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The use of standardized screening tools to identify trauma exposure and associated symptoms is commonly recommended as a key component in the development of trauma informed services and is seen as integral to facilitating access to evidence‐based therapies. However, there is limited evidence in the UK about the factors influencing the adoption of such tools into routine practice in children's social care. This paper presents the findings from a process evaluation of how practitioners implemented a screening tool for post‐traumatic stress disorder, anxiety and depression into their day‐to‐say practice and what worked or did not work during the process. The findings from this study highlight the potential benefits for both young people and practitioners, alongside some of the challenges involved. In particular, practitioners need to see the direct benefit for young people of being assessed. Additionally, practitioners value regular mentoring as they become more proficient in using standardized screening tools.

In cognitive behavioural journals and scientific meetings, the subject of grief seems to receive less attention than other emotional states, such as anxiety or depression. Grief is recognised as a normal human reaction to the death of a loved one and incorporates unpleasant, potentially distressing emotions, psychological phenomena, such as intrusive images, and physical sensations. Understandably, there has been reluctance to pathologise grief responses. However, the COVID-19 pandemic has put the subject of death centre stage as millions of people worldwide have been bereaved in extraordinary circumstances. Psychological therapists have been asked to provide effective therapeutic responses for clients with enduring distressing grief reactions.In this paper, we draw on decades of research and clinical expertise from our experience in applying cognitive therapy for post-traumatic stress disorder (PTSD) to enduring grief reactions. We derive lessons learned for treating prolonged and traumatic bereavement. Many of the clinical trials at the Oxford Centre for Anxiety Disorders and Trauma and Omagh/Queen’s University Belfast trauma centres have included patients who have experienced significant traumatic loss (Duffy et al., 2007; Ehlers et al., 2014; Ehlers et al., 2022).During the pandemic the authors of this paper delivered several workshops on prolonged and traumatic grief where clinicians raised a number of thought-provoking questions. Our responses form the basis of this paper.(1)How do we differentiate between normal and abnormal or pathological grief?(2)How should we describe or categorise or label pathological grief, and is it a specific and distinct condition or disorder?(3)How effective are existing therapies for prolonged and traumatic grief and is there a role for CBT in the treatment of these conditions?(4)Can our experiences with cognitive therapy for PTSD (Ehlers et al., 2005) help with these conditions or are different techniques and skills required?The purpose of this paper is to answer these important questions and in so doing, consider the historical and theoretical concepts relating to complex and traumatic grief; factors that differentiate normal grief from abnormal grief; and maintenance factors as well as implications for CBT treatments.

Traumatic loss is associated with high rates of post-traumatic stress disorder (PTSD) and appears to inhibit the natural process of grieving, meaning that patients who develop PTSD after loss trauma are also at risk of experiencing enduring grief. Here we present how to treat PTSD arising from traumatic bereavement with cognitive therapy (CT-PTSD; Ehlers et al., 2005). The paper describes the core components of CT-PTSD for bereavement trauma with illustrative examples, and clarifies how the therapy differs from treating PTSD associated with trauma where there is no loss of a significant other. A core aim of the treatment is to help the patient to shift their focus from loss to what has not been lost, from a focus on their loved one being gone to considering how they may take their loved one forward in an abstract, meaningful way to achieve a sense of continuity in the present with what has been lost in the past. This is often achieved with imagery transformation, a significant component of the memory updating procedure in CT-PTSD for bereavement trauma. We also consider how to approach complexities, such as suicide trauma, loss of a loved one in a conflicted relationship, pregnancy loss and loss of life caused by the patient. Key learning aims (1) To be able to apply Ehlers and Clark’s (2000) cognitive model to PTSD arising from bereavement trauma. (2) To recognise how the core treatment components differ for PTSD associated with traumatic bereavement than for PTSD linked to trauma where there is no loss of life. (3) To discover how to conduct imagery transformation for the memory updating procedure in CT-PTSD for loss trauma.

Traumatic experiences during childhood are common and often lead to chronic mental health conditions such as posttraumatic stress disorder (PTSD). The primary aim of this study was to determine whether a well-validated screening tool for PTSD administered in frontline services effectively identifies diagnosable PTSD in young people with a history of maltreatment. In total, 141 young people in community care settings were screened using three screening instruments (Child Revised Impact of Events Scale-8; Generalised Anxiety Disorder-2; Patient Health Questionnaire-2). Participants described a range of adverse life events: 110 of the 141 participants reported at least one adverse life experience (mean number for the total sample was 2.8), with 44.2 per cent (n = 46) experiencing at least one form of interpersonal trauma; and 102 participants (72.3 per cent) screened positively for probable PTSD and subsequent mental health assessments confirmed this condition in 64.7 per cent of these participants. Further, 36.9 per cent (n = 52) and 46.8 per cent (n = 66) met the threshold for probable depression and anxiety, respectively. Three items were associated with positive PTSD screens: a history of being on the child protection register, previous mental health contact and interpersonal index trauma. Interpersonal traumas were also associated with higher risks of offending. It seems feasible to use screening measures effectively within frontline social care services if staff are provided with appropriate training and support to identify young people with PTSD who may benefit from evidence-based mental health therapies.

Bone cements and dental resins are methacrylate-based materials that have been in use for many years, but their failure rates are quite high with essentially all dental resins failing within 10 years and 25% of all prosthetic implants will undergo aseptic loosening. There are significant healthcare costs and impacts on quality of life of patients. Self-healing bone cements and resins could improve the lifespan of these systems, reduce costs, and improve patient outcomes, but they have been limited by efficacy and toxicity of the components. To address these issues, we developed a self-healing system based on a dual nanocapsule system. Two nanocapsules were synthesized, one containing an initiator and one encapsulating a monomer, both in polyurethane shells. The monomer used was triethylene glycol dimethacrylate. The initiator capsules synthesized contained benzoyl peroxide and butylated hydroxytoluene. Resins containing the nanocapsules were tested in tension until failure, and the fractured surfaces were placed together. 33% of the samples showed self-healing behaviors to the point where they could be reloaded and tested in tension. Furthermore, the capsules and their components showed good biocompatibility with Caco-2 cells, a human epithelial cell line suggesting that they would be well tolerated in vivo.

Myocarditis can focally or diffusely involve the myocardium and is associated with arrhythmia, cardiac failure, and sudden death. The majority of cases of myocarditis are lymphocytic in etiology, and neutrophilic myocarditis is relatively uncommon. Although reported in lymphocytic myocarditis, isolated/focal neutrophilic myocarditis of the atrium causing death is not reported in the postmortem literature, and its postmortem computed tomography correlation is not documented. We report a fatal case of isolated neutrophilic atrial myocarditis affecting only the left atrium in a 33-year-old woman presenting as a sudden unexpected death. Microscopy of the left atrium, a not commonly sampled area of the heart, showed florid neutrophilic myocarditis with the remaining right atrium, conduction system, and both ventricles uninvolved. Similar to previously reported fatal isolated atrial lymphocytic myocarditis, postmortem computed tomography was unable to detect any atrial abnormalities. This case highlights a potential "blind spot" for both routine postmortem imaging and examination.

The effectiveness of nonlinear filters depends on many factors, but one of the most important is how accurately the filter is able to predict the state dynamics of the underlying system between measurements. For a wide class of Gaussian white noise driven nonlinear systems the Bayesian optimal prior can be obtained by solving the system’s corresponding Fokker–Planck Equation (FPE). Unfortunately the Fokker–Planck Equation is a partial differential equation with dimension equal to the number of states in the underlying dynamical system, making it extremely difficult to solve for realistic systems due to Curse of Dimensionality scaling issues. As a result it has been and still largely remains computationally impractical to simulate higher dimensional Fokker–Planck equations, at least while obtaining very high accuracy across the entire transient probability density function. This paper presents a general nonlinear filter based on solving the transient Fokker–Planck equation via Smooth Particle Hydrodynamics (SPH) at lower resolution, which turns out to still allow for accurate state estimation. The filter is enabled by an efficient heuristic resampling scheme of the SPH solution also presented here. The FPE-SPH Filter is able to replicate the accuracy of the Particle Filter and Extended Kalman filter (EKF) for lower-dimensional systems, while also being more robust than the EKF on certain classes of system.

The age hardenability of Al-alloyed lightweight stainless steels with the base chemical composition Fe–10.5Cr–3Al (wt.%) and Ni concentrations in the range 3–15 wt.% was studied. Alloys containing 3% and 6% Ni exhibited almost fully ferritic matrix microstructures and a weak age hardening response. Alloys containing 9%, 12%, and 15% Ni, on the other hand, developed primarily martensitic microstructures. Differential scanning calorimetry measurements indicated the occurrence of an exothermic reaction in the approximate temperature range 375–625 °C. Dilatometry measurements indicated that the exothermic reaction was accompanied by a net contraction. Hardness measurements after aging for 5 min indicated significant hardening of alloys already at 350 °C due to the formation of B2-(Ni,Fe)Al intermetallic precipitates. The age hardening response was significantly superior to that of conventional precipitation-hardenable martensitic stainless steels. Tensile elongation in the aged condition was negatively influenced by the presence of soft ferrite regions. Processing conditions associated with a fully martensitic microstructure prior to aging are required to render a uniform age hardening response. Guidelines for the development of a new family of lightweight precipitation-hardenable steels with lower raw material costs and a higher corrosion resistance compared to the standard 18Ni maraging steels are provided.

Digital currency is a ‘disrupter’ of financial services and currency markets, and as such presents new regulatory challenges. International regulatory responses to digital currency range from being largely ignored in some jurisdictions to being banned in others, with most jurisdictions charting a middle course of ‘wait and see’ while attempting to deal with pressing issues (such as taxation liability and potential money laundering and terrorism financing issues). This article explains digital currency, its benefits, its problems, its risks and the regulatory response so far. It analyses the extent to which the Australian Securities and Investments Commission (ASIC, the national securities regulator) may or may not have regulatory power and jurisdiction under existing Australian law, and the role of other relevant regulators and institutions. It concludes that digital currency may well be a ‘financial product’ under Corporations Act 2001 (Cth) s 763A (though many suppliers/issuers of that product will be website operators located outside Australia). If it is a financial product, ASIC would also have jurisdiction over issuers and markets that trade in that product. This conclusion could easily be fortified by legislative confirmation; however, it is suggested that ASIC should in all events test its powers to determine whether any legislative change is needed. Regulation by ASIC would add to recent moves to deal with digital currency by the Australian Transaction Reports and Analysis Centre (AUSTRAC) and the Australian Taxation Office (ATO). In all cases, this article argues that the time has come for Commonwealth regulation of digital currencies by ASIC as the relevant regulator. This would then trigger the obligations set out in the Corporations Act and the ASIC Act, including Australian Financial Services Licensing, Australian Market Licensing, standards of efficiency, honesty and fairness, disclosure provisions, possible market offences and corporate regulation generally. The suggested jurisdiction of ASIC would build on its existing role as well as the roles of the Australian Competition and Consumer Commission, the ATO and AUSTRAC.

Sudden cardiac death (SCD) is the most common natural cause of death. The hypothesized mechanism of death is an arrhythmia precipitated by increased sympathetic outflow. The left stellate ganglion provides sympathetic innervation to the heart and plays a role in arrhythmogensis. We present a SCD with stellate ganglionitis in which the inflammatory cells were characterized. The case was 37-year-old man who died from ischemic and hypertensive heart disease. The left stellate ganglion showed lymphocytic inflammation with features of humoral immune response. This case report provides evidence that stellate ganglionitis can be seen in SCD and raises the possible association between the two.

Weighing of organs is a standard requirement in post-mortem examination. Ideally, the lungs should be weighed intact to prevent pulmonary fluids loss. However, there are instances where the lungs a...

Convolutional neural network (CNN) has advanced in recent years and translated from research into medical practice, most notably in clinical radiology and histopathology. Research on CNNs in forensic/postmortem pathology is almost exclusive to postmortem computed tomography despite the wealth of research into CNNs in surgical/anatomical histopathology. This study was carried out to investigate whether CNNs are able to identify and age myocardial infarction (a common example of forensic/postmortem histopathology) from histology slides. As a proof of concept, this study compared 4 CNNs commonly used in surgical/anatomical histopathology to identify normal myocardium from myocardial infarction. A total of 150 images of the myocardium (50 images each for normal myocardium, acute myocardial infarction, and old myocardial infarction) were used to train and test each CNN. One of the CNNs used (InceptionResNet v2) was able to show a greater than 95% accuracy in classifying normal myocardium from acute and old myocardial infarction. The result of this study is promising and demonstrates that CNN technology has potential applications as a screening and computer-assisted diagnostics tool in forensic/postmortem histopathology.

Common Fund Orders’ (CFOs) have had a significant effect on Australian third party-funded class actions by requiring all class members to make a contribution to the third-party litigation funder’s fee in the event of a successful outcome. This altered past practice whereby only class members who had contracted with the litigation funder would be liable for such a contribution. However in a 5:2 decision in BMW Australia Ltd v Brewster in 2019, the High Court cast some doubt on CFOs, determining that neither s 33ZF Federal Court of Australia Act 1976 (Cth) nor s 183 Civil Procedure Act 2005 (NSW) provided a legal basis for making CFOs at the outset of proceedings so as to secure litigation funding support. In late 2020, the Commonwealth Parliamentary Joint Committee (PJC) on Corporations and Financial Services recommended that legislation be enacted to ‘address uncertainty’ in Brewster in a manner that would enable CFOs to be made at settlement or judgment. The authors canvass normative arguments as to the merits of CFOs and compare the alternative practice of making Funding Equalisation Orders (FEOs). They also consider the related issue of courts setting overall funding commissions. Given the possibility of legislative intervention, they also review arguments as to the potential constitutional validity of CFOs, a matter that was raised, but received very limited treatment from the High Court in BMW.

Intestinal perforation is an uncommon complication and presentation of verocytotoxigenic Escherichia coli (VTEC) infection in individuals with Prader-Willi syndrome (PWS). The common site of perforation from VTEC infection is in the colon (and almost exclusively in the pediatric population), whereas PWS is in the stomach. Terminal ileum perforation is uncommon and is not reported in either these 2 conditions. We report a death from terminal ileum perforations in an adult who had PWS and was infected with VTEC. Potential reasons why the perforation occurred at this rare location, rather than in other more common location, in an adult are discussed.

Maternal nutrition impacts fetal development, and may play a role in determining resilience to stress and vulnerability to stress-precipitated psychiatric disorders, such as anxiety and depression. In this study, we examined the effect of a reduction in maternal dietary protein during pregnancy on the brain neurochemistry and behavior of offspring. We focused specifically on the serotonin system, the 5-HT1A receptor and the responsivity of offspring as adults to stress. Dams were fed either a low protein diet (10% protein by weight) or isocaloric control diet (20% protein by weight). The low protein diet did not alter maternal food intake and body weight, or litter size and the average birth weight of male or female littermates. 5-HT1A receptor function, as measured by quantitative autoradiography of 8-OH-DPAT (1 μM)-stimulated [35S]GTPγS binding, was markedly reduced in hippocampus of weanling female, but not male offspring (postnatal day, PND 21) of dams fed the low protein diet. The number of serotonergic cell bodies in the rostral raphe, and 5-HT metabolism in the limbic system of weanling offspring was not altered by maternal low protein diet. The deficit in hippocampal 5-HT1A receptor function observed in weanling female offspring persisted into adulthood (PND 112), and was accompanied by an increased sensitivity to stress, specifically increased immobility during a 15-minute forced swim challenge and increased anorexia following 30-minute restraint (PND 97-100). The present work begins to uncover important future directions for understanding the early developmental origins of resilience to stress, and factors that may put individuals at greater risk for stress-related psychiatric disorders.

Performance-enhancing or ‘supplements’ usage in sport presents a challenge for sporting clubs and leagues internationally and is, in large part, a legal and governance issue. The authors argue that the increasing commercialization of sport points to the conclusion that it is better that corporate governance has a significant role to play in modern sporting clubs in avoiding such problems. The recent experience of the Essendon Australian Rules Football Club is examined at some length as are the corporate governance practices of other Australian Football League clubs. The article concludes with recommendations for improvements to corporate governance practice in sporting clubs, including increased use of independent directors and board subcommittees.

“This study examined the perception of journalism ethics by residents in a red state. A 2016 poll found that only 15% rated the honesty and ethical standards of journalists as high or very high, about 12 percentage points below the all-time low findings of a national Gallup poll. Chi square tests revealed statistically significant associations between those ratings and political party, with Republicans grading journalists much lower than Democrats, especially if they supported Donald Trump.”

Thermoelectric generators (TEGs) fabricated using additive manufacturing methods are attractive because they offer the advantages of scalability, lower cost, and potentially higher power density than conventional TEGs. Additive manufacturing of TEGs requires active thermoelectric particles to be dispersed in a polymer binder to synthesize printable slurries, and printed films to be subsequently subjected to a long and high temperature curing to enhance their thermoelectic properties. A large amount of polymer binder present in composite films results in a sizable loss in the electrical conductivity. In addition, a long and high-temperature film curing results is a slow and energy intensive fabrication process. In this work, we demonstrate the feasibility of using a small amount (≤10−3 wt ratio) of novel nanofiber cellulose (NFC) as a binder to provide sufficient adhesion strength to hold the TE particles together in the composite films. We also demonstrate a pressure induced densification process to enhance the thermoelectic properties of printed composite films. This novel approach has the potential to fundamentally transform the manufacting method for printing TEGs by eliminating the need of long-duration and high-temperature curing. A higher applied pressure leads to a compact packing and densification of films resulting in an improvement in the electrical conductivity. The highest power factor achieved for best performing p-type thermoelectric-NFC composite film subjected to pressure induced densification is 611 μW/m-K2.