Telerobotic interventions from a distance: an initial experience in 3D phantom mapping

Introduction

The current COVID-19 pandemic has fostered several accelerations in “remote” patient care such as video and telephone clinics, as well as multidisciplinary collaborations using online platforms with experts consulting the local teams from a distance. The next logical step would be to also offer remote-controlled interventions which the expert operator not on site, but in support of the local team. This is especially valuable for complex interventions when either patient or expert operator can not be present at the same place.

Purpose

We aimed to demonstrate that an expert operator located at far distance (Austria) could directly interact with the remote magnetic navigation system in London (UK) whilst mapping a 3D phantom using an electroanatomical mapping system.

Method

Two experienced operators of the magnetic navigation system were tasked with creating fast anatomic maps (FAM) of the atrial and ventricular chambers of a 3D phantom using remote magnetic navigation in combination with 3D electroanatomical mapping. One was located in the control room of the magnetic catheter lab (UK) and the second one was in Tirol, Austria and connected through a secure remote desktop connection (via high speed fibre optic cable). Using a solid tip magnetic catheter connected to a mechanical drive, all interactions with the system were carried out via the Odyssey platform. Acquisitions for right and left atrium, as well as right and left ventricles plus aorta was compared with regards to mapping duration, map completeness (as judged by the average distance of surface points from 3D CT scan reconstruction), total 3D map volume and need for additional radiation exposure during the mapping process.

Results

Mapping time and map completeness when performed by the distant operator was not inferior to the local operator and both did not require any additional radiation exposure during the mapping process. Table 1 demonstrates the mean parameters for each chamber, respectively. Figure 1 depicts the matched data for chamber completeness as compared for the LA (green= local operator, pink= distant operator) using a contrast CT scan as the gold standard.

Conclusion

Telerobotic 3D mapping of a 3D phantom from a distance was equally fast delivered from the control room as compared to an operator located 1200 km away without compromising on map completeness. This demonstrates the feasibility of telerobotic interventions and stress the need for remote collaboration which is especially valuable when travel of patients and/or physician experts is restricted.

Funding Acknowledgement

Type of funding sources: None.  

Oral care experiences of palliative care patients, their relatives/carers and healthcare professionals

AIM

To explore the oral care experiences of palliative care patients and of those who support or deliver oral care to these patients: nurses, doctors, dentists, their relatives and carers.

DATA SOURCES

An electronic search of the databases included: Embase, MEDLINE, DOSS, AMED and PsycINFO was performed.

DATA SELECTION

Six articles were included in the final synthesis.

DATA EXTRACTION

Thematic analysis was applied by two researchers.

DATA SYNTHESIS

Three themes were identified: 'performing oral care', 'effects on oral health' and 'challenges in palliative care'.

CONCLUSIONS

Despite similarities of oral care experiences, this review identified some differences, crucially in terms of the wider impact of oral symptoms, namely social interactions with others and challenges to oral care. This confirms the need to investigate these topics further in relation to different stakeholders, such as nurses; and to have consistent guidance to facilitate the provision of effective oral care to palliative care patients.

Telerobotic interventions from a distance: an initial experience in 3D phantom mapping

Introduction

The current COVID-19 pandemic has fostered several accelerations in “remote” patient care such as video and telephone clinics, as well as multidisciplinary collaborations using online platforms with experts consulting the local teams from a distance. The next logical step would be to also offer remote-controlled interventions which the expert operator not on site, but in support of the local team. This is especially valuable for complex interventions when either patient or expert operator can not be present at the same place.

Purpose

We aimed to demonstrate that an expert operator located at far distance (Austria) could directly interact with the remote magnetic navigation system in London (UK) whilst mapping a 3D phantom using an electroanatomical mapping system.

Method

Two experienced operators of the magnetic navigation system were tasked with creating fast anatomic maps (FAM) of the atrial and ventricular chambers of a 3D phantom using remote magnetic navigation in combination with 3D electroanatomical mapping. One was located in the control room of the magnetic catheter lab (UK) and the second one was in Tirol, Austria and connected through a secure remote desktop connection (via high speed fibre optic cable). Using a solid tip magnetic catheter connected to a mechanical drive, all interactions with the system were carried out via the Odyssey platform. Acquisitions for right and left atrium, as well as right and left ventricles plus aorta was compared with regards to mapping duration, map completeness (as judged by the average distance of surface points from 3D CT scan reconstruction), total 3D map volume and need for additional radiation exposure during the mapping process.

Results

Mapping time and map completeness when performed by the distant operator was not inferior to the local operator and both did not require any additional radiation exposure during the mapping process. Table 1 demonstrates the mean parameters for each chamber, respectively. Figure 1 depicts the matched data for chamber completeness as compared for the LA (green= local operator, pink= distant operator) using a contrast CT scan as the gold standard.

Conclusion

Telerobotic 3D mapping of a 3D phantom from a distance was equally fast delivered from the control room as compared to an operator located 1200 km away without compromising on map completeness. This demonstrates the feasibility of telerobotic interventions and stress the need for remote collaboration which is especially valuable when travel of patients and/or physician experts is restricted.

Funding Acknowledgement

Type of funding sources: None. Matched data for aorta

Relationship between early language competence and cognitive emotion regulation in adolescence

Cognitive emotion regulation improves throughout adolescence and promotes good mental health. Here, we test whether language skills at school entry predict success in emotion regulation in an experimental task at age 10-11, using longitudinal data from the Surrey Communication and Language in Education Study. We additionally compared the performance of children with and without language disorder (LD). Across the whole sample (N = 344), language skills at school entry predicted emotion regulation success in Year 6 (β = 0.23), over and above the concurrent association between language and regulation success. There was no evidence that children with LD that could engage in the task were less successful regulators compared to peers with typical language. However, a quarter of children with LD were unable to complete the task. These children had more severe language difficulties, lower non-verbal IQ and more comorbid conditions. This has implications for clinicians addressing mental health needs for children with neurodevelopmental conditions that affect language, as conversations about emotions and emotion regulation are an integral part of therapy. The longitudinal relationship between language skills and the capacity to use temporal distancing for emotion regulation in early adolescence suggests that language may drive improvements in emotion regulation.

Sources of variability in the prospective relation of language to social, emotional, and behavior problem symptoms: Implications for developmental language disorder

Children with developmental language disorder (DLD) are at risk for social, emotional, and behavioral (SEB) maladjustment throughout development, though it is unclear if poor language proficiency per se can account for this risk as associations between language and SEB appear more variable among typical-language children. This study investigated whether the relationship between language and SEB problems is stronger at very low levels of language and considered confounders including socioeconomic status, sex, and nonverbal intelligence. These were examined using a population-based survey design, including children with a wide range of language and cognitive profiles, and assessed using the Strengths and Difficulties Questionnaire and six standardized language measures (n = 363, weighted n = 6,451). Structural equation models adjusted for prior levels of SEB revealed that the relationship of language at age 5-6 years to SEB at 7-9 years was nonlinear. Language more strongly predicted all clusters of SEB at disordered language levels relative to typical language levels, with standardized betas of -.25 versus .03 for behavioral, -.31 versus -.04 for peer, and .27 versus .03 for prosocial problems. Wald tests between these pairs of betas yielded p values from .049 to .014. Sex moderated the nonlinear association between language and emotional symptoms. These findings indicate a clinical need to support language development in order to mitigate against problems of SEB and to carefully monitor the mental health needs of children with DLD, particularly in the context of multiple, and potentially sex-specific, risks. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

"She knows me best": a qualitative study of patient and caregiver views on the role of the primary care physician follow-up post-hospital discharge in individuals admitted with chronic obstructive pulmonary disease or congestive heart failure

Background

Patients with chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) are at high-risk of readmission after hospital discharge. There is conflicting evidence however on whether timely follow-up with a primary care provider reduces that risk. The objective of this study is to understand the perspectives of patients with COPD and CHF, and their caregivers, on the role of primary care provider follow-up after hospital discharge.

Methods

A qualitative study design with semi-structured interviews was conducted among patients or their family caregivers admitted with COPD or CHF who were enrolled in a randomized controlled study at three acute care hospitals in Ontario, Canada. Participants were interviewed between December 2017 to January 2019, the majority discharged from hospital at least 30 days prior to their interview. Interviews were analyzed independently by three authors using a deductive directed content analysis, with the fourth author cross-comparing themes.

Results

Interviews with 16 participants (eight patients and eight caregivers) revealed four main themes. First, participants valued visiting their primary care provider after discharge to build upon their longitudinal relationship. Second, primary care providers played a key role in coordinating care. Third, there were mixed views on the ideal time for follow-up, with many participants expressing a desire to delay follow-up to stabilize following their acute hospitalization. Fourth, the link between the post-discharge visit and preventing hospital readmissions was unclear to participants, who often self-triaged based on their symptoms when deciding on the need for emergency care.

Conclusions

Patients and caregivers valued in-person follow-up with their primary care provider following discharge from hospital because of the trust established through pre-existing longitudinal relationships. Our results suggest policy makers should focus on improving rates of primary care provider attachment and systems supporting informational continuity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12875-021-01524-7.

Oral Care Experiences of Palliative Care Patients, Their Relatives, and Health Care Professionals: A Qualitative Study

Oral symptoms in a growing number of palliative care patients are often neglected. Dental professionals are not always involved in palliative care. Oral care is often inadequately delivered to palliative care patients, while oral problems can affect the quality of life. A qualitative study was conducted to explore oral care experiences of palliative care patients, their relatives, and health care professionals (HCPs). Four patients, 4 relatives, and 4 HCPs were interviewed in a hospice. Transcripts were analyzed using thematic analysis and revealed 3 themes. Patients who were capable of performing oral care mainly brushed their teeth and looked after their dentures. Other care tended to be carried out by relatives and HCPs, adapted based on a person's level of consciousness. When describing the effects on oral health, relatives and HCPs tended to focus on xerostomia, whereas patients provided detailed accounts denoting the psychological and social impact of oral symptoms. Perceptions of enablers and barriers to oral care differed between groups. Patients reported lack of access to professional dental care and patients' fatigue were the main barriers to oral care. Nevertheless, there is great scope for further research into good oral care practices identified in this study and possible implementation in other settings.

Policy mixes to achieve sustainable mobility after the COVID-19 crisis

The COVID-19 pandemic has the potential to have lasting impacts on energy and the environment at the global scale. Shelter-in-place measures implemented to mitigate the spread of COVID-19 have resulted in expectations for 2020 global energy demand to contract by nearly 5% with related global CO₂ emissions declining by as much as 7%. Exactly how long and to what extent we will see continue to see energy demand, CO₂ and related greenhouse gas (GHG) emission destruction resulting from COVID-19 is uncertain but dependent on global policy responses to the pandemic. Policy responses targeting the transportation sector, particularly ground-based transportation, can stimulate a sustainable mobility transition that mitigates the potential for long-term environmental damage. This paper reviews and examines social and cultural dynamics of transportation and extends state-of-the-art knowledge to consider how events surrounding the COVID-19 crisis may have created a sustainable mobility opportunity though (1) avoiding unnecessary transportation volume, (2) shifting transportation norms and practices and/or (3) improving the carbon-efficiency of transportation systems. Relevant policies for a low-carbon transportation transition are considered and those most appropriate to the current context are proposed with consideration of key factors that may help or hinder their implementation success.

Intermediate layer contribution in placental membrane allografts

Placental membrane (PM) allografts are commonly used to treat chronic wounds. Native PM is composed of an amnion, chorion, and intermediate layer (IL) that contain matrix structures and regulatory components beneficial in wound healing. Historically, commercially available allografts were composed of only one or two layers of the PM. To maximize the conserved material in PM allografts, a dehydrated complete human placental membrane (dCHPM) allograft processed using the Clearify™ process was developed. Histological and proteomic characterization comparing dCHPM allografts with native PM demonstrated that the majority of matrix structures and regulatory proteins are retained in dCHPM allografts through processing. To evaluate the importance of maintaining the entire intact PM and the contribution of the IL, the structural and proteomic makeup of the IL was compared with that of dCHPM allografts. This is the first known characterization of regulatory proteins in the IL. Results demonstrate that the IL contains over 900 regulatory and signaling components, including chemokines, growth factors, interleukins, and protease inhibitors. These components are key regulators of angiogenesis, neurogenesis, osteogenesis, inflammation, tissue remodeling, and host defense. The results show that the proteomic composition of the IL is consistent with that of the entire dCHPM allograft. Although further investigation is required to fully understand the contribution of the IL in PM allografts, these results demonstrate that the IL contains structural and regulatory proteins that can enhance the barrier and wound healing properties of PM allografts.

Early language competence, but not general cognitive ability, predicts children's recognition of emotion from facial and vocal cues

The ability to accurately identify and label emotions in the self and others is crucial for successful social interactions and good mental health. In the current study we tested the longitudinal relationship between early language skills and recognition of facial and vocal emotion cues in a representative UK population cohort with diverse language and cognitive skills (N = 369), including a large sample of children that met criteria for Developmental Language Disorder (DLD, N = 97). Language skills, but not non-verbal cognitive ability, at age 5–6 predicted emotion recognition at age 10–12. Children that met the criteria for DLD showed a large deficit in recognition of facial and vocal emotion cues. The results highlight the importance of language in supporting identification of emotions from non-verbal cues. Impairments in emotion identification may be one mechanism by which language disorder in early childhood predisposes children to later adverse social and mental health outcomes.

A comparison between water uptake and root length density in winter wheat: effects of root density and rhizosphere properties

BACKGROUND AND AIMS

We aim to quantify the variation in root distribution in a set of 35 experimental wheat lines. We also compared the effect of variation in hydraulic properties of the rhizosphere on water uptake by roots.

METHODS

We measured the root length density and soil drying in 35 wheat lines in a field experiment. A 3D numerical model was used to predict soil drying profiles with the different root length distributions and compared with measured soil drying. The model was used to test different scenarios of the hydraulic properties of the rhizosphere.

RESULTS

We showed that wheat lines with no detectable differences in root length density can induce soil drying profiles with statistically significant differences. Our data confirmed that a root length density of at least 1 cm/cm3 is needed to drain all the available water in soil. In surface layers where the root length density was far greater than 1 cm/cm3 water uptake was independent of rooting density due to competition for water. However, in deeper layers where root length density was less than 1 cm/cm3, water uptake by roots was proportional to root density.

CONCLUSION

In a set of wheat lines with no detectable differences in the root length density we found significant differences in water uptake. This may be because small differences in root density at depth can result in larger differences in water uptake or that the hydraulic properties of the rhizosphere can greatly affect water uptake.

Reliability and validity of a temporal distancing emotion regulation task in adolescence

Adopting a temporally distant perspective on stressors, also known as using a temporal distancing emotion regulation strategy, can alleviate distress. Young adults’ ability to adopt a temporal distancing strategy has previously been measured using an experimental temporal distancing task (Ahmed, Somerville, & Sebastian, 2018). In the current study, we evaluate the psychometric properties of this task in younger (N = 345, aged 10–11) and older (N = 99, aged 18–21) adolescents and explore developmental differences in the ability to use temporal distancing to alleviate distress. Participants listened to scenarios and rated negative affect when adopting a distant-future perspective, a near-future perspective, or when reacting naturally. We evaluated the test–retest reliability of the measure in older adolescents and its construct validity in both younger and older adolescents by assessing correlations with self-report measures of emotion regulation strategy use. Our findings broadly replicated those of Ahmed et al. (2018): Adopting distant- and near-future perspectives produced significantly lower self-reported distress relative to reacting naturally, with the distant-future strategy producing the least distress. Older adolescents alleviated their distress more effectively than younger adolescents and reported projecting further into the future. Regulation success scores on the temporal distancing task showed adequate test–retest reliability. However, these scores did not correlate with self-reported habitual use of temporal distancing or reappraisal strategies generally. These findings suggest that the ability to use a temporal distancing strategy for emotion regulation improves during adolescence, but that ability may not be related to habitual use of this strategy.

A comparison between water uptake and root length density in winter wheat: effects of root density and rhizosphere properties

BACKGROUND AND AIMS

We aim to quantify the variation in root distribution in a set of 35 experimental wheat lines. We also compared the effect of variation in hydraulic properties of the rhizosphere on water uptake by roots.

METHODS

We measured the root length density and soil drying in 35 wheat lines in a field experiment. A 3D numerical model was used to predict soil drying profiles with the different root length distributions and compared with measured soil drying. The model was used to test different scenarios of the hydraulic properties of the rhizosphere.

RESULTS

We showed that wheat lines with no detectable differences in root length density can induce soil drying profiles with statistically significant differences. Our data confirmed that a root length density of at least 1 cm/cm³ is needed to drain all the available water in soil. In surface layers where the root length density was far greater than 1 cm/cm³ water uptake was independent of rooting density due to competition for water. However, in deeper layers where root length density was less than 1 cm/cm³, water uptake by roots was proportional to root density.

CONCLUSION

In a set of wheat lines with no detectable differences in the root length density we found significant differences in water uptake. This may be because small differences in root density at depth can result in larger differences in water uptake or that the hydraulic properties of the rhizosphere can greatly affect water uptake.

Identification of QTLs for resistance to leaf and stem rusts in bread wheat (Triticum aestivum L.) using a mapping population of ‘Pamyati Azieva × Paragon’

Leaf rust (LR) and stem rust (SR) are harmful fungal diseases of bread wheat (Triticum aestivum L.). The purpose of this study was to identify QTLs for resistance to LR and SR that are effective in two wheat-growing regions of Kazakhstan. To accomplish this task, a population of recombinant inbred lines (RILs) of ‘Pamyati Azieva × Paragon’ was grown in the northern and southeastern parts of Kazakhstan, phenotyped for LR/SR severities, and analyzed for key yield components. The study revealed a negative correlation between disease severity and plant productivity in both areas. The mapping population was genotyped using a 20,000 Illumina SNP array. A total of 4595 polymorphic SNP markers were further selected for linkage analysis after filtering based on missing data percentage and segregation distortion. Windows QTL Cartographer was applied to identify QTLs associated with LR and SR resistances in the RIL mapping population studied. Two QTLs for LR resistance and eight for SR resistance were found in the north, and the genetic positions of eight of them have matched the positions of the known Lr and Sr genes, while two QTLs for SR were novel. In the southeast, eight QTLs for LR and one for SR were identified in total. The study is an initial step of the genetic mapping of LR and SR resistance loci of bread wheat in Kazakhstan. Field trials in two areas of the country and the genotyping of the selected mapping population have allowed identification of key QTLs that will be effective in regional breeding projects for better bread wheat productivity.

2400Early and late effects of cardiac resynchronization therapy in adult congenital heart disease

Background

There are limited data regarding cardiac resynchronization therapy (CRT) in adult congenital heart disease (ACHD).

Purpose

We aimed to assess early and late outcomes of CRT amongst patients with ACHD.

Methods

We retrospectively studied ACHD patients receiving CRT (2004–2017). Clinical and echocardiographic data were analyzed at baseline, early (1.8±0.8 years) and late (4.7±0.8 years) follow-up after CRT.

Results

Fifty-four ACHD patients (median age 46 years, range 18–73 years, 74% male) had CRT (biventricular paced >90%) and were followed for 5.7±3.0 years. Thirty-nine (72%) patients had a systemic left ventricle (LV). Underlying cardiac anatomy included left ventricular outflow tract lesions (n=17; 32%), tetralogy of Fallot (n=11; 20%), right ventricular outflow tract lesions (n=5; 9%), atrioventricular septal defects (n=5; 9%) and atrial septal defect with right aortic arch (n=1; 2%). Fifteen (28%) patients had a systemic right ventricle (RV): 13 (24%) with congenitally corrected transposition of great arteries, and 2 (4%) with transposition of the great arteries after Mustard repair.

Compared to baseline, CRT was associated with significant improvement at early follow-up in NYHA functional class, QRS duration, cardiothoracic ratio, left and right atrial volume index (P<0.05 for all) in the overall population; improvement in NYHA class was sustained at late follow-up. Amongst patients with a systemic LV, there was significant increase in LV ejection fraction and reduction in LV end-systolic volume at early and late follow up (P<0.05 for both). There is trend in improvement of RV fractional area change in the patients with a systemic RV but not met statistical significance (P=0.070). Findings were summarized in Figure 1.

Eleven patients died and 2 had heart transplantation unrelated to systemic ventricular morphology. Thirty-five (65%) patients responded positively to CRT but only baseline QRS duration was a predictor of the positive response.

Conclusion

CRT results in sustained improvement in functional class, systemic LV size and function. QRS duration but not QRS morphology was a predictor of the positive response seen at early follow-up in 2/3 of ACHD patients.

Impaired Recognition of Basic Emotions from Facial Expressions in Young People with Autism Spectrum Disorder: Assessing the Importance of Expression Intensity

It has been proposed that impairments in emotion recognition in ASD are greater for more subtle expressions of emotion. We measured recognition of 6 basic facial expressions at 8 intensity levels in young people (6-16 years) with ASD (N = 63) and controls (N = 64) via an Internet platform. Participants with ASD were less accurate than controls at labelling expressions across intensity levels, although differences at very low levels were not detected due to floor effects. Recognition accuracy did not correlate with parent-reported social functioning in either group. These findings provide further evidence for an impairment in recognition of basic emotion in ASD and do not support the idea that this impairment is limited solely to low intensity expressions.

The Vulnerability Experiences Quotient (VEQ): A Study of Vulnerability, Mental Health and Life Satisfaction in Autistic Adults

Co‐morbid mental health conditions such as anxiety and depression are extremely common in autistic adults. Vulnerability to negative life experiences such as victimisation and unemployment may be partially responsible for the development of these conditions. Here we measure the frequency of negative life experiences in autistic adults and explore how these are associated with current anxiety and depression symptoms and life satisfaction. We developed the Vulnerability Experiences Quotient (VEQ) through stakeholder consultation. The VEQ includes 60 items across 10 domains. Autistic adults with a clinical diagnosis and non‐autistic controls completed the VEQ, screening measures for anxiety and depression, and a life‐satisfaction scale in an online survey. Likelihood of experiencing each VEQ event was compared between groups, using binary logistic regression. Mediation analysis was used to test whether total VEQ score mediated the relationship between autism and (1) depression (2) anxiety and (3) life satisfaction. Autistic adults (N = 426) reported higher rates of the majority of events in the VEQ than non‐autistic adults (N = 268). They also reported more anxiety and depression symptoms and lower life satisfaction. Group differences in anxiety, depression and life satisfaction were partially mediated by VEQ total score. This study highlights several important understudied areas of vulnerability for autistic adults, including domestic abuse, contact with social services (as parents) and financial exploitation and hardship. Improved support, advice and advocacy services are needed to reduce the vulnerability of autistic adults to negative life experiences, which may in turn improve mental health and life satisfaction in this population. Autism Res 2019, 12: 1516–1528. © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc.

Lay Summary

This study investigated whether autistic adults are more vulnerable to certain negative life experiences, and whether these experiences are related to anxiety, depression and life satisfaction. We found that autistic adults are more vulnerable to many different negative life events, including employment difficulties, financial hardship and domestic abuse. Negative life experiences partially explained the higher rates of anxiety and depression symptoms and lower life satisfaction in autistic adults compared to non‐autistic adults. Improved support services are required to reduce the vulnerability of autistic adults. Reducing vulnerability may improve mental health and increase life satisfaction in this population.

Autistic traits in adults who have attempted suicide

Background

An emerging literature suggests that autistic adults are at increased risk of experiencing suicidal thoughts, making suicidal plans and attempts, and dying by suicide. However, few studies have investigated whether autistic traits are related to suicidal behaviour. The current study examined autistic traits in a sample of adults who reported at least one suicide attempt.

Methods

An online questionnaire was advertised between June and September 2017 on suicide prevention websites, research databases, and social media. Participants reported whether they had ever attempted suicide (yes/no), and if so, how many times they had attempted (once/more than once). They also reported diagnosed and suspected mental health or neurodevelopmental conditions, and completed the Autism Spectrum Quotient (AQ). Two hundred forty-five adults accessed the survey; 132 reported having attempted suicide and also completed the AQ. It was hypothesised that AQ total scores and subscale scores would be higher in adults who had attempted suicide more than once compared to adults who had attempted once. These hypotheses were tested using an independent samples t test, Mann-Whitney U tests, and binary logistic regression.

Results

Most participants were female (83.3%, male = 12.9%, other = 3.8%), and ages ranged from 18 to 65 (median = 36.00; IQR = 19.00). Total AQ scores, as well as communication and imagination subscale scores were significantly higher in adults who had attempted suicide more than once compared to adults who had attempted suicide once. Even after removing participants with diagnosed or suspected autism (n = 34), 40.6% had an AQ score indicative of clinical concern (≥ 26).

Conclusions

The findings suggest that high levels of autistic traits may frequently be present in adults who have attempted suicide, and that AQ scores are higher in those with a history of more than one suicide attempt. It may be possible to better identify suicide risk by screening autistic adults with mental health conditions for suicidal thoughts and behaviours, and by screening people with suicidal thoughts and/or behaviours for autism.