#EAD Class 10 Science

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Solved CBSE Class 10 Sample Paper 2024 Science

Get best offers on latest edition of ‘Together with’ Class 10 CBSE Sample Paper Science for 2024 Board Examination released by Rachna Sagar. Unsolved & solved EAD sample papers, Latest Pre Board Papers, Mock Test Paper to practice. Ace the score game by practicing Together with CBSE Sample Paper (EAD) Class 10 Science (based on latest syllabus) for Academic Session 2023-24.

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Get Latest CBSE Sample Paper (MCQ) Science  for 2021 Term 1 Board Exams- Rachna Sagar

Together with CBSE Sample Paper, Science has been designed as per the special scheme of assessment vide CBSE Circular No. 75/2021 for Term 1 ( For 2021 Nov-Dec Examination ) for Class 10 has been prepared as per the latest assessment pattern. 

Together with EAD Science Sample Paper (with answers) is a perfect step-by-step approach to ensure one’s readiness for Term 1 board examination. This Sample Paper for Class 10 assists the students with the right practice and approach to the newest MCQ pattern. 

EAD—Easy, Average, Difficult 

The content matter in this EAD 12+1 Science Sample Paper Class 10 has been arranged as complete papers with three levels of difficulty—Easy, Average and Difficult (EAD). 

Easy: The first set of papers in this CBSE Sample Paper 2021 is based on 'Easy' concept, thus contains Multiple Choice Questions of simple level, which a student can attempt at the beginning of the preparatory stage. 

Average: The next set based on 'Average' concept (MCQs) is graded to a level of difficulty to test mid-level preparedness for the examination. 

Difficult: The challenging papers allocated to the third set based on 'Difficult' concept are a test of complete preparedness for the examination. 

The EAD sample paper is a self-test drive for the students. 

Key Features 

This Sample Paper includes:

CBSE (2021-2022) Term 1 Sample Paper. 

3 Sample Papers each of Easy, Average & Difficult level. 

2 Pre-Board Papers based on CBSE pattern. 

1 Mock Paper Based On CBSE Pattern with OMR Sheet. 

Includes Assertion Reasoning and Case-Based Objective Type Questions. 

The 4-Step Process 

Step 1 The students are advised to attempt the set of EASY Papers first and obtain at least 80% marks to move onto the next set of papers which is Average. 

Step 2 If the student obtains 75% marks in the AVERAGE category of this EAD 12+1 Science Sample Paper Class 10, he/she can switch to the next category, i.e., Difficult. 

Step 3 If 70% marks in DIFFICULT category have been obtained, the students are expected to take the PRE-BOARD PAPERS that are exactly based on the CBSE pattern. 

Step 4 Attempt the MOCK PAPER (given at the end) for a final-go for your board exam preparations. 

Why EAD Latest Sample Papers? 

Learning gets strengthened with practice and its evaluation uplifts the preparation. The answers of the MCQs have been given at the end of each Sample Paper for evaluation purposes. The CBSE Sample Papers for class 10 All Subjects 2021-2022 have been prepared by a panel comprising experienced teachers, tabulators and examiners, who have jointly come up with a student-friendly approach to prepare the students for the forthcoming CBSE Board Examination. Repetitive practice of CBSE Sample Papers for class 10 All Subjects 2021-2022 will surely help the students to make their mark in the CBSE Board Examination. 

Good Luck!

[oceaninsight-blog]

Fiji Development Journal

Development is a term coined by 'developed' nations in order to measure desirable change in society; today the dominant focus pertains to growth of gross national income, quality of life, sustainable development, and the millennium development goals (Dang & Sui Pheng). According to Bucknall (2013), economic growth is the change in national income over time per year, while national income is the amount produced by a country per year (p. 1). An effective aspect of economic development is that it is a broader measurement of 'growth' that does not simply rely on the economy. In addition, the Human Development Index is a tool that is increasingly becoming a standard, which evaluates countries based on "the standard of living, GDP, living conditions, technological advancement, improvement of self-esteem needs, the creation of opportunities, per capita income, infrastructural and industrial development and much more" (Surbhi, 2015, p. 2-3).

However the abundance of problems with development begin with the ambiguity of the term itself, which pertains to a set of beliefs and assumptions about the nature of social progress: “'Development' was no longer considered a social construct or the result of political will, but rather the consequence of a 'natural' world order that was deemed just and desirable. This trick – which is at the root of what Bourdieu calls 'symbolic violence' – has been highly instrumental in preventing any possible critique of 'development', since it was equated almost with life itself" (Rist, 2010, p. 486). Along with this particular term, over the past few weeks I have been deconstructing English words such as 'modernity,' 'nature', and 'coloniality.' As a result, it has been brought to my attention that, as Rist (2010) explains, dominant views of development bring colonizers and the colonized into seemingly equal members of the same family (p. 20).

With that, there is general disagreement over the strategies used to measure growth rates within countries, especially under the globally dominant economic system of capitalism, which prioritizes monetary profits over everything else: “According to Marxist theory, the development of human society is driven by material productive forces. These productive forces and the productive relations form what Marx calls the economic base, which is the material foundation of all societies. It is the contradiction between the productive forces and the productive relations that brings about class struggle, and transforms a society’s superstructure, including its political system, its legal institutions and its ideologies" (Yanbing and Ying, 2012, p. 26).

After spending the first two of my three weeks in the capital city of Suva, Fiji, I was immersed in heavy discussions about climate change and the vulnerability of the Pacific Island nations. Fiji is spearheading COP23 in November, where the "Implementation Guidelines" from the Paris Agreement will be finalized. Fiji, along with other member nations of SIDS (Small Island Developing States), is at the forefront in the demand for 1.5 degrees Celsius temperature cap to replace the two degrees Celsius decision of COP 15. Through a variety of guest lectures at our local community center and the University of the South Pacific, I became increasingly aware of Fiji's efforts to combat climate change. As I examined development and the notion of sustainable development simultaneously to this experience, the contradictions in their connotations became exceedingly apparent: "The essence of 'development' is the general transformation and destruction of the natural environment and of social relations in order to increase the production of commodities (goods and services) geared, by means of market exchange, to effective demand" (Rist, 2010, 488). Consequently, the prioritization of development exceeds that of climate change.

My final week in Fiji took place in the country's third largest island of Taveuni. I stayed in a Native Fijian village called Waitabu, studying village dynamics and being introduced to the land. A key ideology of Native Fijian livelihood is Vanua, a concept that evokes a meaningful conjunction between people and the land as non-separate entities. Although the time I spent in Waitabu did not circulate around my Introduction to International Development class, it opened my eyes to a new interpretation of 'development' in which I hope to explore throughout the semester.

The classical Western development theory that has led to the global supremacy of capitalism is one that propagates modern Eurocentric tradition based on the extraction of earth's resources. In order to effectively address modern development and capitalism, I conclude that alternative modes of development that are increasingly coherent with indigenous epistemologies is necessary in order to move toward a more community based and environmentally friendly world. Waitabu is merely one example of the peacefulness and sustainable manner of indigenous peoples livelihood.

References:

Bucknall, K. (2013) The Differences Between 'Economic Growth' and 'Economic Development'. http://www.keweipress.com (accessed 1-10-2017)

Dang, G. and Sui Pheng, I. (2015) 'Theories of Economic Development', in Infrastructure Investments in Developing Economies. Springer Science+Business Media, Singapore, 11>26

Rist, G. (2010) 'Development as a buzzword,' in Andrea Cornwall and Deborah Eade (Editors) Deconstructing Development Discourse: Buzzwords and Fuzzwords. Practical Action Publishing, Warwickshire UK, pages 19 > 27

Yanbing, Z. and Ying, H. (2012) Foreign Aid: The ideological Differences between China and the West, in Journal of China and International Relations (CIR) Volume 22, No. 2, pages 20 > 36

[differentchildmusic-blog]

Aircraft Seat Material Market value is $0.14 Billion by 2023 at a CAGR of 6.6% During 2018-2023.

In the report “Aircraft Seat Material Market: By Material Type (Aluminium Structure, Foam Cushions, Plastic Molding, Others); By Seat Type (Suite, First, Business, Premium Economy & Economy Classes); By Aircraft Type (RTA, WBA, Others); By Geography - (2018-2023), published by IndustryARC, the market isset to experience an upsurge in civil aircrafts,andwith rising passenger traffic estimated to double in the next 10 years, a brighter investment scenario is presented for aircraft seat material manufacturers. ​ Asia-Pacific demanding major share in the Aircraft Seat Material Market: Asia-Pacific is the major region for aircraft seating market with revenue of $0.03 billion in 2018, and is estimated to reach $0.04billion by 2023. Also, Asia-Pacific market is growing at a faster growth rate compared to other established markets in America and Europe. Leadingregions of Asia-Pacific such as China, Japan and India, are strongly involved in variousaircraft design development activities, which makes it a high demand region for seat materials. Apart from Asia-Pacific, the seat material market revenue in the American and European region are estimated to grow with a high CAGR of 3.6% and 3.4% respectively. Aircraft Seat Material Market Analysis done in the full Report: Global Aircraft Seat Material market by type is classified broadly in the report. Structure is one of thetypeswhere seatdimensions include load bearing and seating space, each having elements for securing a seat from the continuous movement between first and second positions. Structuring is very important as this allows spacing.Flight cushions is the most important type of the aircraft, providingcomfort, looking after the well-being and safety. Materials used in the manufacture of foam cushions are polyurethane, neoprene, silicon and polyethylene. Polyurethane is a vital element in aircraft seat materials as it caters to the requirements.. The recent findingsstate that the rising civil aircrafts and aircraft upholstery business are becoming a profitable business segment. Amongst all material types, polyester frame is a noteworthy constituent among the synthetic fiber industry. It is followed by FR nylon, whichis also a vital type of material that is toughand has excellent sliding properties. Furthermore, FR cotton and leather has a broad scale of application in this market.In the test conducted by Special Aviation Fire and Explosion Reduction Advisory Committee (SAFER), it was determined thatairplane cushion holds the strongest potential for a fire source.Plastic molding is theforemost type of artificially created non-metallic mixes.. Polycarbonate, ABS and decorative vinyl are types of moldings used in aircraft seat material market. Thisplastic molding embedsliquid fluid, which isstructured into different solidified shapesthat are used in seat shape types. . These extensive varietiesof selectable elements provideequivalent valueto their operation. To access / purchase the full report browse the link below: https://industryarc.com/Report/1313/aircraft-seat-material-market-research-report.html Excerpts on Market Growth Factors: • Modern manufacturers are now strongly looking to minimize the weight of airplane seats, which reduces the overall weight of the aircraft. The minimized weight would positivelysave on fuel costs, provide enhanced travel experience and lower ticket prices. • Growth of global aircraft seating material market includes growth in the demand for new aircraft deliveries, upgradation of aircraft programs, and increased air travel is anticipated to contribute to the market growth. • Attractive composite componentsof fibershad and will lead the series of innovation in this industry.The useof carbon composites has increased in high performance vehicles like jet plane, spacecraft’s, and other aircrafts. Key players of the Aircraft Seat Material Market: Regional manufacturers  that make it an extremely competitive market, are as follows:Zodiac Aerospace, B/E Aerospace, JAMCO Aircraft Interiors Company, HAECO, RECARO Aircraft Seating Gmbh & Co. Kg and others. Zodiac SA holds the major share in the overall seat material market. It holds almost 32% of the marketshare, followed by JAMCO Corp. and others, mentioned above. Aircraft Seat Material Market report is segmented as below: The study across various end user industries is incorporated in the report. A. By Types 1. Structure (Aluminum Frame, Carbon-Fibre Composites, Steel, and Carbon Steel, Fiberglass and Kevlar) 2. Foam Cushions 3. Upholsteries 4. Fire-Blocking Textiles 5. Plastic Molding B. By Aircraft Type 1. Large Wide Body Aircraft 2. Medium Wide-Body Aircraft 3. Small Wide Body Aircraft 4. Single AISLE Aircraft 5. Regional Transport Aircraft C. By Seating Class 1. Suite Class. 2. First Class. 3. Business Class. 4. Premium Economy Class. 5. Economy Class. D. By Geography (covers 10+ countries)   E. By Entropy Companies Cited / Interviewed 1. ZIM FLUGSITZ GMBH. 2. TSI Aviation Seats. 3. Thales Group. 4. EADS SOGERMA 5. Singapore Technologies Aerospace Ltd. 6. AEROSEATING Technologies LLC. 7. Ki Holdings Co., Ltd. 8. Thompson Aero Seating Ltd. 9. AVIOINTERIORS S.P.A. 10. GEVEN S.P.A. Related Report: A. Cockpit Lighting Market https://industryarc.com/Report/18086/cockpit-lighting-market.html B. Maintenance, Repair and Overhaul Aerospace Market https://industryarc.com/Report/18139/maintenance-repair-overhaul-mro-aerospace-market.html What can you expect from the report? The Aircraft Seat Material Market Report is Prepared with the Main Agenda to Cover the following 20 points: 1. Market Size by Product Categories & Application          11. Demand Analysis (Revenue & Volume) 2. Market trends & Relevant Market Data                             12. Country level Analysis 3. Manufacturer Landscape                                                     13. Competit or Analysis 4. Distributor Landscape                                                          14. Market Shares Analysis 5. Pricing Analysis                                                                      15. Value Chain Analysis 6. Top 10 End user Analysis                                                     16. Supply Chain Analysis 7. Product Benchmarking                                                         17. Strategic Analysis 8. Product Developments                                                        18. Current & Future Market Landscape Analysis 9. Mergers & Acquisition Analysis                                         19. Opportunity Analysis 10. Patent Analysis                                                                     20. Revenue and Volume Analysis Frequently Asked Question: Q. Does IndustryARC provide customized reports and charge additionally for limited customization? Response:Yes, we can customize the report by extracting data from our database of reports and annual subscription databases. We can provide the following free customization: 1. Increase the level of data in application or end user industry. 2. Increase the number of countries in geography chapter. 3. Find out market shares for other smaller companies or companies which are of interest to you. 4. Company profiles can be requested based on your interest. 5. Patent analysis, pricing, product analysis, product benchmarking, value and supply chain analysis can be requested for a country or end use segment. Any other custom requirements can be discussed with our team, drop an e-mail to sales@industryarc.com to discuss more about our consulting services. Media Contact: Mr. Venkat Reddy Sales Manager Email 1: sales@industryarc.com Or Email 2: venkat@industryarc.com Contact Sales: +1-614-588-8538 (Ext-101) About IndustryARC: IndustryARC is a Research and Consulting Firm that publishes more than 500 reports annually, in various industries such as Agriculture, Automotive, Automation & Instrumentation, Chemicals and Materials, Energy and Power, Electronics, Food & Beverages, Information Technology, Life sciences & Healthcare. IndustryARC primarily focuses on Cutting-edge Technologies and Newer Applications in a Market. Our Custom Research Services are designed to provide insights on the constant flux in the global supply–demand gap of markets. Our strong team of analysts enables us to meet the client’s research needs at a rapid speed and with a variety of options. We look forward to helping the client  address its customer needs, stay ahead in the market, become the top competitor and get real-time recommendations on business strategies and deals. Contact us to find out how we can help you today.

[rohitkoluguri-blog]

A Quick Look At The Latest Happenings In The Aircraft Seat Material Market

Asia-Pacific demanding major share in the Aircraft Seat Material Market:

Asia-Pacific is the major region for Aircraft seating market with revenue of $0.03 billion in 2018, and is estimated to reach $ 0.04billion by 2023. Also, Asia-Pacific market is growing at a faster growth rate compared to other established markets in America and Europe. Leading regions of Asia-Pacific such as China, Japan and India, are strongly involved in various aircraft design development activities, which makes it a high demand region for seat materials. Apart from Asia-Pacific, the seat material market revenue in the American and European region are estimated to grow with a high CAGR of 3.6% and 3.4% respectively.

Selected Type Analysis done in the full Report:

Global Aircraft Seat Material market by type is classified broadly in the report. Structure is one of the types where seat dimensions include load bearing and seating space, each having elements for securing a seat from the continuous movement between first and second positions. Structuring is very important as this allows spacing. Flight cushions is the most important type of the aircraft, providing comfort, looking after the well-being and safety. Materials used in the manufacture of foam cushions are polyurethane, neoprene, silicon and polyethylene. Polyurethane is a vital element in aircraft seat materials as it caters to the requirements..

The recent findings state that the rising civil aircrafts and aircraft upholstery business are becoming a profitable business segment. Amongst all material types, polyester frame is a noteworthy constituent among the synthetic fiber industry. It is followed by FR nylon, which is also a vital type of material that is tough and has excellent sliding properties. Furthermore, FR cotton and leather has a broad scale of application in this market. In the test conducted by Special Aviation Fire and Explosion Reduction Advisory Committee (SAFER), it was determined that airplane cushion holds the strongest potential for a fire source.

Plastic molding is the foremost type of artificially created non-metallic mixes.. Polycarbonate, ABS and decorative vinyl are types of moldings used in aircraft seat material market. This plastic molding embeds liquid fluid, which is structured into different solidified shapes that are used in seat shape types. . These extensive varieties of selectable elements provide equivalent value to their operation.

Excerpts on Market Growth Factors:

Modern manufacturers are now strongly looking to minimize the weight of airplane seats, which reduces the overall weight of the aircraft. The minimized weight would positively save on fuel costs, provide enhanced travel experience and lower ticket prices.

Growth of global aircraft seating material market includes growth in the demand for new aircraft deliveries, up gradation of aircraft programs, and increased air travel is anticipated to contribute to the market growth.

Attractive composite components of fibers had and will lead the series of innovation in this industry. The use of carbon composites has increased in high performance vehicles like jet plane, spacecraft’s, and other aircrafts.

To access / purchase the full report browse the link below

https://industryarc.com/Report/1313/aircraft-seat-material-market-research-report.html

Key players of the Aircraft Seat Material Market:

Regional manufacturers that make it an extremely competitive market, are as follows: Zodiac Aerospace, B/E Aerospace, JAMCO Aircraft Interiors Company, HAECO, RECARO Aircraft Seating Gmbh & Co. Kg and others. Zodiac SA holds the major share in the overall seat material market. It holds almost 32% of the marketshare, followed by JAMCO Corp. and others, mentioned above.

Aircraft Seat Material Market report is segmented as below

The Global Aircraft Seat Material Market study across various end user industries is incorporated in the report.

A.Aircraft Seat Material Market by Types

1.Structure (Aluminum Frame, Carbon-Fibre Composites, Steel, and Carbon Steel, Fiberglass and Kevlar) 2.Foam Cushions 3.Upholsteries 4.Fire-Blocking Textiles 5.Plastic Molding

B.Aircraft Seat Material Market by Aircraft Type

1.Large Wide Body Aircraft 2.Medium Wide-Body Aircraft 3.Small Wide Body Aircraft 4.Single AISLE Aircraft 5.Regional Transport Aircraft

C.Aircraft Seating Materials by Seating Class

1.Suite Class. 2.First Class. 3.Business Class. 4.Premium Economy Class. 5.Economy Class.

D.Aircraft Seat Material Market by Geography (covers 10+ countries) E.Aircraft Seat Material Market Entropy

Companies Cited / Interviewed

1.ZIM FLUGSITZ GMBH. 2.TSI Aviation Seats. 3.Thales Group. 4.EADS SOGERMA 5.Singapore Technologies Aerospace Ltd. 6.AEROSEATING Technologies LLC. 7.Ki Holdings Co., Ltd. 8.Thompson Aero Seating Ltd. 9.AVIOINTERIORS S.P.A. 10.GEVEN S.P.A. 11.Company 11 12.Company 12 13.Company 13 14.Company 14+

What can you expect from the report? The Aircraft Seat Material Market Report is Prepared with the Main Agenda to Cover the following 20 points:

1. Market Size by Product Categories & Application 11. Demand Analysis (Revenue & Volume) 2. Market trends & Relevant Market Data 12. Country level Analysis 3. Manufacturer Landscape 13. Competitor Analysis 4. Distributor Landscape 14. Market Shares Analysis 5. Pricing Analysis 15. Value Chain Analysis 6. Top 10 End user Analysis 16. Supply Chain Analysis 7. Product Benchmarking 17. Strategic Analysis 8. Product Developments 18. Current & Future Market Landscape Analysis 9. Mergers & Acquisition Analysis 19. Opportunity Analysis 10. Patent Analysis 20. Revenue and Volume Analysis

Frequently Asked Questions:

Q. Does IndustryARC publish country or application based reports in Aircraft Seat Material Market segment? Response: Yes, we do have separate reports as mentioned below:

1.Americas Aircraft Seat Material Market (2018-2023) 2.Asia Pacific Aircraft Seat Material Market (2018-2023) 3.Europe Aircraft Seat Material Market (2018-2023) 4.Types Aircraft Seat Material Market (2018-2023) 5.Aircraft Type & Seat Material Market (2018-2023) 6.Seating Class Aircraft Seat Material Market (2018-2023)

Q. Does IndustryARC provide customized reports and charge additionally for limited customization? Response: Yes, we can customize the report by extracting data from our database of reports and annual subscription databases. We can provide the following free customization: 1. Increase the level of data in application or end user industry. 2. Increase the number of countries in geography chapter. 3. Find out market shares for other smaller companies or companies which are of interest to you. 4. Company profiles can be requested based on your interest. 5. Patent analysis, pricing, product analysis, product benchmarking, value and supply chain analysis can be requested for a country or end use segment.

Any other custom requirements can be discussed with our team, drop an e-mail to sales@industryarc.com to discuss more about our consulting services.

Media Contact:

Mr. Venkat Reddy Sales Manager Email 1: sales@industryarc.com Or Email 2: venkat@industryarc.com Contact Sales: +1-614-588-8538 (Ext-101)

About IndustryARC:

IndustryARC is a Research and Consulting Firm that publishes more than 500 reports annually, in various industries such as Agriculture, Automotive, Automation & Instrumentation, Chemicals and Materials, Energy and Power, Electronics, Food & Beverages, Information Technology, Life sciences & Healthcare.

[venkateshiarc-blog]

The Aircraft Seat Material Market size is expected to gain revenue of $0.14 Billion by 2023 at a CAGR of 6.6% during 2018-2023

In the report “Aircraft Seat Material Market: By Material Type (Aluminium Structure, Foam Cushions, Plastic Molding, Others); By Seat Type (Suite, First, Business, Premium Economy & Economy Classes); By Aircraft Type (RTA, WBA, Others); By Geography - (2018-2023), published by IndustryARC, the market is set to experience an upsurge in civil aircrafts, and with rising passenger traffic estimated to double in the next 10 years, a brighter investment scenario is presented for aircraft seat material manufacturers.

Asia-Pacific demanding major share in the Aircraft Seat Material Market

Asia-Pacific is the major region for aircraft seating market with revenue of $0.03 billion in 2018, and is estimated to reach $ 0.04billion by 2023. Also, Asia-Pacific market is growing at a faster growth rate compared to other established markets in America and Europe. Leading regions of Asia-Pacific such as China, Japan and India, are strongly involved in various aircraft design development activities, which makes it a high demand region for seat materials. Apart from Asia-Pacific, the seat material market revenue in the American and European region are estimated to grow with a high CAGR of 3.6% and 3.4% respectively.

Selected Type Analysis done in the full Report:

Global Aircraft Seat Material market by type is classified broadly in the report. Structure is one of the types where seat dimensions include load bearing and seating space, each having elements for securing a seat from the continuous movement between first and second positions. Structuring is very important as this allows spacing. Flight cushions is the most important type of the aircraft, providing comfort, looking after the well-being and safety. Materials used in the manufacture of foam cushions are polyurethane, neoprene, silicon and polyethylene. Polyurethane is a vital element in aircraft seat materials as it caters to the requirements.. The recent findings state that the rising civil aircrafts and aircraft upholstery business are becoming a profitable business segment. Amongst all material types, polyester frame is a noteworthy constituent among the synthetic fiber industry. It is followed by FR nylon, which is also a vital type of material that is tough and has excellent sliding properties. Furthermore, FR cotton and leather has a broad scale of application in this market. In the test conducted by Special Aviation Fire and Explosion Reduction Advisory Committee (SAFER), it was determined that airplane cushion holds the strongest potential for a fire source. Plastic molding is the foremost type of artificially created non-metallic mixes.. Polycarbonate, ABS and decorative vinyl are types of moldings used in aircraft seat material market. This plastic molding embeds liquid fluid, which is structured into different solidified shapes that are used in seat shape types. . These extensive varieties of selectable elements provide equivalent value to their operation.

To access / purchase the full report browse the link below

https://industryarc.com/Report/1313/aircraft-seat-material-market-research-report.html

Excerpts on Market Growth Factors

Modern manufacturers are now strongly looking to minimize the weight of airplane seats, which reduces the overall weight of the aircraft. The minimized weight would positively save on fuel costs, provide enhanced travel experience and lower ticket prices. Growth of global aircraft seating material market includes growth in the demand for new aircraft deliveries, up gradation of aircraft programs, and increased air travel is anticipated to contribute to the market growth. Attractive composite components of fibers had and will lead the series of innovation in this industry. The use of carbon composites has increased in high performance vehicles like jet plane, spacecraft’s, and other aircrafts.

Key players of the Aircraft Seat Material Market

Regional manufacturers that make it an extremely competitive market, are as follows: Zodiac Aerospace, B/E Aerospace, JAMCO Aircraft Interiors Company, HAECO, RECARO Aircraft Seating Gmbh & Co. Kg and others. Zodiac SA holds the major share in the overall seat material market. It holds almost 32% of the marketshare, followed by JAMCO Corp. and others, mentioned above.

Aircraft Seat Material Market report is segmented as below

The Global Aircraft Seat Material Market study across various end user industries is incorporated in the report.

A. Aircraft Seat Material Market by Types

1. Structure (Aluminum Frame, Carbon-Fibre Composites, Steel, and Carbon Steel, Fiberglass and Kevlar) 2. Foam Cushions 3. Upholsteries 4. Fire-Blocking Textiles 5. Plastic Molding

B. Aircraft Seat Material Market by Aircraft Type

1. Large Wide Body Aircraft 2. Medium Wide-Body Aircraft 3. Small Wide Body Aircraft 4. Single AISLE Aircraft 5. Regional Transport Aircraft

C. Aircraft Seating Materials by Seating Class

1. Suite Class. 2. First Class. 3. Business Class. 4. Premium Economy Class. 5. Economy Class.

D. Aircraft Seat Material Market by Geography (covers 10+ countries) E. Aircraft Seat Material Market Entropy

Companies Cited / Interviewed

1. ZIM FLUGSITZ GMBH. 2. TSI Aviation Seats. 3. Thales Group. 4. EADS SOGERMA 5. Singapore Technologies Aerospace Ltd. 6. AEROSEATING Technologies LLC. 7. Ki Holdings Co., Ltd. 8. Thompson Aero Seating Ltd. 9. AVIOINTERIORS S.P.A. 10. GEVEN S.P.A. 11. Company 11 12. Company 12 13. Company 13 14. Company 14+

What can you expect from the report? The Aircraft Seat Material Market Report is Prepared with the Main Agenda to Cover the following 20 points:

1. Market Size by Product Categories & Application 11. Demand Analysis (Revenue & Volume) 2. Market trends & Relevant Market Data 12. Country level Analysis 3. Manufacturer Landscape 13. Competitor Analysis 4. Distributor Landscape 14. Market Shares Analysis 5. Pricing Analysis 15. Value Chain Analysis 6. Top 10 End user Analysis 16. Supply Chain Analysis 7. Product Benchmarking 17. Strategic Analysis 8. Product Developments 18. Current & Future Market Landscape Analysis 9. Mergers & Acquisition Analysis 19. Opportunity Analysis 10. Patent Analysis 20. Revenue and Volume Analysis

Any other custom requirements can be discussed with our team, drop an e-mail to sales@industryarc.com to discuss more about our consulting services.

Media Contact: Mr. Venkat Reddy Sales Manager Email 1: sales@industryarc.com Or Email 2: venkat@industryarc.com Contact Sales: +1-614-588-8538 (Ext-101)

About IndustryARC:

IndustryARC is a Research and Consulting Firm that publishes more than 500 reports annually, in various industries such as Agriculture, Automotive, Automation & Instrumentation, Chemicals and Materials, Energy and Power, Electronics, Food & Beverages, Information Technology, Life sciences & Healthcare.

[wileydirect]

New Title has been published on Wiley Direct

New Post has been published on http://www.wileydirect.com.au/buy/marketing-4th-edition/

Marketing, 4th Edition

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Marketing, 4th Edition was designed with the first-year marketing student in mind and covers key marketing concepts in a style that is easy to follow and understand. This new edition uses a number of regional case studies to illustrate the relevance and importance of marketing topics covered in class. New to this edition is a whole new chapter on Data and Analytics.

  This Wiley text is delivered through WileyPLUS Learning Space and has a variety of videos and interactive modules that include activities to test your knowledge and aid in your understanding of the text.

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Features

Interactive Online Textbook: The WileyPLUS Learning Space interactive textbook is full of rich media and activities to facilitate engaged learning.

New Chapter: A brand new chapter on Data and Analytics covers this crucial topic that affects the majority of marketers in the real world.

Accessible Content: This new edition comprises insightful and engaging content delivered in concise, digestible chunks to support students’ engagement and retention.

Authors

Professor Greg Elliott

Greg Elliott was formerly Professor of Business (Marketing) in the Faculty of Business and Economics at Macquarie University, a position he held since 2005. Prior to this, he was a Professor of Management in the Macquarie Graduate School of Management. Greg has extensive experience in teaching marketing in Australia and overseas, and in course program management in South-East Asia. He is currently an academic advisor to a number of higher education providers. Before joining Macquarie University, he held academic appointments at the University of Technology, Sydney, the University of Western Australia and the University of Melbourne; and visiting appointments at Trinity College and University College, both in Dublin, Ireland. Greg has published extensively in the academic marketing literature and his current research interests are in the fields of services marketing, financial services and international marketing. Prior to his academic career, Greg spent over a decade in the marketing research and marketing planning area of the banking industry. More recently, his consulting activities have been concentrated in the banking, financial services and professional services sectors.

Professor Sharyn Rundle-Thiele

Professor Sharyn Rundle-Thiele is Director, Social Marketing at Griffith and Editor-in-Chief, Journal of Social Marketing. Drawing on her commercial marketing background, Sharyn’s research focuses on applying marketing tools and techniques to change behaviour for the better. She is currently working on projects delivering changes to the environment, people’s health and for the greater social good. Selected current projects include changing adolescent attitudes towards drinking alcohol (see www.blurredminds.com.au/students), increasing healthy eating and physical activity to combat obesity, reducing food waste and delivering change in wide variety of settings. Research partners include Defence Science and Technology Organisation, Australian Defence Force, Queensland Catholic Education Commission, Redland City Council, VicHealth and more. Sharyn’s research is published in more than 100 books, book chapters and journal papers.

Dr David Waller

David Waller is a Senior Lecturer in the School of Marketing, University of Technology Sydney. David received a Bachelor of Arts from the University of Sydney, a Master of Commerce from the University of New South Wales and a PhD from the University of Newcastle, Australia. He has over 20 years of experience teaching marketing subjects at several universities, including the University of Newcastle, the University of New South Wales and Charles Sturt University. He has taught offshore programs in Malaysia and China. Prior to his academic career, David worked in the film and banking industries. David’s research has included projects on marketing communications, advertising agency–client relationships, controversial advertising, international advertising, marketing ethics and marketing education. He has published over 70 refereed journal articles in publications including the Journal of Advertising, Journal of Advertising Research, European Journal of Marketing, Journal of Consumer Marketing, International Journal of Advertising and the Journal of Marketing Communications. David has also authored or co-authored several books and workbooks that have been used in countries in the Asia–Pacific region, and is a regular presenter at local and international conferences.

Dr Sandra Smith

Sandra Smith is a lecturer in the Department of Marketing at the University of Auckland Business School. Her research interests are framed by a general interest in the way actors in marketing systems construct meaning within and about their consumption experiences, particularly with respect to the brands with which they engage, including the ways employees narrate their experiences of the corporate brand. Sandra has also conducted work in relation to negative consumer brand engagement, movie goers’ interpretations of brand placements and consumer identity work. She has published her work in a number of top marketing journals including Marketing Theory, the European Journal of Marketing and the Journal of Retailing and Consumer Services.

Liz Eades

Liz Eades is a lecturer of Marketing at both RMIT and Swinburne universities, a position she has held for over ten years. She has over 20 years of experience in the fields of marketing and management, having worked for various multinational clients and organisations. She has managed and directed her own business since 2004, where she actively consults numerous clients on marketing, communications and management issues. Liz holds a Master of Marketing, a Master of Business Administration, and membership to various industry organisations.

Dr Ingo Bentrott

Ingo Bentrott is a lecturer in the Marketing Discipline Group at the University of Technology Sydney, a position he has held since 2005. Prior to this, Ingo worked for over six years in the analytics and data mining industry. He also worked in production and quality assurance statistics in electronics manufacturing for five years. Ingo’s research is the use of data mining to boost the accuracy of traditional marketing modelling techniques. Specifically, he looks at ways to improve models that contain unobserved heterogeneity, missing data, unknown data interactions, and large amounts of unstructured text data.

Table of Contents

Chapter 1. Introduction to marketing

Chapter 2. The marketing environment and market analysis

Chapter 3. Market research

Chapter 4. Consumer behaviour

Chapter 5. Business buying behaviour

Chapter 6. Markets: segmentation, targeting and positioning

Chapter 7. Product

Chapter 8. Price

Chapter 9. Promotion

Chapter 10. Distribution (place)

Chapter 11. Services marketing

Chapter 12. Digital marketing

Chapter 13. International marketing

Chapter 14. Social marketing and not-for-profit marketing

Chapter 15. Marketing planning, implementation and evaluation

Chapter 16. Data and analytics

Wiley Affordability Program Mission Statement

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ISBNs

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A World Without Suicide

Steve Mallen thinks the signs first started to show when his son stopped playing the piano. Edward, then 18, was a gifted musician and had long since passed his Grade 8 exams, a series of advanced piano tests. Playing had been a passion for most of his life. But as adulthood beckoned, the boy had never been busier. He had won a place to study geography at the University of Cambridge and was reviewing hard for his final exams. At his school, Edward was head boy and popular among pupils and teachers. His younger brother and sister idolized him.

“We didn’t attach any particular significance to it,” says Mallen of what he saw as merely a musical pause. “I think we just thought, ‘Well, the poor lad’s been at the piano for years and years. He’s so busy ... ’ But these are the small things—the ripples in the fabric of normal life—that you don’t necessarily notice but which, as I know now, can be very significant.”

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Three months after Edward stopped playing, and just two weeks after he handed in an English essay his teacher would later describe as among the best he had read, police knocked at the door of the family home in Meldreth, a village 10 miles south of Cambridge. Steve Mallen was at home, alone. “You become painfully aware that something appalling has happened,” he recalls. “You go through the description, they offer commiserations and a booklet, and then they leave. And that’s it. Suddenly you are staring into the most appalling abyss you can ever imagine.”

The next time Mallen heard his son play the piano, the music filled Holy Trinity Parish Church, a mile from the station where Edward caught the train to school every morning, and where he died by suicide on February 9, 2015. Steve says 500 people came to the funeral. Friends had organized a sound system to play a performance of Edward’s filmed on a mobile phone. “My son played the music at his own funeral,” Mallen says as he remembers that day over a mug of tea in a café in central London. “You couldn’t dream this stuff.”

I first talk to Mallen, who is 52, in November 2016, 21 months to the day since Edward’s death. His hair is white; his blazer, navy. He wears a white shirt and a remembrance poppy. He talks in perfect paragraphs with a default setting of businesslike, but it is clear that the abyss still falls away before him. He says it always will. But life has also become a mission, and in the two years since his son’s death by suicide, Mallen, a commercial property consultant, has become a tireless campaigner, a convener of minds. He has earned the prime minister’s ear and given evidence to health select committees. The study at his home is filled with files and research papers.

“As a father, I had one thing to do and I failed,” he says, his voice faltering for the first time. “My son was dying in front of me and I couldn’t see it, despite my education, despite my devotion as a father ... So you see this is coming from an incredible sense of guilt. I suppose what I’m trying to do is save my boy in retrospect. I stood next to his coffin in the church. It was packed with people—a shattered community—and I made him a public promise. I said that I would investigate what had happened to him and that I would seek reform for him, and on behalf of his generation.

“Quite simply, I’m just a guy honoring a promise to his son. And that’s probably the most powerful motivation that you could imagine, because I’m not about to let him down twice.”

* * *

Edward’s suicide was one of 6,188 recorded in the U.K. in 2015, an average of almost 17 a day, or two every three hours. In the U.K., suicide is the leading cause of death among women under 35 and men under 50. The World Health Organization estimates that 788,000 people died by suicide globally in 2015. Somewhere in the world, someone takes their life every 40 seconds. And despite advances in science and a growing political and popular focus on mental health, recorded suicides in the U.K. have declined only slightly over the past few decades, from 14.7 per 100,000 people 36 years ago to 10.9 in 2015.

A simple belief drives Mallen: that Edward should still be alive, that his death was preventable—at several stages during the rapid onset of his depression. Moreover, Mallen and a growing number of mental health experts believe that this applies to all deaths by suicide. They argue that with a well-funded, better-coordinated strategy that would reform attitudes and approaches in almost every function of society—from schools and hospitals to police stations and the family home—it might be possible to prevent every suicide, or at least to aspire to.

They call it Zero Suicide, a bold ambition and slogan that emerged from a Detroit hospital more than a decade ago, and which is now being incorporated into several National Health Service trusts. Since our first meeting, Mallen has himself embraced the idea, and in May of this year held talks with Mersey Care, one of the specialist mental health trusts already applying a zero strategy. His plans are at an early stage, but he is setting out to create a Zero Suicide foundation. He wants it to identify good practices across the 55 mental health trusts in England and create a new strategy to be applied everywhere.

The zero approach is a proactive strategy that aims to identify and care for all those who may be at risk of suicide, rather than reacting once patients have reached crisis point. It emphasizes strong leadership, improved training, better patient screening and the use of the latest data and research to make changes without fear or delay. It is a joined-up strategy that challenges old ideas about the “inevitability” of suicide, stigma, and the idea that if a reduction target is achieved, the deaths on the way to it are somehow acceptable. “Even if you believe we are never going to eradicate suicide, we must strive toward that,” Mallen says. “If zero isn’t the right target, then what is?”

Zero Suicide is not radical, incorporating as it does several existing prevention strategies. But that it should be seen as new and daringly ambitious reveals much about how slowly attitudes have changed. In The Uses of Literacy: Aspects of Working-Class Life (1957), a semiautobiographical examination of the cultural upheavals of the 1950s, Richard Hoggart recalled his upbringing in Leeds. “Every so often one heard that so-and-so had ‘done ’erself in,’ or ‘done away with ’imself,’ or ‘put ’er ’ead in the gas-oven,’” he wrote. “It did not happen monthly or even every season, and not all attempts succeeded; but it happened sufficiently often to be part of the pattern of life.” He wondered how “suicide could be accepted—pitifully but with little suggestion of blame—as part of the order of existence.”

Hoggart was writing about working-class communities in the north of England, but this sense of expectation and inevitability defined broad societal attitudes to suicide as well. It was also a crime. In 1956, 613 people in England and Wales were prosecuted for attempting to “commit” suicide, 33 of whom were imprisoned. The law only changed in 1961, but the stigma endured; mental health experts and the U.K. helpline Samaritans advise against the use of the term “commit” in relation to suicide, preferring “to die by suicide,” but the word still regularly appears in newspaper headlines. The same voices have strongly opposed the view that suicide is “part of the pattern of life,” ultimately giving rise to the idea that its eradication—or at least a drastic reduction—might be possible.

* * *

Traditionally, suicide has been viewed as a deliberate action, a conscious choice. As a result, mental-health systems have tended to regard at-risk patients in one of two ways. “There were the individuals who are at risk but can’t really be stopped,” says David Covington, a Zero Suicide pioneer based in Phoenix, Arizona. “They’re ‘intent on it’ is the phrase you hear. ‘You can’t stop someone who’s fully intent on killing themselves.’ So there is this strange logic that individuals who die couldn’t be stopped because they weren’t going to seek care and tell us what was going on. And those who do talk to us were seen as somehow manipulative because of their ambivalence. You heard the word ‘gesturing.’ So we have this whole language that seemed to minimize the risk.”

Covington is president and CEO of RI International, a mental-health group based in Phoenix that has more than 50 crisis centers and other programs across the United States, as well as a number in Auckland, New Zealand. A prominent and energetic speaker, he is also president-elect of the board of directors of the American Association of Suicidology, a charitable organization based in Washington, D.C., and leads an international Zero Suicide initiative. When he started in mental health more than 20 years ago, he was dismayed by the gaps in training and thinking he found in the system. Breakthroughs have come only recently, long enough for Covington to have observed and promoted a shift away from a fatalism—and a stigma—that was preventing any progress in reducing death from suicide while we eradicated diseases and tackled other threats, such as road accidents and smoking.

Covington credits a book and a bridge with accelerating that change. In Why People Die by Suicide (2005), Thomas Joiner, a professor of psychology at Florida State University, drew on the testimony of survivors, stacks of research and the loss of his own father to upend minds. He recognized the myriad pressures on a suicidal mind—substance abuse, genetic predisposition to mental illness, poverty—but identified three factors present in all of those most at risk: a genuine belief, however irrational, that they have become a burden to those around them; a sense of isolation; and the ability, which goes against our hard-wired instincts of self-preservation, to hurt oneself (this combines access to a means of suicide with what Joiner describes as a “learned fearlessness”; Covington calls it an “acquired capability”). “[The book] gave an architecture to what was going on that we had not seen before,” Covington says. “It was like a crack through the entire field.”

Then came the bridge—or The Bridge, the 2006 documentary about suicides at the Golden Gate Bridge. A swirl of outrage greeted its release, although anger was generally directed at the filmmaker rather than the toll of death and bereavement at the San Francisco landmark. Its maker Eric Steel also faced accusations of ghoulishness; The Bridge features footage of people falling to their deaths and subsequent interviews with their families. “This could be the most morally loathsome film ever made,” film critic Andrew Pulver wrote in The Guardian. Yet Steel intended to shock, and to expose an attitude to suicide on the bridge that exemplified society’s. “It hit the public psyche, it challenged core myths in a way that was extremely powerful,” Covington says.

In the 1970s, local newspapers launched countdowns to the 500th death on the bridge since its completion in 1937 (deaths have occurred on average once every two to three weeks). In 1995, a radio DJ promised a case of Snapple to the 1,000th victim’s family. Only when police intervened did official counting cease, at 997.

For decades the bridge’s directors have resisted calls, on financial and aesthetic grounds, for a safety barrier between the pedestrian walkway—which has a low railing—and the water 75 meters below. In 1953, one bridge supervisor argued that it was better that jumpers die there than on a pavement below a tall building. But in 1978, Richard Seiden, then a professor emeritus at the University of California, Berkeley’s School of Public Health, found 515 people who had been stopped from jumping from the Golden Gate Bridge between 1937 and 1971. Ninety-four percent were living or had died of natural causes.

The study, which Covington says was “ignored for 25 years,” suggested what several others have shown: Simply by removing access to danger, and an easy outlet for “learned fearlessness,” simple interventions can dramatically reduce suicide rates. On a bridge that could not be constantly patrolled, it also intensified calls for a safety net. Later, in 2008, the bridge’s board of directors voted in favor of one. Construction began only in May of this year. The steel net, to be placed six meters below the walkway, is due to be completed in 2021. It is designed not to catch people, but to deter them from jumping.

Anthony Gerace / Mosaic Science

Edward Mallen’s own Golden Gate Bridge was the train station he used every day to get to school. His father Steve will never know what went through his mind that day, but those who survive attempts to take their own life—and go on to talk about it—are being embraced in the fight for further understanding. As of 2005, a year before Steel’s documentary came out, only 26 people had lived after hitting the water below the Golden Gate Bridge at 75 mph. Those whose injuries—broken bones, punctured organs—do not kill them on impact typically then drown in pain. Recovered bodies have shown the effects of shark and crab bites.

Kevin Hines was 19 and suffering from severe bipolar disorder when he caught a bus, alone, toward the bridge in September 2000. His family knew that he had been mentally ill, and he was receiving treatment, but the voices in the young man’s head, which often came with hallucinations, willed him to take his life. They told him that he was nothing but a burden to everyone around him, and that if he revealed to anyone the extent of his suffering he would be locked up. “When you self-loathe long enough, and believe the voices, you lose all hope and suicide becomes an option,” Kevin says by phone from his home in Atlanta. “What people in that position can’t recognize is that the voice is nothing but a liar—a false reality created by your brain’s misaligning chemistry ... they believe the people around them don’t have the ability to empathize.”

Kevin was neglected by his birth parents, who had drug and mental health problems. As a newborn, before he was placed into foster care, they left him alone on the concrete floor of a motel in San Francisco and fed him Coke and stolen, sour milk. A landmark 1998 study published in the American Journal of Preventive Medicine, and cited in a report published in March by the Samaritans, showed that people with exposure to four or more “adverse childhood experiences” (known as ACEs, which include physical abuse, violence against the mother, exposure to substance abuse, or the imprisonment of a parent) were 12 times more likely to have made a suicide attempt in their lifetimes.

Kevin’s devoted adoptive parents were aware something was wrong, and helped him get treatment, but Kevin kept everyone in the dark. He told doctors he was following a plan he had not read and that he was taking his medication, which he only took sporadically, often while drinking until he blacked out. “I was a wrestling state champion, a football player, by all accounts doing great on the outside.” By the night before his bus ride, Kevin had suffered days of decline. “That’s when the bridge was the spot I decided on,” he recalls.

Anthony Gerace / Mosaic Science

Kevin rejects the notion that anyone “chooses” to take their own life. “It’s not a choice when a voice in your head, a third party to your own conscience, is literally screaming in your head, ‘You must die, jump now.’” He also challenges the idea that suicide is a selfish act, because to a person in extremis, compelled to believe they are a burden, living can feel like the selfish act. Yet he also remembers feeling how little it would have taken to deter him that morning in 2000. “I had made a pact with myself, and many survivors report this, that if anyone said to me that day, ‘Are you OK?’ or ‘Is something wrong?’ or ‘Can I help you?’—I narrowed it down to those three phrases—I would tell them everything and beg for help.” As he sat on the bus, where he remembers crying, yelling aloud at the voices to stop, nobody said anything. “It still baffles me that human beings can’t see someone like that, wailing in pain, and say something kind—anything,” he says.

As Kevin walked along the bridge and leaned over the rail, he thought help might have arrived when a woman approached him. “But she pulled out a digital camera and asked me to take her picture. She had a German accent. I figured the sun was in her eyes, maybe she didn’t see the tears. So I take this woman’s picture five times, hand her the camera, she thanks me and walks away. At that moment I said, ‘Absolutely nobody cares. Nobody.’ The voice said, ‘Jump now,’ so I did.”

It takes just under five seconds for a person to fall from the Golden Gate Bridge into the water below. “It was instant regret the moment my hand left the rail,” Kevin recalls. “But it was too late.” He opened his eyes deep underwater, his spine broken. “All I wanted to do was survive. I remember thinking, before I broke the surface, I can’t die here. If I do, nobody will know I didn’t want to die, that I’d made a mistake.” Kevin struggled to stay afloat while the coastguard came to his aid. He spent weeks recovering in a psychiatric ward and says it took years to be honest with himself about his mental health. He still works hard to stay stable, and has become a powerful voice in suicide prevention, as a researcher, writer and speaker. “Of the 25 or 26 people who have survived jumping from the Golden Gate Bridge and are still alive, 19 have said they felt instant regret the second their hand left the rail,” he says. “The act of suicide is separate from the thought of suicide.”

Removing the means of suicide has become a growing part of modern prevention strategies, whether or not they come with a “zero” tag. In the early 2000s, the U.K. Department of Health asked the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, based at the University of Manchester, to recommend a way to reduce suicides in mental health wards. “From our data, we said remove the ligature points that make it possible for people to hang themselves,” recalls Louis Appleby, a professor of psychiatry and the director of the inquiry. He also leads the National Suicide Prevention Strategy for England.

By 2002, wards were required to remove non-collapsible curtain rails in bathrooms and around beds. A later study by Appleby’s team, published in 2012, showed that inpatient suicide cases by hanging on the ward in England and Wales fell from 57 in 1999 to 15 in 2007. “There was also a broader effect, because mental health wards seem to have got safer more generally as the issue of safety became more prominent,” Appleby says. Outside hospitals, measures that have reduced suicide by specific methods, whether or not that was the intention, have included legislation to reduce the size of paracetamol packages (intended) and the conversion of coal-gas ovens to natural gas in the 1950s (unintended).

* * *

Edward Mallen and Kevin Hines had some things in common; they were young men suffering from severe mental illness. But while Kevin identifies his traumatic first months as a cause, Edward had no adverse childhood experiences. His father is not aware of a history of depression in his family, but can only surmise that genetic flaws created the fatal cocktail of chemicals that compelled him to end his life. Research in this field is evolving. Last year, scientists at Massachusetts General Hospital identified 17 genetic variations that appeared to increase the risk of depression, in an analysis of DNA data from more than 300,000 people, published in Nature Genetics. “There are vulnerability factors we all have and part of them are genetically influenced,” says Rory O’Connor, a professor of psychology at the University of Glasgow, where he leads the Suicidal Behavior Research Laboratory.

More significantly, Kevin and Edward both attempted suicide while seeking treatment for mental illness. According to the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, just over a quarter of suicide victims have had contact with mental health services in the preceding 12 months. Soon after the piano playing stopped, it became clear Edward was not well. Mallen remembers his son withdrawing. He became pale and looked unwell. He told his mother, Suzanne, that he was down, but never revealed to his parents he felt suicidal. Two weeks before his death, Edward saw his family’s general practitioner, who immediately referred him to an NHS crisis intervention team, recommending he be assessed within 24 hours. But when a triage mental health nurse with limited experience spoke to Edward, he downgraded the risk and recommended a five-day wait. Moreover, while Edward had turned 18 less than two months before his death, he had given permission for his parents to be told about his suicidal thoughts. They never were.

After an inquest in June last year, Cambridgeshire and Peterborough NHS Foundation Trust said in a statement that “while there are elements in what occurred that may well not have been foreseeable there were also things the Trust could have done better. The Trust has held an internal inquiry and also commissioned an independent report and it is implementing [their] recommendations.”

Mallen describes in an email his son’s case as “a haphazard fiasco of confused process, unclear responsibilities and tortuous post-tragedy contention which greatly deepened a family’s distress,” adding: “The real concern here is that this was not an isolated incident.”

The Zero Suicide approach started as an attempt to reduce deaths in mental health systems. At a meeting in 2001 at the Henry Ford Health System, which manages hospitals, clinics and emergency rooms across Detroit, Ed Coffey, then the CEO of its Behavioral Health Services, remembers discussing Crossing the Quality Chasm, a report published that year by the Institute of Medicine (now the National Academy of Medicine) that called for sweeping healthcare reforms. The report had triggered a debate about the idea of “perfect care,” and Coffey wondered what that might mean for mental health. “I remember a nurse raising her hand and saying, ‘Well, perhaps if we were providing perfect depression care, none of our patients would commit suicide,’” Coffey has said. (Coffey, who is now president and CEO of the Menninger Clinic, a psychiatric hospital in Houston, Texas, did not respond to requests for interview.)

Coffey took that as a challenge and set about reforming the Henry Ford Health System’s own approach with a new, Zero Suicide goal in mind. The initiative involved improvements in access to care and restrictions in access to the means of suicide. Any patient with a mental illness was treated as a suicide risk and asked two questions at every visit: “How often have you felt down in the past two weeks?” and “How often have you felt little pleasure in doing things?” High scores triggered new questions about sleep deprivation, appetite loss and thoughts about self-harm. Screenings would create personal care and safety plans and involve a patient’s family. Every death would be studied as a “learning opportunity.”

What caught global attention were the results that the Henry Ford system reported. In 1999, its annual suicide rate for mental health patients stood at 110 per 100,000. In the following 11 years, there were 160 suicides, but the average rate fell to 36 per 100,000. And in 2009, for the first time, there were zero suicides among patients. The stats were startling. But the strategy also faced criticism, partly in the way staff felt it made medical professionals hostages to fortune, with many already operating in a culture of blame. Louis Appleby also points out a lack of hard evidence to back up the strategy. But he does believe in its power to raise the profile of suicide prevention and compel mental health authorities to consider their own practices. At Magellan Health Services in Arizona, where Covington was an early adopter of Zero Suicide before moving to RI International, the network has reported a 50 percent fall in the suicide rate in the past 10 years. “We had an enormous pushback in our community and healthcare providers to get started,” he admits. “But as soon as the resistance gave way, ‘zero’ goes into the brain ... Once that seed plants, people get really excited.”

* * *

In 2013, Ed Coffey visited Mersey Care—which employs more than 5,000 people and serves more than 10 million across North West England—to talk about suicide prevention. In 2015, the trust, which sees more than 40,000 patients a year, became the first in the U.K. to adopt a Zero Suicide policy, which it ratified last year, committing to eliminating suicide from within its care by 2020. In a nondescript office at the trust’s headquarters at a business park in east Liverpool, I meet Jane Boland, a health administrator and Mersey Care’s suicide prevention clinical lead. When she started as a mental health clinician 18 years ago, she says suicide training did not exist. “We weren’t taught how to speak to someone who is suicidal,” she recalls. “It was talked about as an occupational hazard, an inevitability.” As part of Mersey Care’s new policy, Boland is responsible for delivering training to all the trust’s staff, from senior clinicians to receptionists and cleaners. “And these 5,000 people don’t exist in isolation,” she says. “They’re out in the city, on trains, noticing when people aren’t feeling great.”

The training begins with an online course designed to help staff look out for signs of distress. It also challenges the inevitability and selfishness myths around suicide. Boland gives talks too, and invites people who have been affected by suicide to share their experiences. She has even persuaded her own husband to talk about the death by suicide of his sister when he was 16 and she was 21. “He’d talked to me about it, but I hadn’t realized I was one of about four people he’d ever told,” Boland says. “Now he tells hundreds of people that there’s not a day goes by that he doesn’t think about this sister, and you can hear a pin drop.”

Anthony Gerace / Mosaic Science

Mersey Care’s plan also includes easier access to crisis care, better safety plans for each patient and swifter investigations after deaths or suicide attempts, with a focus on learning rather than blame. Joe Rafferty, the trust’s chief executive, told me in May this year that it is too soon for the policy to have shown an effect on its suicide rates, which are 5.5 per 100,000 patient contacts (Rafferty says this equates to a death per fortnight on average, and places Mersey Care in the lowest 20 percent of mental health trusts).

“But the big win has been around culture and attitude,” he says. “Even two years ago I’d talk to senior colleagues about suicide and the conversation would finish with, ‘Don’t worry, we’re in the lowest quintile’ or ‘We benchmark very favorably’ ... The biggest change has been moving to an absolute view that the benchmark should be zero.”

Rafferty sees the Zero Suicide foundation he has discussed with Steve Mallen as a way to spread this thinking to other trusts, and to any organization that might be willing to change. Mersey Care is already trying to reach some of the 70 percent of suicide victims who do not have contact with mental health services in the year before they die. Boland works with local authorities and has delivered suicide training to Job Center staff in Liverpool. The trust is in talks about delivering training to taxi drivers and barbers.

Versions of a Zero Suicide strategy have also been adopted by NHS clinical networks covering large areas of the southwest and the east of England. The spread of the approach coincides with belated political focus on suicide. In January 2015, Nick Clegg, then the deputy prime minister, launched a new mental health initiative and called on the NHS to adopt a Zero Suicide campaign. Earlier this year, the health select committee welcomed the Zero Suicide pilots, but noted that the strategy had not been more widely adopted, while outcomes were still to be evaluated. The most recent Conservative manifesto made no mention of suicide, but reaffirmed government commitment to improving mental health care. The current government target, set by the independent Mental Health Taskforce, is a modest reduction of 10 percent by 2020. Meanwhile, mental health advocates are pushing hard for better funding for mental health research, which remains a fraction of that devoted to physical health conditions such as cancer.

* * *

As a businessman, Steve Mallen finds it hard to understand why, if not the moral case for suicide prevention alone, the economic case has not brought about more rapid change.

“We’re losing so many people who would have gone on to contribute to society,” Mallen says. He wants a new focus on earlier intervention, in schools and homes and general practitioners’ offices, to identify problems before they lead to crisis, and improvements in mental health literacy. “Edward existed in a family, in a friendship group, at a sixth-form college and nobody picked up what was happening to him,” he says. “Yet in retrospect when I think back, the signs were there.”

Edward’s death devastated his family. “He was empathetic, sharing, nurturing,” Mallen says, preferring not to name his other two children, who are themselves now approaching adulthood. “We never had a lot of squabbling. He also kept me and Suzanne in check. He was wise beyond his years. Losing any member of a family is difficult, but it’s like the heart has been ripped out of the middle of ours and that has made it practically impossible.”

Mallen, in common with the mental health experts I speak to, does not believe total eradication is possible. Suicide will always be more complicated than polio. But no one doubts that huge reductions can—and must—be made, and there is a growing body of evidence to show how. If there is one thing he could change first, it would be continuing shifts in attitudes.

“Why didn’t my son ask for help?” he says as he heads to the station for the train home to Cambridge. “If my son had been taught about mental health in the same way he was taught about diet, citizenship, physical health, he would have understood that it’s okay to feel shit. But despite his brilliance, he didn’t have the education to help him come forward. At the start of that eight-week period when he stopped playing the piano, he would have said, ‘Dad, I think I might need some help.’ And we’d have got him help.”

This post appears courtesy of Mosaic.

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Article source here:The Atlantic

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A World Without Suicide

Steve Mallen thinks the signs first started to show when his son stopped playing the piano. Edward, then 18, was a gifted musician and had long since passed his Grade 8 exams. Playing had been a passion for most of his life. But as adulthood beckoned, the boy had never been busier. He had won a place to study geography at the University of Cambridge and was revising hard for his A levels. At his school, Edward was head boy and popular among pupils and teachers. His younger brother and sister idolized him.

“We didn’t attach any particular significance to it,” says Mallen of what he saw as merely a musical pause. “I think we just thought, ‘Well, the poor lad’s been at the piano for years and years. He’s so busy ... ’ But these are the small things—the ripples in the fabric of normal life—that you don’t necessarily notice but which, as I know now, can be very significant.”

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Three months after Edward stopped playing, and just two weeks after he handed in an English essay his teacher would later describe as among the best he had read, police knocked at the door of the family home in Meldreth, a village 10 miles south of Cambridge. Steve Mallen was at home, alone. “You become painfully aware that something appalling has happened,” he recalls. “You go through the description, they offer commiserations and a booklet, and then they leave. And that’s it. Suddenly you are staring into the most appalling abyss you can ever imagine.”

The next time Mallen heard his son play the piano, the music filled Holy Trinity Parish Church, a mile from the station where Edward caught the train to school every morning, and where he died by suicide on February 9, 2015. Steve says 500 people came to the funeral. Friends had organized a sound system to play a performance of Edward’s filmed on a mobile phone. “My son played the music at his own funeral,” Mallen says as he remembers that day over a mug of tea in a café in central London. “You couldn’t dream this stuff.”

I first talk to Mallen, who is 52, in November 2016, 21 months to the day since Edward’s death. His hair is white; his blazer, navy. He wears a white shirt and a remembrance poppy. He talks in perfect paragraphs with a default setting of businesslike, but it is clear that the abyss still falls away before him. He says it always will. But life has also become a mission, and in the two years since his son’s death by suicide, Mallen, a commercial property consultant, has become a tireless campaigner, a convenor of minds. He has earned the prime minister’s ear and given evidence to health select committees. The study at his home is filled with files and research papers.

“As a father, I had one thing to do and I failed,” he says, his voice faltering for the first time. “My son was dying in front of me and I couldn’t see it, despite my education, despite my devotion as a father ... So you see this is coming from an incredible sense of guilt. I suppose what I’m trying to do is save my boy in retrospect. I stood next to his coffin in the church. It was packed with people—a shattered community—and I made him a public promise. I said that I would investigate what had happened to him and that I would seek reform for him, and on behalf of his generation.

“Quite simply, I’m just a guy honouring a promise to his son. And that’s probably the most powerful motivation that you could imagine, because I’m not about to let him down twice.”

* * *

Edward’s suicide was one of 6,188 recorded in the U.K. in 2015, an average of almost 17 a day, or two every three hours. In the U.K., suicide is the leading cause of death among women under 35 and men under 50. The World Health Organization estimates that 788,000 people died by suicide globally in 2015. Somewhere in the world, someone takes their life every 40 seconds. And despite advances in science and a growing political and popular focus on mental health, recorded suicides in the U.K. have declined only slightly over the past few decades, from 14.7 per 100,000 people 36 years ago to 10.9 in 2015.

A simple belief drives Mallen: that Edward should still be alive, that his death was preventable—at several stages during the rapid onset of his depression. Moreover, Mallen and a growing number of mental health experts believe that this applies to all deaths by suicide. They argue that with a well-funded, better-coordinated strategy that would reform attitudes and approaches in almost every function of society—from schools and hospitals to police stations and the family home—it might be possible to prevent every suicide, or at least to aspire to.

They call it Zero Suicide, a bold ambition and slogan that emerged from a Detroit hospital more than a decade ago, and which is now being incorporated into several NHS trusts. Since our first meeting, Mallen has himself embraced the idea, and in May of this year held talks with Mersey Care, one of the specialist mental health trusts already applying a zero strategy. His plans are at an early stage, but he is setting out to create a Zero Suicide foundation. He wants it to identify good practices across the 55 mental health trusts in England and create a new strategy to be applied everywhere.

The zero approach is a proactive strategy that aims to identify and care for all those who may be at risk of suicide, rather than reacting once patients have reached crisis point. It emphasizes strong leadership, improved training, better patient screening and the use of the latest data and research to make changes without fear or delay. It is a joined-up strategy that challenges old ideas about the “inevitability” of suicide, stigma, and the idea that if a reduction target is achieved, the deaths on the way to it are somehow acceptable. “Even if you believe we are never going to eradicate suicide, we must strive toward that,” Mallen says. “If zero isn’t the right target, then what is?”

Zero Suicide is not radical, incorporating as it does several existing prevention strategies. But that it should be seen as new and daringly ambitious reveals much about how slowly attitudes have changed. In The Uses of Literacy: Aspects of working-class life (1957), a semiautobiographical examination of the cultural upheavals of the 1950s, Richard Hoggart recalled his upbringing in Leeds. “Every so often one heard that so-and-so had ‘done ’erself in,’ or ‘done away with ’imself,’ or ‘put ’er ’ead in the gas-oven,’” he wrote. “It did not happen monthly or even every season, and not all attempts succeeded; but it happened sufficiently often to be part of the pattern of life.” He wondered how “suicide could be accepted—pitifully but with little suggestion of blame—as part of the order of existence.”

Hoggart was writing about working-class communities in the north of England, but this sense of expectation and inevitability defined broad societal attitudes to suicide as well. It was also a crime. In 1956, 613 people in England and Wales were prosecuted for attempting to “commit” suicide, 33 of whom were imprisoned. The law only changed in 1961, but the stigma endured; the Samaritans and mental health experts advise against the use of the term “commit” in relation to suicide, preferring “to die by suicide,” but the word still regularly appears in newspaper headlines. The same voices have strongly opposed the view that suicide is “part of the pattern of life,” ultimately giving rise to the idea that its eradication—or at least a drastic reduction—might be possible.

* * *

Traditionally, suicide has been viewed as a deliberate action, a conscious choice. As a result, mental-health systems have tended to regard at-risk patients in one of two ways. “There were the individuals who are at risk but can’t really be stopped,” says David Covington, a Zero Suicide pioneer based in Phoenix, Arizona. “They’re ‘intent on it’ is the phrase you hear. ‘You can’t stop someone who’s fully intent on killing themselves.’ So there is this strange logic that individuals who die couldn’t be stopped because they weren’t going to seek care and tell us what was going on. And those who do talk to us were seen as somehow manipulative because of their ambivalence. You heard the word ‘gesturing.’ So we have this whole language that seemed to minimize the risk.”

Covington is president and CEO of RI International, a mental-health group based in Phoenix that has more than 50 crisis centers and other programs across the USA, as well as a number in Auckland, New Zealand. A prominent and energetic speaker, he is also president-elect of the board of directors of the American Association of Suicidology, a charitable organization based in Washington, D.C., and leads an international Zero Suicide initiative. When he started in mental health more than 20 years ago, he was dismayed by the gaps in training and thinking he found in the system. Breakthroughs have come only recently, long enough for Covington to have observed and promoted a shift away from a fatalism—and a stigma—that was preventing any progress in reducing death from suicide while we eradicated diseases and tackled other threats, such as road accidents and smoking.

Covington credits a book and a bridge with accelerating that change. In Why People Die by Suicide (2005), Thomas Joiner, a professor of psychology at Florida State University, drew on the testimony of survivors, stacks of research and the loss of his own father to upend minds. He recognized the myriad pressures on a suicidal mind—substance abuse, genetic predisposition to mental illness, poverty—but identified three factors present in all of those most at risk: a genuine belief, however irrational, that they have become a burden to those around them; a sense of isolation; and the ability, which goes against our hard-wired instincts of self-preservation, to hurt oneself (this combines access to a means of suicide with what Joiner describes as a “learned fearlessness”; Covington calls it an “acquired capability”). “[The book] gave an architecture to what was going on that we had not seen before,” Covington says. “It was like a crack through the entire field.”

Then came the bridge—or The Bridge, the 2006 documentary about suicides at the Golden Gate Bridge. A swirl of outrage greeted its release, although anger was generally directed at the film-maker rather than the toll of death and bereavement at the San Francisco landmark. Its maker Eric Steel also faced accusations of ghoulishness; The Bridge features footage of people falling to their deaths and subsequent interviews with their families. “This could be the most morally loathsome film ever made,” film critic Andrew Pulver wrote in the Guardian. Yet Steel intended to shock, and to expose an attitude to suicide on the bridge that exemplified society’s. “It hit the public psyche, it challenged core myths in a way that was extremely powerful,” Covington says.

In the 1970s, local newspapers launched countdowns to the 500th death on the bridge since its completion in 1937 (deaths have occurred on average once every two to three weeks). In 1995, a radio DJ promised a case of Snapple to the 1,000th victim’s family. Only when police intervened did official counting cease, at 997.

For decades the bridge’s directors have resisted calls, on financial and aesthetic grounds, for a safety barrier between the pedestrian walkway—which has a low railing—and the water 75 meters below. In 1953, one bridge supervisor argued that it was better that jumpers die there than on a pavement below a tall building. But in 1978, Richard Seiden, then a professor emeritus at the University of California, Berkeley’s School of Public Health, found 515 people who had been stopped from jumping from the Golden Gate Bridge between 1937 and 1971. Ninety-four per cent were living or had died of natural causes.

The study, which Covington says was “ignored for 25 years,” suggested what several others have shown: Simply by removing access to danger, and an easy outlet for “learned fearlessness,” simple interventions can dramatically reduce suicide rates. On a bridge that could not be constantly patrolled, it also intensified calls for a safety net. Later, in 2008, the bridge’s board of directors voted in favor of one. Construction began only in May of this year. The steel net, to be placed six meters below the walkway, is due to be completed in 2021. It is designed not to catch people, but to deter them from jumping.

Anthony Gerace / Mosaic Science

Edward Mallen’s own Golden Gate Bridge was the train station he used every day to get to school. His father Steve will never know what went through his mind that day, but those who survive attempts to take their own life—and go on to talk about it—are being embraced in the fight for further understanding. As of 2005, a year before Steel’s documentary came out, only 26 people had lived after hitting the water below the Golden Gate Bridge at 75 mph. Those whose injuries—broken bones, punctured organs—do not kill them on impact typically then drown in pain. Recovered bodies have shown the effects of shark and crab bites.

Kevin Hines was 19 and suffering from severe bipolar disorder when he caught a bus, alone, toward the bridge in September 2000. His family knew that he had been mentally ill, and he was receiving treatment, but the voices in the young man’s head, which often came with hallucinations, willed him to take his life. They told him that he was nothing but a burden to everyone around him, and that if he revealed to anyone the extent of his suffering he would be locked up. “When you self-loath long enough, and believe the voices, you lose all hope and suicide becomes an option,” Kevin says by phone from his home in Atlanta. “What people in that position can’t recognize is that the voice is nothing but a liar—a false reality created by your brain’s misaligning chemistry ... they believe the people around them don’t have the ability to empathize.”

Kevin was neglected by his birth parents, who had drug and mental health problems. As a newborn, before he was placed into foster care, they left him alone on the concrete floor of a motel in San Francisco and fed him Coke and stolen, sour milk. A landmark 1998 study published in the American Journal of Preventive Medicine, and cited in a report published last March by the Samaritans, showed that people with exposure to four or more “adverse childhood experiences” (known as ACEs, which include physical abuse, violence against the mother, exposure to substance abuse or the imprisonment of a parent) were 12 times more likely to have made a suicide attempt in their lifetimes.

Kevin’s devoted adoptive parents were aware something was wrong, and helped him get treatment, but Kevin kept everyone in the dark. He told doctors he was following a plan he had not read and that he was taking his medication, which he only took sporadically, often while drinking until he blacked out. “I was a wrestling state champion, a football player, by all accounts doing great on the outside.” By the night before his bus ride, Kevin had suffered days of decline. “That���s when the bridge was the spot I decided on,” he recalls.

Anthony Gerace / Mosaic Science

Kevin rejects the notion that anyone “chooses” to take their own life. “It’s not a choice when a voice in your head, a third party to your own conscience, is literally screaming in your head, “You must die, jump now.’” He also challenges the idea that suicide is a selfish act, because to a person in extremis, compelled to believe they are a burden, living can feel like the selfish act. Yet he also remembers feeling how little it would have taken to deter him that morning in 2000. “I had made a pact with myself, and many survivors report this, that if anyone said to me that day, ‘Are you OK?’ or ‘Is something wrong?’ or ‘Can I help you?’—I narrowed it down to those three phrases—I would tell them everything and beg for help.” As he sat on the bus, where he remembers crying, yelling aloud at the voices to stop, nobody said anything. “It still baffles me that human beings can’t see someone like that, wailing in pain, and say something kind—anything,” he says.

As Kevin walked along the bridge and leaned over the rail, he thought help might have arrived when a woman approached him. “But she pulled out a digital camera and asked me to take her picture. She had a German accent. I figured the sun was in her eyes, maybe she didn’t see the tears. So I take this woman’s picture five times, hand her the camera, she thanks me and walks away. At that moment I said, ‘Absolutely nobody cares. Nobody.’ The voice said, ‘Jump now,’ so I did.”

It takes just under five seconds for a person to fall from the Golden Gate Bridge into the water below. “It was instant regret the moment my hand left the rail,” Kevin recalls. “But it was too late.” He opened his eyes deep underwater, his spine broken. “All I wanted to do was survive. I remember thinking, before I broke the surface, I can’t die here. If I do, nobody will know I didn’t want to die, that I’d made a mistake.” Kevin struggled to stay afloat while the coastguard came to his aid. He spent weeks recovering on a psychiatric ward and says it took years to be honest with himself about his mental health. He still works hard to stay stable, and has become a powerful voice in suicide prevention, as a researcher, writer and speaker. “Of the 25 or 26 people who have survived jumping from the Golden Gate Bridge and are still alive, 19 have said they felt instant regret the second their hand left the rail,” he says. “The act of suicide is separate from the thought of suicide.”

Removing the means of suicide has become a growing part of modern prevention strategies, whether or not they come with a “zero” tag. In the early 2000s, the U.K. Department of Health asked the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, based at the University of Manchester, to recommend a way to reduce suicides on mental health wards. “From our data, we said remove the ligature points that make it possible for people to hang themselves,” recalls Louis Appleby, a professor of psychiatry and the director of the inquiry. He also leads the National Suicide Prevention Strategy for England.

By 2002, wards were required to remove non-collapsible curtain rails in bathrooms and around beds. A later study by Appleby’s team, published in 2012, showed that inpatient suicide cases by hanging on the ward in England and Wales fell from 57 in 1999 to 15 in 2007. “There was also a broader effect, because mental health wards seem to have got safer more generally as the issue of safety became more prominent,” Appleby says. Outside hospitals, measures that have reduced suicide by specific methods, whether or not that was the intention, have included legislation to reduce the size of paracetamol packages (intended) and the conversion of coal-gas ovens to natural gas in the 1950s (unintended).

* * *

Edward Mallen and Kevin Hines had some things in common; they were young men suffering from severe mental illness. But while Kevin identifies his traumatic first months as a cause, Edward had no adverse childhood experiences. His father is not aware of a history of depression in his family, but can only surmise that genetic flaws created the fatal cocktail of chemicals that compelled him to end his life. Research in this field is evolving. Last year, scientists at Massachusetts General Hospital identified 17 genetic variations that appeared to increase the risk of depression, in an analysis of DNA data from more than 300,000 people, published in Nature Genetics. “There are vulnerability factors we all have and part of them are genetically influenced,” says Rory O’Connor, a professor of psychology at the University of Glasgow, where he leads the Suicidal Behavior Research Laboratory.

More significantly, Kevin and Edward both attempted suicide while seeking treatment for mental illness. According to the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, just over a quarter of suicide victims have had contact with mental health services in the preceding 12 months. Soon after the piano playing stopped, it became clear Edward was not well. Mallen remembers his son withdrawing. He became pale and looked unwell. He told his mother, Suzanne, that he was down, but never revealed to his parents he felt suicidal. Two weeks before his death, Edward saw his family’s GP, who immediately referred him to an NHS crisis intervention team, recommending he be assessed within 24 hours. But when a triage mental health nurse with limited experience spoke to Edward, he downgraded the risk and recommended a five-day wait. Moreover, while Edward had turned 18 less than two months before his death, he had given permission for his parents to be told about his suicidal thoughts. They never were.

After an inquest in June last year, Cambridgeshire and Peterborough NHS Foundation Trust said in a statement that “while there are elements in what occurred that may well not have been foreseeable there were also things the Trust could have done better. The Trust has held an internal enquiry and also commissioned an independent report and it is implementing [their] recommendations.”

Mallen describes in an email his son’s case as “a haphazard fiasco of confused process, unclear responsibilities and tortuous post-tragedy contention which greatly deepened a family’s distress,” adding: “The real concern here is that this was not an isolated incident.”

The Zero Suicide approach started as an attempt to reduce deaths in mental health systems. At a meeting in 2001 at the Henry Ford Health System, which manages hospitals, clinics and emergency rooms across Detroit, Ed Coffey, then the CEO of its Behavioural Health Services, remembers discussing Crossing the Quality Chasm, a report published that year by the US Institute of Medicine that called for sweeping healthcare reforms. The report had triggered a debate about the idea of “perfect care,” and Coffey wondered what that might mean for mental health. “I remember a nurse raising her hand and saying, ‘Well, perhaps if we were providing perfect depression care, none of our patients would commit suicide,’” Coffey has said. (Coffey, who is now president and CEO of the Menninger Clinic, a psychiatric hospital in Houston, Texas, did not respond to requests for interview.)

Coffey took that as a challenge and set about reforming the Henry Ford Health System’s own approach with a new, Zero Suicide goal in mind. The initiative involved improvements in access to care and restrictions in access to the means of suicide. Any patient with a mental illness was treated as a suicide risk and asked two questions at every visit: “How often have you felt down in the past two weeks?” and “How often have you felt little pleasure in doing things?” High scores triggered new questions about sleep deprivation, appetite loss and thoughts about self-harm. Screenings would create personal care and safety plans and involve a patient’s family. Every death would be studied as a “learning opportunity.”

What caught global attention were the results that the Henry Ford system reported. In 1999, its annual suicide rate for mental health patients stood at 110 per 100,000. In the following 11 years, there were 160 suicides, but the average rate fell to 36 per 100,000. And in 2009, for the first time, there were zero suicides among patients. The stats were startling. But the strategy also faced criticism, partly in the way staff felt it made medical professionals hostages to fortune, with many already operating in a culture of blame. Louis Appleby also points out a lack of hard evidence to back up the strategy. But he does believe in its power to raise the profile of suicide prevention and compel mental health authorities to consider their own practices. At Magellan Health Services in Arizona, where Covington was an early adopter of Zero Suicide before moving to RI International, the network has reported a 50 per cent fall in the suicide rate in the past 10 years. “We had an enormous pushback in our community and healthcare providers to get started,” he admits. “But as soon as the resistance gave way, ‘zero’ goes into the brain ... Once that seed plants, people get really excited.”

* * *

In 2013, Ed Coffey visited Mersey Care—which employs more than 5,000 people and serves more than 10 million across the Northwest—to talk about suicide prevention. In 2015, the trust, which sees more than 40,000 patients a year, became the first in the U.K. to adopt a Zero Suicide policy, which it ratified last year, committing to eliminating suicide from within its care by 2020. In a nondescript office at the trust’s headquarters at a business park in east Liverpool, I meet Jane Boland, a health administrator and Mersey Care’s suicide prevention clinical lead. When she started as a mental health clinician 18 years ago, she says suicide training did not exist. “We weren’t taught how to speak to someone who is suicidal,” she recalls. “It was talked about as an occupational hazard, an inevitability.” As part of Mersey Care’s new policy, Boland is responsible for delivering training to all the trust’s staff, from senior clinicians to receptionists and cleaners. “And these 5,000 people don’t exist in isolation,” she says. “They’re out in the city, on trains, noticing when people aren’t feeling great.”

The training begins with an online course designed to help staff look out for signs of distress. It also challenges the inevitability and selfishness myths around suicide. Boland gives talks too, and invites people who have been affected by suicide to share their experiences. She has even persuaded her own husband to talk about the death by suicide of his sister when he was 16 and she was 21. “He’d talked to me about it, but I hadn’t realized I was one of about four people he’d ever told,” Boland says. “Now he tells hundreds of people that there’s not a day goes by that he doesn’t think about this sister, and you can hear a pin drop.”

Anthony Gerace / Mosaic Science

Mersey Care’s plan also includes easier access to crisis care, better safety plans for each patient and swifter investigations after deaths or suicide attempts, with a focus on learning rather than blame. Joe Rafferty, the trust’s chief executive, told me in May this year that it is too soon for the policy to have shown an effect on its suicide rates, which are 5.5 per 100,000 patient contacts (Rafferty says this equates to a death per fortnight on average, and places Mersey Care in the lowest 20 per cent of mental health trusts).

“But the big win has been around culture and attitude,” he says. “Even two years ago I’d talk to senior colleagues about suicide and the conversation would finish with, ‘Don’t worry, we’re in the lowest quintile’ or ‘We benchmark very favourably’ ... The biggest change has been moving to an absolute view that the benchmark should be zero.”

Rafferty sees the Zero Suicide foundation he has discussed with Steve Mallen as a way to spread this thinking to other trusts, and to any organization that might be willing to change. Mersey Care is already trying to reach some of the 70 per cent of suicide victims who do not have contact with mental health services in the year before they die. Boland works with local authorities and has delivered suicide training to Job Centre staff in Liverpool. The trust is in talks about delivering training to taxi drivers and barbers.

Versions of a Zero Suicide strategy have also been adopted by NHS clinical networks covering large areas of the south-west and the east of England. The spread of the approach coincides with belated political focus on suicide. In January 2015, Nick Clegg, then the deputy prime minister, launched a new mental health initiative and called on the NHS to adopt a Zero Suicide campaign. Earlier this year, the health select committee welcomed the Zero Suicide pilots, but noted that the strategy had not been more widely adopted, while outcomes were still to be evaluated. The most recent Conservative manifesto made no mention of suicide, but reaffirmed government commitment to improving mental health care. The current government target, set by the independent Mental Health Taskforce, is a modest reduction of 10 per cent by 2020. Meanwhile, mental health advocates are pushing hard for better funding for mental health research, which remains a fraction of that devoted to physical health conditions such as cancer.

* * *

As a businessman, Steve Mallen finds it hard to understand why, if not the moral case for suicide prevention alone, the economic case has not brought about more rapid change.

“We’re losing so many people who would have gone on to contribute to society,” Mallen says. He wants a new focus on earlier intervention, in schools and homes and GP surgeries, to identify problems before they lead to crisis, and improvements in mental health literacy. “Edward existed in a family, in a friendship group, at a sixth-form college and nobody picked up what was happening to him,” he says. “Yet in retrospect when I think back, the signs were there.”

Edward’s death devastated his family. “He was empathetic, sharing, nurturing,” Mallen says, preferring not to name his other two children, who are themselves now approaching adulthood. “We never had a lot of squabbling. He also kept me and Suzanne in check. He was wise beyond his years. Losing any member of a family is difficult, but it’s like the heart has been ripped out of the middle of ours and that has made it practically impossible.”

Mallen, in common with the mental health experts I speak to, does not believe total eradication is possible. Suicide will always be more complicated than polio. But no one doubts that huge reductions can—and must—be made, and there is a growing body of evidence to show how. If there is one thing he could change first, it would be continuing shifts in attitudes.

“Why didn’t my son ask for help?” he says as he heads to the station for the train home to Cambridge. “If my son had been taught about mental health in the same way he was taught about diet, citizenship, physical health, he would have understood that it’s OK to feel shit. But despite his brilliance, he didn’t have the education to help him come forward. At the start of that eight-week period when he stopped playing the piano, he would have said, ‘Dad, I think I might need some help.’ And we’d have got him help.”

This post appears courtesy of Mosaic.

from Health News And Updates https://www.theatlantic.com/health/archive/2017/08/zero-suicide-strategy/535587/?utm_source=feed

[valqin]

Day 4, 5/3/2017

I swear I’m literally the slowest person walking in nyc right now. I spent 20 minutes walking from home to Stern because i don’t want to pay 8 bucks for uber. As I was walking, I saw an 80-year-old grandpa walking past me, and I was like yo i’m chill keep walking good for you (fake lols)

I went to PT, i told Robert: i have two news, one good, one bad, which one do you wanna hear first? Robert: What’s the good news. I: I think I’m having some motion back for my right ankle. He looked at me: I think something happened to your left foot.... I: (real lols) Yah i sprained my left foot. Precious conversations. Robert said both my feet actually looked fine and forced me to do leg press right after. I don’t like intense people (sarcasm sign up lmao)

It feels great to go outside again. Feels great to see the sun again. Feels great to have human interaction again. Yesterday had a long fun talk with Serena and she tried to take 乌青眼 back but I fought to keep her. 乌青眼 is a super cute fluffy cat which I secretly stole from Serena and i just named her yesterday. I named every one of my fluffy animal and I talk to them like psycho does and I introduce them to my friends and freak them out. My favorite one is George, he’s a penguin I got in Atlanta when I went to Shaky Beats. Because ATL is in Georgia State, so I named him George. He’s the one that needs the most love, I can just tell. So one time when Winny came over and slept on my bed, I said can you hold George when you’re sleeping cuz he needs love. I’m not psycho I promise, I’m just so “emotionally available” quote Serena- I explained it as there’re just too much love in my chest and they’re pouring out but no one’s at the other end to receive so i give all of them to my fluffy friends. 

Serena logged on my facebook yesterday so I guess now I’m officially going on messenger right now. (Her favorite is Dolan the bunny by the way). And the moment i checked my message I realize how care-free I was the last three days, because you don’t care when you don’t know. It bugs me how much I care while the others don’t. Christina labeled me as “pro of ignoring people” I said no I miss human contact, but human just keep disappointing you don’t they. I never ignore people who don’t ignore me, I ignore because it’s my revenge, it’s me paying you back passive aggressively. I need an intervention geez (fake lols)

Apparently i am a funny person- I myself don’t even see it. My friend screenshot my email and send it to me and say he can’t stop laughing reading my email. I wish i have the ability to amuse myself just as I amuse others (fake lols)

Today is such a great day. I talked to tons of people I bumped into at school. I asked Damodaran question and he answered so nicely and I’m more than pumped to write my own story on COH! I get productive with Daisy and get all my data from Capital IQ, which I’ve never tried before (woohoo) I ate healthily, and I went to PT. I don’t see how this is not a great way to spend my last 10 days at NYU, especially when i’m officially disabled. Serena said she’s really glad that I still have a sense of humor right now. DUH dude.

I realized I missed the last class of The Science of Happiness and this fact made me so unhappy I felt like the half semester of this class went to waste. I miss those weirdly wonderful people raising their hands and sharing their stories in front of 350 strangers. It feels like a rehab. It’s okay. How can you spell LIFE without REGRET anyway (you actually can, this is a very bad joke, sorry)

1. Apple now has $250 bn cash on balance sheet right now, WHERE THE HELL can they even store this amount of cash??? that’s why it’s trapped cash i guess

2. Damodaran told the best joke of the day. “WSJ posted an article listing the 60 companies that Apple can buy with $250 bn, like Tesla or Disney (what the hell does Apple want Tesla for??) I don’t know what’s the point. You look at world’s GDP, and you can list out 60 countries Apple can buy with $250 bn, they can buy Venezuela.” OMG MADE MY DAY LMAO.

3. My EAD card is finally in process! HELLO TAIWAN!!

4. I don’t like the feeling when I start using messenger again, the itch in my hand is back, and I constantly want to check if people reply I HATE IT

5. I am so emotionally available to the extent that I can feel this emotionally attached with someone I’ve never seen and never even had real conversations with. Wait is this emotionally available or just low self-esteem I don’t even understand myself (i think it’s just the fact that he commented “city of stars” on soundcloud really blow the cuteness out of me LIKE FOR REAL<3)

6. I swear in a month I won’t even remember this guy’s name so just let time does its working magic thanks

7. Now i find you can call uber on your laptop, WHAT’S THE POINT OF HAVING A PHONE EVER AGAIN??

Today’s college report features Odesza, simply because I miss ATL SO F MUCH THAT MY CHEST PHYSICALLY HURTS WHEN I TYPE THESE. 

Faded- Zhu, Odesza Remix, 5/21/2016 

Take me back to the good old time when I’m not graduating, when I have all my friends in new york and not in the fear of losing them to the rest of the world.

Still, everything aside. Perfect fourth day without a phone but very few minutes dedicated to messenger. I don’t think I need to touch my phone again, except when I need to buy more shares of COH lol.

All is more than well, all is perfect. 

[sagarrachnagrp]

Best Sample Paper Science Class 10 CBSE 2025 with more than 35 question papers

Together with CBSE Class 10th CBSE Sample Paper Science 2025 (EAD) with Physical & Digital question papers for board exams. The perfect step-by-step study material for students is based on latest syllabus with right practice and approach to newest pattern of question paper & marking scheme. Grab Sample Paper Class 10 2025 at best offers.

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Get Latest CBSE Sample Paper (MCQ) Social Science for 2021 Term 1 Board Exams- Rachna Sagar

Together with CBSE Sample Paper, Social Science has been designed as per the special scheme of assessment vide CBSE Circular No. 75/2021 for Term 1 ( For 2021 Nov-Dec Examination ) for Class 10 has been prepared as per the latest assessment pattern. 

Together with EAD Social Science Sample Paper (with answers) is a perfect step-by-step approach to ensure one’s readiness for Term 1 board examination. This Sample Paper for Class 10 assists the students with the right practice and approach to the newest MCQ pattern. 

EAD—Easy, Average, Difficult 

The content matter in this EAD 12+1 Social Science Sample Paper Class 10 has been arranged as complete papers with three levels of difficulty—Easy, Average and Difficult (EAD). 

Easy: The first set of papers in this CBSE Sample Paper 2021 is based on 'Easy' concept, thus contains Multiple Choice Questions of simple level, which a student can attempt at the beginning of the preparatory stage. 

Average: The next set based on 'Average' concept (MCQs) is graded to a level of difficulty to test mid-level preparedness for the examination. 

Difficult: The challenging papers allocated to the third set based on 'Difficult' concept are a test of complete preparedness for the examination. 

The EAD sample paper is a self-test drive for the students. 

Key Features 

This Sample Paper includes:

CBSE (2021-2022) Term 1 Sample Paper. 

3 Sample Papers each of Easy, Average & Difficult level. 

2 Pre-Board Papers based on CBSE pattern. 

1 Mock Paper Based On CBSE Pattern with OMR Sheet. 

Includes Assertion Reasoning and Case-Based Objective Type Questions. 

The 4-Step Process 

Step 1 The students are advised to attempt the set of EASY Papers first and obtain at least 80% marks to move onto the next set of papers which is Average. 

Step 2 If the student obtains 75% marks in the AVERAGE category of this EAD 12+1 Social Science Sample Paper Class 10, he/she can switch to the next category, i.e., Difficult. 

Step 3 If 70% marks in DIFFICULT category have been obtained, the students are expected to take the PRE-BOARD PAPERS that are exactly based on the CBSE pattern. 

Step 4 Attempt the MOCK PAPER (given at the end) for a final-go for your board exam preparations. 

Why EAD Latest Sample Papers? 

Learning gets strengthened with practice and its evaluation uplifts the preparation. The answers of the MCQs have been given at the end of each Sample Paper for evaluation purposes. The CBSE Sample Papers for class 10 All Subjects 2021-2022 have been prepared by a panel comprising experienced teachers, tabulators and examiners, who have jointly come up with a student-friendly approach to prepare the students for the forthcoming CBSE Board Examination. Repetitive practice of CBSE Sample Papers for class 10 All Subjects 2021-2022 will surely help the students to make their mark in the CBSE Board Examination. 

Good Luck!

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Most recommended Class 10 CBSE Sample Paper 2025 Social Science |EAD books

Together with CBSE Sample Paper Class 10 Social Science as per Easy, Average & Difficult levels of questions to prepare for 2025 board exams with right strategy. Practicing more than 35 EAD level based question papers are given in Best Sample Paper for Class 10 CBSE 2025.

Shop Now: https://www.rachnasagar.in/cbse/together-with-cbse-sample-paper-ead-class-10-social-science-for-board-examination-2025?id=2428

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Class 10th CBSE board Sample Paper English, Science & Social Science EAD 2025

Combo set of 3 books by Rachna Sagar, Together with CBSE EAD Sample Paper Class 10 2025 includes Science, Social Science & English Language & Literature with 105+ SQPs having 35+ paper with Digital content for each subject for Board Exams. Latest Examination Paper, 2024. CBSE Class 10 Sample Paper 2025 and CBSE Topper‘s Sheet gives a clear picture of question & answer pattern.

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Best Sample Paper for Class 10 CBSE 2025 Science as per EAD levels

Together with the Class 10th Science CBSE Sample Paper released by Rachna Sagar is 100% based on Latest Sample Paper pattern for 2025 Board Exams. Latest edition of EAD Class 10 Sample Paper 2025 Science with digital content is a perfect step-by-step study material for students to prepare for Board Exams as per the latest exam pattern.

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Best Sample Paper for Class 10 CBSE 2025 Social Science

Together with EAD Class 10 Sample Paper 2025 Social Science for best results in CBSE Board Exams 2024-25. EAD levels of Class 10th CBSE Sample Paper are given in Physical + Digital Content. Best practice material to ace 2024-25 Social science board exams includes more than 35 SQPs to achieve 100% success.