustainable Development in Johannesburg and the discussion about the impact of biotechnology on smallholder farmers in the Makhathini flats in KwaZulu Natal, South Africa. Our findings demonstrate that arguments about biotechnology are informed by diverging conceptions of who the African farmer is, what is important for the African farmer, and what role the African farmer has in relation to agricultural biotechnology. These findings remain relevant for current discussions on gene editing technologies like CRISPR-Cas. Openly discussing these different views on the identity of smallholder farmers is crucial for moving forward in the biotechnology controversy and can inform future attempts to elicit the farmer’s voice.

588 There is a wide variation in cesarean delivery rates by the mother’s country of birth

To compare cesarean delivery rates in the United States (US) by mother’s country of birth. Retrospective analysis of the Centers for Disease Control and Prevention, Natality Live Birth database (2016-2018). We calculated cesarean delivery rates (CDR) for nulliparous, term, vertex, singleton (NTSV) pregnancies separately by the country where the mother was born for deliveries that exceeded a total of 2,000 between 2016-2018. The study included a total of 3,212,843 pregnancies from 44 countries with births of 2,000 births or more between 2016-2018. The countries with the highest CDR (Cuba: 45.1% and Iran: 44.1%) had a nearly 3-times increased cesarean delivery rate compared to countries with the lowest rates (Yemen: 16.6% and Moldova: 18.2%). Our study is the first to show significant differences in cesarean delivery rates among countries of mothers’ births. Women born in the 3 countries with the highest rates had a nearly 3-fold increased cesarean delivery rate when compared to women born in countries with the lowest rates. This discrepancy is much higher than discrepancies between the US States (3-fold versus about 1.5-fold). The reasons for these differences are poorly understood. Future attempts to better understand the cause of high cesarean delivery rates require a better understanding of the impact of a woman’s place of birth and race on cesarean delivery rates.

Geographic potential of the world's largest hornet, Vespa mandarinia Smith (Hymenoptera: Vespidae), worldwide and particularly in North America.

The Asian giant hornet (AGH, Vespa mandarinia) is the world’s largest hornet, occurring naturally in the Indomalayan region, where it is a voracious predator of pollinating insects including honey bees. In September 2019, a nest of Asian giant hornets was detected outside of Vancouver, British Columbia; multiple individuals were detected in British Columbia and Washington state in 2020; and another nest was found and eradicated in Washington state in November 2020, indicating that the AGH may have successfully wintered in North America. Because hornets tend to spread rapidly and become pests, reliable estimates of the potential invasive range of V. mandarinia in North America are needed to assess likely human and economic impacts, and to guide future eradication attempts. Here, we assess climatic suitability for AGH in North America, and suggest that, without control, this species could establish populations across the Pacific Northwest and much of eastern North America. Predicted suitable areas for AGH in North America overlap broadly with areas where honey production is highest, as well as with species-rich areas for native bumble bees and stingless bees of the genus Melipona in Mexico, highlighting the economic and environmental necessity of controlling this nascent invasion.

Polyunsaturated fatty acids as predictors of future suicide attempt

Polyunsaturated fatty acids (PUFAs) and cholesterol are lipids implicated in suicide risk. We prospectively studied plasma glycerophospholipid PUFAs and cholesterol as putative predictors of suicide attempts. In a multicenter cohort study, we enrolled 123 patients admitted to the emergency department (ED) for suicidal ideation or suicide attempt. Clinical assessments were performed, with follow-up telephone evaluations 6, 12, 18, and 24 months later. Blood samples were obtained in the ED and assayed for PUFAs. Using survival analysis, suicide events were not predicted by eicosapentaenoic acid (EPA, HR: -0.83, 95%CI: 0.39–1.76, p = 0.621) or docosahexaenoic acid (DHA, HR: -0.60, 95%CI: 0.19–1.86, p = 0.371). However, higher arachidonic acid (AA) was a trend for a protective factor (HR=0.30, 95%CI: 0.08–1.08, p = 0.065) in the entire trans-diagnostic sample. This protective effect was significant in all participants with a prior suicide attempt history (n = 85; HR=0.16, 95%CI: 0.04–0.67, p = 0.012), and in the subgroup of attempters with major depressive disorder (MDD; n = 55, HR=0.15, 95%CI:0.03–0.76, p = 0.002). Total LDL- and HDL-cholesterol did not predict subsequent suicide events. AA, but not DHA or EPA, positively correlated with baseline depression severity in MDD patients (r = 0.3, p = 0.006). Contrary to our hypothesis that low n-3 PUFA levels would create risk, we found that while higher AA was associated with greater depression severity at baseline, low AA unexpectedly predicted subsequent suicide attempts, the more so in higher-risk patients. Although surprising, this result agrees with a minority of reports concerning n-6 PUFAs and may represent complex interactions with sample characteristics.

Identification of Suicide Attempt Risk Factors in a National US Survey Using Machine Learning

Because more than one-third of people making nonfatal suicide attempts do not receive mental health treatment, it is essential to extend suicide attempt risk factors beyond high-risk clinical populations to the general adult population. To identify future suicide attempt risk factors in the general population using a data-driven machine learning approach including more than 2500 questions from a large, nationally representative survey of US adults. Data came from wave 1 (2001 to 2002) and wave 2 (2004 to 2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). NESARC is a face-to-face longitudinal survey conducted with a national representative sample of noninstitutionalized civilian population 18 years and older in the US. The cumulative response rate across both waves was 70.2% resulting in 34 653 wave 2 interviews. A balanced random forest was trained using cross-validation to develop a suicide attempt risk model. Out-of-fold model prediction was used to assess model performance, including the area under the receiver operator curve, sensitivity, and specificity. Survey design and nonresponse weights allowed estimates to be representative of the US civilian population based on the 2000 census. Analyses were performed between May 15, 2019, and June 10, 2020. Attempted suicide in the 3 years between wave 1 and wave 2 interviews. Of 34 653 participants, 20 089 were female (weighted proportion, 52.1%). The weighted mean (SD) age was 45.1 (17.3) years at wave 1 and 48.2 (17.3) years at wave 2. Attempted suicide during the 3 years between wave 1 and wave 2 interviews was self-reported by 222 of 34 653 participants (0.6%). Using survey questions measured at wave 1, the suicide attempt risk model yielded a cross-validated area under the receiver operator characteristic curve of 0.857 with a sensitivity of 85.3% (95% CI, 79.8-89.7) and a specificity of 73.3% (95% CI, 72.8-73.8) at an optimized threshold. The model identified 1.8% of the US population to be at a 10% or greater risk of suicide attempt. The most important risk factors were 3 questions about previous suicidal ideation or behavior; 3 items from the 12-Item Short Form Health Survey, namely feeling downhearted, doing activities less carefully, or accomplishing less because of emotional problems; younger age; lower educational achievement; and recent financial crisis. In this study, after searching through more than 2500 survey questions, several well-known risk factors of suicide attempt were confirmed, such as previous suicidal behaviors and ideation, and new risks were identified, including functional impairment resulting from mental disorders and socioeconomic disadvantage. These results may help guide future clinical assessment and the development of new suicide risk scales.

Compact polarimetric heterodyning DBR fiber laser sensor with high temperature resistance.

We report on a short-cavity polarization beat-frequency distributed Bragg reflector (DBR) fiber laser that can operate in an unprecedentedly wide range of temperatures from -200∘ C to 500°C. The beat-frequency signal inherited by the intrinsic fiber birefringence enables implementation of the laser as an eligible temperature or hydrostatic pressure sensor. Furthermore, type-IIa Bragg reflectors allow the annealing of high temperature on the laser cavity to suppress the phase noise of the lasing signal effectively. This research will guide future attempts to achieve high-precision sensing and high-performance signal generation using polarized beat-frequency DBR fiber lasers in harsh environments.

Suicidal thoughts, suicidal attempts, and nonsuicidal self-injury among undergraduate health professionals

Background and Aim: Nonsuicidal selfinjury (NSSI) was observed in both males and females, with higher rate among females. NSSI could increase the risk of future suicide attempts. Adolescence is considered as stressful period because of identity crisis, physical growth, coupled with set of decision regarding future profession and personality traits. The study is aimed to find suicidal thoughts, suicidal attempts, extent of the NSSI and its impact on the undergraduate health professionals. Materials and Methods: A cross-sectional study was carried out among medical, dental, and physiotherapy undergraduate college students of Jamnagar, Gujarat. A total of 1850 students were approached, out of them 1050 medical, 500 dental and 300 were physiotherapy students. Participants were requested to fill the pro forma containing following parts: (1) Demographic details, (2) Inventory of Statements about Self-injury, (3) Impact of Non-Suicidal Self-Injury Scale. Results: A total of 1408 students completed the pro forma. Overall 13.99% prevalence rate of NSSI was reported. Female participants had higher prevalence of self-harming behavior than male participants (χ2 = 24.226, P < 0.001). NSSI was related to suicidal thoughts and suicidal attempts with (χ2 = 263.050, P < 0.001) and (χ2 = 197.777, P < 0.001), respectively. A negative correlation was observed with age of onset of NSSI behaviors with and numbers of NSSI behavior (r = −0.317, P < 0.001). Conclusions: Participants engaged in different NSSI behaviors for affect regulation, interpersonal boundaries, sensation seeking, self-punishment, revenge, and self-care. High prevalence of NSSI among young health professionals needs independent clinical attention. There is a need of crisis interventions for the management of self-harming behaviors and to prevent future fetal suicidal attempts.

Brain-Computer Interface-Progress and Prospects

Since the advent of Brain-Computer Interface (BCI), this technology has been significantly contributed modern society in many aspects such as medical and informational science. With further approaches in this interdisciplinary technology and based on current research, BCI is considered to be the potential solution to medical or surgical difficulties such as restoration of neurological function or motor abilities. In this article, the current state of BCI development in multiple platforms was briefly introduced. By organizing and analyzing laboratory data from the state-of-the-art BCI research, this article also illustrated the breakthrough on different BCI systems based on the lab data. The multitude of applications and contributions in medical science and engineering of both invasive and non-invasive systems were also discussed with the help of clinical data. Eventually, the potential and future attempts will be projected and inferred based on the present state of such connection in this article. After comparing and contrasting two types of interfaces and analysis, a conclusion could be made that invasive systems will eventually surpass noninvasive methods in more applications areas due to its preponderance of precise control.

The interaction between suicidal ideation, insomnia symptoms, and student status

Abstract Evidence demonstrates increased vulnerability to thoughts and behaviors related to suicide (i.e., suicidal ideation) in students. This study examined the interaction between insomnia-symptoms and student-status (students vs. non-students) on reports of suicidal thoughts of behaviors. A total of 363 (N = 363) university students and 300 (N = 300) members of the general population provided complete data on measures of insomnia-symptoms and suicidal ideation. Students indicated greater reports of both total and lifetime ideation while also considering suicidal behavior within the past year. However, no differences were observed in reports of possible future attempt(s) and the disclosure of suicidal thoughts and behaviors to another person. Moreover, students presenting concurrent symptoms of insomnia reported significantly elevated levels of suicidal ideation relative to nonstudents. These outcomes highlight the possible role of insomnia symptoms in accentuating suicidal thoughts and behaviors in the student population.

Facing Uncertainty With GIS, Using Non-Normative Tools To Plan Non-Normative Territories. The Case of Dropull

Uncertainty represents an Oxymoron in planning. The truth is that the world, cities, and people have never stood still; they are both complex and indeterminate; therefore, uncertainty refers to the ongoing process of the future. (Klosterman, 1978) GIS enables access to large volumes of data and is a tool for effective decision-making in urban and regional planning. Insofar as it is about predicting the future and anticipating change and addressing both the past and the future of its sites, planning is a process that faces uncertainty eventually (Abbott, 2005). Planning is a form of decision making, which involves data, people, physical territory and social dynamics. (Friedmann, 1987) This paper inquire a step further: what happens with GIS after the plan has come to its full circle. The case of Dropull municipality represented quite a challenge since the newly formed municipality faced a lack of data, informational gap, territorial disparities, and mobility barriers. In attempts to better address these challenges, the team of Polis University, which assisted in the making of the plan, established the possibility of using a tailor-made geographic informational system model as a planning methodology, among others. GIS is defined as an intelligent tool in planning, aimed to develop and support highly complex activities. These challenges were addressed by using GIS mainly oriented towards online data records and overlay of information to bring together both quantitative data with its geographical location. In light of a special emphasis on the question of what happens after the fact, this paper prescribes to Dropull municipality must use this tool to provide both transparency and continuity of information to any future plan attempt.

The Impact of Logistics 4.0 on Performance in Manufacturing Companies: A Pilot Study

The application of Industry 4.0 technologies and technological concepts to logistics processes is termed ‘Logistics 4.0’. However, most of the recent Logistics 4.0 studies are conceptual or theoretical and, therefore, miss an empirical validation of the proposed causal effects on logistics performance, especially in manufacturing companies. By conducting a pilot study in Central Europe, this paper investigates the relationship between Logistics 4.0 concepts and technologies and logistics performance indicators in manufacturing enterprises. As a result, the implementation of smart and lean concepts has a major impact on logistics performance, whereas information and communication technologies, as well as autonomous logistics systems and vehicles, are not completely implemented and exploited yet. The causal model, therefore, was validated in a first step and will be extended by resilience and sustainability output indicators and revalidated in a larger field study in future research attempts.

Pharmacotherapy based on medical genetics for smoking cessation

Indonesia is the fourth highest consumer of cigarettes in the world with an estimated high cost in healthcare expenditure on tobacco-related diseases. Nonetheless, regulations on tobacco products are lax and healthcare provider involvement in aiding smoking cessation is minimal. Generally, a variety of smoking cessation aids exists and medical genetics have come into play to enhance their efficacy. A questionnaire survey was piloted to query participants on their smoking habits, past cessation attempts, opinions on factors related to smoking cessation, and reactions to information that medical genetics could provide within the context of smoking cessation. The findings showed that most participants have attempted cessation without aid. Pharmacotherapy was not used by any respondents while behavioral interventions were scarcely used. Nevertheless, 83% of participants indicated that medical genetics information would be useful in future cessation attempts and that they would consult physicians for advice.

Bitcoin’s Value Proposition: Shorting Expansionary Monetary Policies

In this paper I discuss Bitcoin’s defining features that make it a unique asset. I argue that Bitcoin should not be considered as a single purpose asset only, but rather as a new digital financial asset serving several function. In addition to functioning as a means of payment (at least partially) and a diversification tool, I argue that part of Bitcoin’s value proposition stems from its worth as a short position on modern expansionary monetary policies. Indeed, Bitcoin’s value should rise if expansionary monetary policies are maintained, amounting to a tool to short these policies, which should be considered in future attempts to value Bitcoin. I discuss the role of Bitcoin in the traditional financial system, contrast Bitcoin to gold, consider the implications of the continuance of expansionary policies on Bitcoin, and discuss the impact of the emergence of cryptocurrencies as a new asset class on public policies.

Perception Regarding Care of Attempted Suicide Patients among Nursing Students in Kathmandu University School of Medical Sciences

Background Suicide is an act of deliberately killing oneself. It is a global health problem and is the second leading cause of death in 15 to 29 years. Thus, studying nursing students' perception towards suicide attempters has paramount importance in understanding and addressing the existing gaps in healthcare delivery system. Objective To assess the nursing students' perception towards attempted suicide and to find out the association between perception and selected variables. Method A descriptive, cross sectional design was carried out to assess the nursing students' perception towards suicide attempters in Kathmandu University School of Medical Sciences. The respondents were 193 nursing students. A structured questionnaire was used in order to collect data. Descriptive statistics including frequency, percentage, mean and standard deviation were calculated to summarize the data and inferential statistics, Mann Whitney-U test was used for the association between perception and selected variables. Result A total 193 nursing students participated in this study. The scores between 1 and 2.4 were considered 'positive', 'unsure' or 'uncertain', between 2.5 and 3.4 and negative for 3.5 and above' over all nurses showed relatively negative perception towards suicide attempters. According to results from eight domains of perception, those who did not attend the courses on psychiatry nursing presented higher score, which was found to have significant association with permissiveness, unpredictability and incomprehensibility. A younger nursing student shows significant association with incomprehensibility. Younger nursing student showed statistically significant association with duration of suicide process. Conclusion Nursing students are frequently encountered with attempted suicide patients. Therefore, they must be aware of their attitudes toward this group of patients as part of their professional and therapeutic role. Thus a nurse's positive perception towards attempted suicide can play a key role in communicating and preventing a future suicide attempt.

Self-rated risk as a predictor of suicide attempts among high-risk adolescents

Background. Predicting suicide attempts is a challenging task for clinicians and researchers, particularly among high-risk individuals (i.e. adolescents with lifetime suicide attempts). In this study, we examined whether adolescents were able to predict their own risk of attempting suicide in the future and whether borderline personality disorder (BPD) or depressive symptoms impacted the predictive value of self-ratings.Methods. Structured clinical assessments were conducted at baseline and after 12 months in a high-risk sample of treatment-seeking adolescents (n = 134; 12-17y.; 90% female) with at least one lifetime suicide attempt.Results. During the follow-up period, n = 51 participants (38%) attempted suicide at least once. Self-rated risk was a significant predictor for the recurrence of a suicide attempt, whereas BPD and depression were not. While there was no significant interaction between self-rated risk and BPD, a negative interaction emerged between self-rated risk and depression in the prediction of a suicide attempt. Greater depression severity diminished the predictive value of self-ratings.Limitations. Depression severity was measured using a questionnaire, not a clinical interview. The findings may not be applicable to less burdened samples.Conclusions. Asking high-risk adolescents to rate their own risk of attempting suicide appears to be an easy to apply method in improving the prediction of future suicide attempts in the clinical context.