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Co-developing suicide prevention guidelines for Pakistan: a mixed-methods Delphi consensus study
Get PDFBackground
Suicide is a serious public health concern globally. Many suicide deaths occur in low- and-middle-income countries such as Pakistan, where the stigma related to mental health and suicidal behaviour is high, help-seeking is low, and availability of trained mental health professionals is limited. Community-based suicide prevention programmes such as suicide prevention first-aid guidelines are recognised as cost-effective approaches to strengthen the motivation of local partners within communities and lay public to act. However, there is no such evidence from Pakistan. Therefore, this study aimed to co-develop suicide prevention guidelines for gatekeepers to assist individuals in Pakistan experiencing suicidal ideation or behaviours. This will not only help to prevent or deter suicidal tendency among those experiencing suicidal thought/behaviours but also the stakeholders, especially mental health professionals.
Methods
This Delphi expert consensus study was conducted in two phases: (i) development of a semi-structured questionnaire aimed to develop suicide prevention guidelines. This involved compilation of statements from existing guidelines developed for similar context, followed by a one-day multi-disciplinary stakeholder consultation to review and contextualise each statement. The questionnaire with final statement was translated into Urdu. (ii) Phase 2 involved the Delphi process to co-produce contextually relevant consensus-based set of suicide prevention guidelines endorsed by a diverse panel of experts including expert by profession and expert by experience. Statements describing suicide prevention guideline were rated by the participants in two Delphi rounds, using in-person and online approaches.
Results
A total of 45 experts by profession and 27 lived experience experts from across Pakistan completed both rounds of Delphi. The initial compilation from existing guidelines led to a total of 460 statements, which increased to 564 statements after stakeholder consultation, to be rated in Round-1 of the Delphi. The total number of items describing guidelines accepted at Round-1 and 2 were 478. The statements are organised into eleven thematic sections, including the identification of suicide risk and its severity, initial support for individuals at risk, communication strategies for engaging with suicidal individuals, safety planning, and confidentiality protocols. Stakeholders recommended the inclusion of context-specific guidelines, such as recognising culturally relevant warning signs (e.g., verbal or behavioral expressions of feeling unloved or being forced into an unwanted marriage), advising first responders to adopt a friendly and non-judgmental tone, and assessing the urgency of intervention based on the individual’s mental health status.
Conclusion
The guidelines developed as result of this mixed-method research has successfully engaged stakeholder to contextualise guidelines for Pakistan such as by adding culturally appropriate examples of warning signs, methods used for self-harm and suicide, and reasons of self-harm etc. and Delphi survey to reach consensus. These guidelines co-adapted through consultations with experts by profession and experience will inform much needed public health initiatives to increase awareness and education and build capacity in a wide range of stakeholders across sectors for suicide prevention in Pakistan
Play matters. Why play matters in early childhood
No full textPlay is at the heart of childhood, shaping the way children learn, grow, and connect with the world around them. The Play Matters project is dedicated to championing the importance of play in all aspects of children’s lives, with a particular focus on ensuring that the early years sector recognises and values both play and the child. By providing parents, early childhood professionals and caregivers with practical resources, Play Matters empowers adults to integrate play into daily routines, enriching children’s development. Beyond individual practice, the project also seeks to influence policies and initiatives that prioritise play as a fundamental aspect of child wellbeing. Ultimately, Play Matters aims to foster vibrant communities where every child has the opportunity to experience the joy, creativity, and learning that come through play. A play environment is not just about fun, it is a vital space where children develop essential social and emotional skills. Through play, they form strong relationships, build trust, and learn how to navigate interactions with others. By fostering a play-rich setting, early childhood professionals and caregivers provide children with the foundation for meaningful connections that will support them throughout their lives.
The Play Matters project aims to:
1. Advocate for the value of play in all aspects of children’s lives and more importantly to advocate for an early years sector that values play and the child.
2. Equip parents, early childhood professionals, and caregivers with practical resources to incorporate play into daily routines.
3. Influence policies and practices that prioritise play as an essential component of child development and wellbeing.
4. Foster communities where every child has the opportunity to experience the joy, creativity, and learning that comes through play
The right to life, jus cogens and the death penalty
Get PDFThat the right to life is a peremptory norm (jus cogens) is generally admitted. Although when the right to life is framed in some human rights treaties the issue of capital punishment is excluded to some extent, this was always a concession to retentionist States rather than a recognition that the death penalty was a logical limitation. The notion of jus cogens became an entrenched part of international law subsequent to the adoption of these treaties. Capital punishment cannot be reconciled with the peremptory nature of the right to life
International Criminal Court and International Court of Justice: judging Netanyahu and Putin
No full textLes mandats d’arrêt émis contre Benjamin Netanyahu et Yoav Gallant sont une première, même s’ils ne devraient pas être exécutés dans un avenir proche. La question de l’immunité se pose en raison de l’incohérence entre la jurisprudence de la Cour pénale internationale et celle de la Cour internationale de justice. C’est cette dernière qui fait soudain preuve d’un dynamisme sans précédent.The arrest warrants issued against Benjamin Netanyahu and Yoav Gallant represent a significant development, even if they are unlikely to be enforced in the near future. The question of immunity arises due to inconsistencies between the jurisprudence of the International Criminal Court (ICC) and that of the International Court of Justice (ICJ). Notably, it is the ICJ that has recently displayed an unprecedented degree of dynamism
Gender matters: respectful approaches to gender equity in primary school
No full textTeachers are responsible for inclusive teaching about gender and addressing gender bias through teaching practices. In this Unit Professor Jayne Osgood supports early career teachers to examine ideas about gender in childhood. The unit starts with background information about gender, followed by a description of ways in which restrictive ideas and practices concerning gender in school have come about and how, by engaging in critical reflection on (often unacknowledged) personal prejudices, ideas about gender in childhood can be reappraised. Finally, some practical approaches to pursue more inclusive practices to achieve improved gender equity in primary school are discussed
(Don't) look back: three Portraits of a Lady on Fire
Get PDFThis article explores the dialectical movement of Céline Sciamma’s Portrait of a Lady on Fire (Portrait de la jeune fille en feu, 2019) through close attention to three visual logics, or “portraits” painted by the film. That Portrait of a Lady on Fire offers a cinematic meditation on the “gaze” is self-evident: Marianne’s first painting of Héloïse is created according to an aesthetic logic already described by Laura Mulvey, while the second, co-created painting embodies Sciamma’s declaration that the film is a “manifesto about the female gaze” and inspires Iris Brey’s critical framework in Le regard féminin. To this, I will add a third logic, embodied in the cine-portrait painted by Sciamma/Mathon’s camera in the film’s final shot of Héloïse/Adèle Haenel. I will argue that the encounter with this shot’s duration necessitates a reconsideration of Portrait’s film-philosophical significance as an exploration of the “gaze”, leading us towards a Lacano-Hegelian paradigm. In short, my claim is that – through its modalities of the gaze – Sciamma’s film stages the drama of recognition and its failure described by Hegel in the Phenomenology of Spirit, and in doing so compels us to recognise its dialectical movement from self-consciousness to the absolute, with contradiction as its motor force
Signature-based security analysis and detection of IoT threats in advanced message queuing protocol
Get PDFThe Advanced Message Queuing Protocol (AMQP) is a widely used communication standard in IoT systems due to its robust and reliable message delivery capabilities. However, its increasing adoption has made it a target for various cyber threats, including Distributed Denial of Service (DDoS), Man-in-the-Middle (MitM), and brute force attacks. This study presents a comprehensive analysis of AMQP-specific vulnerabilities and introduces a statistical model for the detection and classification of malicious activities in IoT networks. Leveraging a custom-designed IoT testbed, realistic attack scenarios were simulated, and a dataset encompassing normal, malicious, and mixed traffic was generated. Unique attack signatures were identified and validated through repeated experiments, forming the foundation of a signature-based detection mechanism tailored for AMQP networks. The proposed model demonstrated high accuracy in detecting and classifying attack-specific traffic while maintaining a low false positive rate for benign traffic. Notable results include effective detection of RST packets in DDoS scenarios, precise classification of MitM attack patterns, and identification of brute force attempts on AMQP systems. This research highlights the efficacy of signature-based approaches in enhancing IoT security and offers a benchmark for future machine learning-driven detection systems. By addressing AMQP-specific challenges, the study contributes to the development of resilient and secure IoT ecosystems
Engagement in influencer marketing: a systematic review of key drivers, behaviours, and future research directions
No full textInfluencer marketing research is rapidly evolving, with growing interest in the dynamics between social media influencers and their followers. Engagement, defined as the active interaction between followers and influencers, remains a fragmented area of study, despite valuable insights from recent research. This systematic literature review synthesizes findings from 43 scholarly articles retrieved from the Web of Science database, focusing explicitly on engagement with SMIs. Using the Antecedents, Decisions, Outcomes (ADO) framework, the review categorizes factors influencing engagement into source, content, and audience-related dimensions and integrates them into a comprehensive framework. This framework clarifies how these factors drive various engagement behaviours, such as likes, comments, and shares, and explores conceptualizations of engagement across cognitive, emotional, and behavioural dimensions. By consolidating existing knowledge, identifying gaps, and proposing future research directions, this review enhances theoretical understanding and offers actionable insights for practitioners aiming to increase engagement with social media influencers
Crisis or contentment? A mixed-method exploration of psychosocial factors influencing meaning in life during midlife
Get PDFThe concept of meaning in life has received growing empirical interest over the last decade; however, it remains less explored in the context of midlife transition. This mixed-method study assesses factors associated with the search for and presence of meaning in life in a sample of middle-aged adults residing in the United Arab Emirates. Multiple regression analysis of data from 152 participants revealed that personal growth and self-compassion, but not materialism, significantly predicted the search for and presence of meaning in life. Qualitative data from five participants were analyzed using Interpretative Phenomenological Analysis (IPA). Three central themes were identified- “lessons learnt from the midlife transition,”“spirituality redefined at midlife,” and “growing through giving.” The findings contribute to the domains of humanistic psychology and counselling practice. Researchers recommend shifting from the crisis approach to a more positive, growth-oriented view of midlife
Inter-limb asymmetry tracking during an intense road cycling training camp
Get PDFIt has been proposed that monitoring asymmetry within athletic training programmes may be useful for injury mitigation and/or performance improvement. Within cycling, asymmetry calculation is typically limited to costly on-bike methods. The current study aimed to investigate the usefulness of an off-bike method of asymmetry assessment and assess the reliability of asymmetry calculated on subsequent days during a training camp. Eight semi-professional road cyclists completed an intense 7-day warm weather training camp. Athletes performed single leg countermovement jumps (SLCMJ) to determine inter-limb asymmetry, and scored their daily exercise intensity through rate of perceived exertion and heart rate training stress score. Neuromuscular fatigue was measured through daily countermovement jump height (CMJ). Within-session reliability was good to excellent for SLCMJ, ICC values > 0.83. Mean SLCMJ asymmetry was somewhat variable day-to-day, ranging from 11.72 ± 13.09% (Day 4) to 5.93 ± 6.19% (Day 7). Cohen’s Kappa showed a wide range of agreements from slight to substantial (0.06–0.75) for daily comparisons to baseline asymmetry scores. These results show that while measuring asymmetry as part of single day testing can be informative, successive assessment highlights the changeable nature at the individual level, which is not necessarily detectable at the group-level. Practitioners should consider creating individual baseline scores if intending to use asymmetry, which can be time consuming