Re-constructing parental identity after parents face their offspring's suicidal behaviour: An interview study.

INTRODUCTION: Parents are affected when their offspring engages in non-fatal suicidal behaviour. Although research exists on parents' mental and emotional state when they realise this behaviour, relatively little attention has been devoted to exploring how their parental identity is affected. PURPOSE: To explore how parents re-constructed and negotiated their parental identity after realising that their offspring was suicidal. METHOD: A qualitative exploratory design was adopted. We conducted semi-structured interviews with 21 Danish parents who self-identified as having offspring at risk of suicidal death. Interviews were transcribed, analysed thematically and interpreted by drawing on the interactionist concepts of negotiated identity and moral career. FINDINGS: Parents' perspectives on their parental identity were conceptualised as a moral career encompassing three distinct stages. Each stage was negotiated through social interaction with other people and the wider society. Entry into the first stage, disrupted parental identity, occurred when parents realised that they could lose their offspring to suicide. At this stage, parents trusted their own abilities to resolve the situation and keep their offspring safe and alive. This trust was gradually undermined by social encounters, which caused career movement. In the second stage, impasse, parents lost faith in their ability to help their offspring and to change the situation. Whereas some parents gradually resigned entirely to impasse, others regained their trust in their own abilities through social interaction in the third stage, restored parental agency. CONCLUSION: Offspring's suicidal behaviour disrupted parents' self-identity. Social interaction was fundamental if parents were to re-construct their disrupted parental identity. This study contributes with knowledge about the stages characterising the reconstructive process of parents' self-identity and sense of agency.

Causes of spontaneous sow deaths in the farrowing units of 10 Danish sow herds.

This study established the causes and timing of spontaneous sow deaths in the farrowing units of ten Danish sow herds. Herds participated for seven to 15 months during 2018-19. We received data (production data and detailed information on the sows that died) on a total of 126 sows. Fifty-three sows were necropsied, and tissues were evaluated histopathologically. Twenty-four percent of the sows died 0-5 days postpartum. The main cause of death in the study was liver lobe torsion, which was diagnosed in 22 of 53 necropsied sows (42%). Deaths caused by liver lobe torsions were less often seen during the 0-5 day postpartum period compared to deaths caused by other reasons (P = 0.002). Seven of the necropsied sows (13%) died from endotoxaemic shock from retained foetuses. This cause of death was seen in seven of ten herds. These sows typically died 1-3 days postpartum. Pneumonia accounted for 13% of deaths in the necropsied sows, but the majority of these sows originated from one herd experiencing a respiratory outbreak caused by the introduction of M. hyopneumonia. Less prevalent causes of death in the study were torsion of the intestinal segment (8%), suspected cardiovascular collapse (8%), rupture of blood vessels (uterine and nonuterine) (8%), gastric ulcer (4%), sepsis (2%) and liver abscess (2%). We concluded that liver lobe torsion needs further attention to establish the background of this surprisingly prevalent cause of death. Furthermore, a need for procedures that ensure efficient farrowing was identified.

Relatives' experiences of providing care for individuals with suicidal behaviour conceptualized as a moral career: A meta-ethnographic study.

BACKGROUND: An increasing number of qualitative research articles have reported on relatives' experiences of providing care for individuals displaying suicidal behaviour. To contribute more fully to theory and practice, these reported experiences must be synthesized. OBJECTIVES: To identify original qualitative studies of relatives' experiences of providing care for individuals with non-fatal suicidal behaviour and to systematically review and synthesize this research using a meta-ethnographic approach. DESIGN: Systematic review and meta-ethnography. DATA SOURCES: Literature searches were undertaken in six bibliographic databases (PubMed, CINAHL, Embase, PsycINFO, Web of Science and Scopus) and limited to peer-reviewed original studies. Eligible studies reported relatives' experiences of providing care for individuals with suicidal behaviour, published in English or a Scandinavian language. REVIEW METHODS: One reviewer screened the titles, abstracts and full texts and then collaborated with another reviewer on excluding ineligible studies. A two-step strategy was used while reviewing publications: 1) appraising study quality, and 2) classifying study findings according to degree of data interpretation. This strategy was used for each study by two independent reviewers who subsequently reached a shared decision on inclusion. Noblit and Hare's methodology for translation and synthesis was followed in developing a novel theoretical interpretation of relatives' experiences. The concept of moral career was adopted in producing this synthesis. RESULTS: Of 7,334 publications screened, 12 studies were eligible for inclusion. The synthesis conveyed relatives' moral career as comprising four stages, each depicting relatives' different perspectives on life and felt identities. First, relatives negotiated conventional ideas about normalcy and positioned themselves as living abnormal family lives in the stage from normal to abnormal. The first career movement could be mediated by social interactions with professionals in the stage feeling helpful or feeling unhelpful. For some relatives, this negotiated perspective of abnormality got stuck in an impasse. They did not interact with their surroundings in ways that would enable them to renegotiate these fixed views, and this stage was named stuck in abnormality. For other relatives, career movement took place as relatives re-positioned themselves as negotiating an alternative perspective of normalcy in the stage from abnormal to normal. CONCLUSIONS: Interactions with other people facing similar difficulties enabled relatives to shift perspectives and alleviated experiences of distress.

Promoting physical health in severe mental illness: patient and staff perspective.

OBJECTIVE: To explore physical health problems and their causes in patients with severe mental illness, as well as possibilities for prevention and treatment from the patients' and staff's perspectives. METHOD: We conducted six focus groups with patients and staff separately, from three out-patient clinics treating patients with schizophrenia or substance-use disorder comorbid to another psychiatric disorder. Focus groups were audio-recorded, transcribed verbatim and analysed using a template approach. RESULTS: Paramount physical health problems are weight issues, cardiovascular diseases and poor physical shape. Main causes are lifestyle, the mental disorder and organisational issues. Patients and staff expressed similar opinions regarding physical health problems and their causes. Possibilities for prevention and treatment includes a case manager and binding communities with like-minded, as well as management support and implementation of physical health into daily psychiatric practice. Although patients and staff suggested different possibilities for prevention and treatment, they support one strategy: less fragmentation of the treatment system and cooperation between psychiatric and somatic healthcare. CONCLUSION: To prevent and treat physical health problems in patients with severe mental illness, support in daily structure and lifestyle changes is needed. Management support is needed to change daily practice and implement routines regarding physical health.

Suppression of complex fingerlike patterns at the interface between air and a viscous fluid by elastic membranes.

Growth of complex dendritic fingers at the interface of air and a viscous fluid in the narrow gap between two parallel plates is an archetypical problem of pattern formation. We find a surprisingly effective means of suppressing this instability by replacing one of the plates with an elastic membrane. The resulting fluid-structure interaction fundamentally alters the interfacial patterns that develop and considerably delays the onset of fingering. We analyze the dependence of the instability on the parameters of the system and present scaling arguments to explain the experimentally observed behavior.

Scaling properties of coating flows in rectangular channels.

We present an experimental study of the aspect-ratio dependence of two-phase displacement flows in channels of rectangular cross section. Above a buoyancy-dependent threshold Ca[over ;]_{t}, we find that the bulk features of the flow depend only on a modified capillary number Ca[over ;]=[1+0.12(alpha-1)+0.018(alpha-1);{2}]Ca, where Ca is the unmodified capillary number and alpha is the aspect ratio. This novel scaling has tremendous practical significance because it implies that the bulk features of the flows in any rectangular channel can be inferred from those in a square channel for Ca[over ;]>Ca[over ;]_{t}.

Scaling of the turbulence transition threshold in a pipe.

We report the results of an experimental investigation of the transition to turbulence in a pipe over approximately an order of magnitude range in the Reynolds number Re. A novel scaling law is uncovered using a systematic experimental procedure which permits contact to be made with modern theoretical thinking. The principal result we uncover is a scaling law which indicates that the amplitude of perturbation required to cause transition scales as O(Re-1).

Suppression of dripping from a ceiling.

An isothermal layer suspended from a surface is gravitationally (Rayleigh-Taylor) unstable. We find that, when a vertical temperature difference DeltaT above a critical value (DeltaT)(c) is imposed across the liquid-gas layer system (heated from below), the restoring force provided by the temperature-dependent surface tension (thermocapillarity) can stabilize the layer. Our measurements of the most unstable wave number for DeltaT<(DeltaT)(c) agree well with our linear stability analysis. The instability occurs at long wavelengths: the most unstable wavelength at (DeltaT)(c) is infinite.