Intuition, Imagination and Innovation 2023 in Suicidology Conference Virtual Conference 23–24 May & 1 June 2023 Programme and Abstract Book e ncree onfC Suicidology in tionav Inno 2023 Intuition, Imagination and Innovation in Suicidology Conference Virtual Conference | 23–24 May & 1 June 2023 nd Programme and Abstract Book a E-ISSN 2712-5467 tion Edited by · Diego de Leo and Vita Poštuvan Editorial Board · Diego De Leo, Vita Poštuvan, Vanja Gomboc, and Lucia Rojs Cover Photo, Design and Layout · Alen Ježovnik Published by · University of Primorska Press Imagina Titov trg 4, 6000 Koper · hippocampus.si Editor in Chief · Jonatan Vinkler Managing Editor · Alen Ježovnik Koper · 2023 tuition, © 2023 University of Primorska In The publication has been co-financed by the Slovenian Research and Innovation Agency, project Alive? Alive! Research and Prevention of Suicide 2023 (grant number P3-0384 FAMNIT). Electronic Edition https://www.hippocampus.si/ISBN/978-961-293-251-0.pdf https://www.hippocampus.si/ISBN/978-961-293-252-7/index.html https://doi.org/10.26493/978-961-293-251-0 Kataložni zapis o publikaciji (CIP) pripravili v Narodni in univerzitetni knjižnici v Ljubljani COBISS.SI-ID 161689091 ISBN 978-961-293-251-0 (PDF) ISBN 978-961-293-252-7 (HTML) e ncre Table of Contents e onfC Welcome Address · 4 Organizers · 6 Programme Outline · 7 Understanding Grief and Effective Support, with Special Reference to Suicide Suicidology Bereavement in Karl Andriessen · 8 Sudden Deaths in Schools: Breaking Bad News and Interventions of Support tiona Vita Poštuvan · 10 v Next Steps in Survivor Research: Studying Survivors in the Community at Large to Gain Better Insights Into Their Characteristics and Grieving Problems Inno William Feigelman · 11 nda Eye of the Survivor: Continuing Bonds, Storytelling and Healing for People Bereaved by Suicide tion Sally Spencer-Thomas · 13 Turning a Personal Tragedy Into a Triumph: Grief and Growth Among Suicide-Loss Survivors Yossi Levi-Belz · 14 Imagina Temporal Risk Factors for Suicide After Suicide Bereavement Alexandra Pitman · 15 tuition, The Beginning of the Nightmare: The Communication of a Suicide Death In Diego De Leo · 16 Suicide Loss as a Crisis of Meaning: Basic Concepts 2023 Robert A. Neimeyer · 17 3 e ncree Welcome Address onfC Dear intuitive, imaginative and innovative guest, We are pleased to welcome you to the Intuition, Imagination and Innovation in Suicidology Conference, an event hosted by the Slovene Centre for Suicide Research (University of Primorska, Andrej Marušič Institute). Suicidology The conference is an international annual event organised by the UP IAM in Slovene Centre for Suicide Research in cooperation with UP FAMNIT. By holding a conference, we aim to raise awareness and knowledge about suicide tiona and thus contribute to the development of suicide prevention and postven-v tion activities. Additionally, we seek to provide what the conference has developed over the years: a platform for fruitful discussions between distingui-Inno shed experts in suicide research and prevention, interacting with young and nd aspiring suicidologists and other mental health professionals. a For the fourth consecutive year, the conference will be held in an online tion format in Zoom’s video conferencing environment. One of the highlights of this online experience is the opportunity to engage with distinguished suicidologists from around the world. Participants will have the opportunity to hear their insightful presentations and engage in meaningful discussions. Imagina By embracing this digital format, we have successfully opened the doors wi-de, providing a global audience with a unique opportunity for knowledge exchange and cross-cultural learning. Experts in the field of suicidology will tuition, share their best practices while participants can enjoy the enlightening lec-In tures from the comfort of their own homes. The 2023 Intuition, Imagination and Innovation in Suicidology Conference 2023 programme includes topics on bereavement. Speakers will discuss current issues with a focus on suicidal behaviour, suicide and bereavement. Presentations will include understanding grief and the experiences of those affected by suicide in the broader community, aspects of effective support in grieving a loss by suicide and its implications for grief therapy. The lectures will also highlight the risk factors for suicide after loss by suicide, emphasise the importance of continuing bonds and storytelling in the grieving process, and pay particular attention to aspects of delivering bad news. Each lecture will be followed by a discussion in which participants are invited to share their views. Existing difficulties in both research and clinical work will be addressed. Let the Intuition, Imagination and Innovation in Suicidology Conference 4 e nc be an opportunity for you to express and practice your intuition, imagination ree and innovative ideas. onfC Prof. Diego De Leo and Prof. Vita Poštuvan, Chairs Prof. Diego De Leo, Prof. Vita Poštuvan, Vanja Gomboc, and Lucia Rojs, Organising Committee Suicidology in tionav Inno nda tion Imagina tuition,In 2023 Diego de Leo Vita Poštuvan Vanja Gomboc Lucia Rojs 5 e ncre Organizers e onfC Slovene Centre for Suicide Research (UP IAM SCSR) The Slovene Centre for Suicide Research (www.zivziv.si) was founded in 2011 at the Andrej Marušič Institute, University of Primorska. The initiative to establish an independent unit within the Institute was taken by Prof. Diego De Suicidology Leo and a group of former colleagues of the late Prof. Andrej Marušič in me-in mory of his work, aiming to continue it. Research and prevention of suicide are the main activities of the clinical and academic work of the Centre. tion Through its involvement in national and international projects, the Centre is av the initiator of numerous innovative approaches in suicidology. The Centre’s vision is to provide high-quality research for a better understanding of su-Inno icidal behaviour, thus contributing to suicide prevention, intervention and nd postvention. a You are welcome to read more about us at zivziv.si! tion You are also warmly welcome to join us at the 32nd IASP World Congress that the International Association for Suicide Prevention is hosting between 19 and 23 September 2023 in Piran, Slovenia together with UP IAM Slovene Centre for Suicide Research. Imagina Learn more about the Congress at https://www.iasp.info/piran2023/ tuition,In 2023 6 e nc Programme Outline ree onfC 23 May 2023 9.00 Dr. Karl Andriessen: ‘Understanding Grief and Effective Support, With Special Reference to Suicide Bereavement’ 10.30 Assoc. Prof. Vita Poštuvan: ‘Sudden Deaths in Schools: Breaking Bad News and Interventions of Support’ Suicidology 12.30 Prof. William Feigelman: ‘Next Steps in Survivor Research: Studying in Survivors in the Community at Large to Gain Better Insights Into Their Characteristics and Grieving Problems’ tiona 14.00 Dr. Sally Spencer-Thomas: ‘Eye of the Survivor: Continuing Bonds, v Storytelling and Healing for People Bereaved by Suicide’ Inno 24 May 2023 nda 9.00 Prof. Yossi Levi-Belz: ‘Turning a Personal Tragedy into a Triumph: Grief and Growth Among Suicide-Loss Survivors’ tion 10.30 Assoc. Prof. Alexandra Pitman: ‘Temporal Risk Factors for Suicide After Suicide Bereavement’ 12.30 Prof. Diego De Leo: ‘The Beginning of the Nightmare: The Communication of a Suicide Death’ Imagina 14.00 Discussion, Prof. Diego De Leo and Assoc. Prof. Vita Poštuvan with participants: ‘Open Issues and Needs in Bereavement’ tuition, 1 June 2023 In 18.00 Prof. Robert Neimeyer: ‘Suicide Loss as a Crisis of Meaning: Basic Concepts’ 2023 7 e ncre Understanding Grief and Effective Support, e with Special Reference to Suicide Bereavement onfC Invited lecture · Karl Andriessen Karl Andriessen, PhD, MSuicidology, BSW, is a Senior Research Fellow at the Cen-Suicidology tre for Mental Health in the Melbourne School of Population and Global Health, in The University of Melbourne, Australia, an Adjunct Senior Lecturer at the School of Psychiatry, University of New South Wales, and a Research Fellow at the KU Le-tion uven, University of Leuven, Belgium. Karl’s involvement in the field of suicide be-av reavement and suicide prevention is rooted in clinical practice, starting 35 years ago in Belgium as a social worker in youth and family counselling, and telepho-Inno ne crisis lines, followed by leading positions in suicide prevention, bereavement, community mental health, and policy development. He co-founded and serves nda as Chair (2002–2015, 2022–present) of the Special Interest Group on Suicide Bereavement of the International Association of Suicide Prevention, and is an advi-tion sor to several projects in the field of suicide prevention and bereavement. He also serves as Associate Editor of Death Studies. In recognition of his achievements, he has received several awards, including the 2005 IASP Farberow Postvention Award. He has published widely, including Postvention in Action: The Interna-Imagina tional Handbook of Suicide Bereavement Support (with Dr Krysinska and Dr Grad), the go-to resource on postvention (Hogrefe, 2017). tuition, Abstract. Grief is a natural reaction to a major loss. Common grief reactions In include crying and feelings of sadness, anger or guilt. Most people cope well with their grief. However, others may struggle with their loss, and may be 2023 at-risk of developing maladaptive grief reactions or mental health problems. Those bereaved by suicide or other traumatic death may also be at risk of adverse long-term outcomes. In addition to grief feelings such as feelings of shock, anxiety or rejection, they commonly struggle with daunting ‘why’ questions, and receive less social support than other bereaved people. People bereaved by suicide also present increased risks of depression, posttraumatic stress disorder, and suicidal behaviour compared to other bereaved and non-bereaved counterparts. While most research in the field has focused on adverse outcomes, there is a growing body of evidence that many bereaved people also report posttraumatic growth – a positive psychological transformation that occurs through a process of meaning-making and struggling with a highly challenging and stressful event. Informed by the litera-8 https://doi.org/10.26493/978-961-293-251-0.1 e nc ture and own research, this presentation offers a comprehensive conceptu-ree alization of grief, and grief after suicide in the context of contemporary grief models, and summarizes what is known about the efficacy of interventions onfC provided to bereaved adults, and the potentially effective components of interventions. In addition, the presentation will focus on the impact of suicide and other traumatic death on family systems and how best to support bereaved young people. Suicidology in tionav Inno nda tion Imagina tuition,In 2023 9 e ncre Sudden Deaths in Schools: Breaking Bad News e and Interventions of Support onfC Invited lecture · Vita Poštuvan Assoc. prof. Vita Poštuvan works as a researcher and Deputy Head of the Slovene Suicidology Centre for Suicide Research (UP IAM) and Department of Psychology (FAMNIT) at the University of Primorska. She leads the work related to clinical-research and in public-health interventions in suicidology, bereavement, crisis interventions and tion psychotherapy. She has participated in major European and Slovenian studies in av the fields of (public) mental health, suicidology and psychology, which were published in international journals. She has worked at the National Center of Neu-Inno rology and Psychiatry (NCNP) in Tokyo, Japan as well as in the Suicide Research Group, Department for Psychoanalysis and Psychotherapy, Medical University nda of Vienna, Austria, as a fellow researcher. Her professional work is also focused on psychological counselling, psychotherapy and prevention. As a psychological tion counsellor and cognitive-behavioural therapist she offers psychological support for students and individuals and implements mindfulness-based cognitive therapy. She is a member of the national unit for psychological research within civil protection. Imagina Abstract. The death of a young person happens more rarely compared to older people. Although any news of the death of a loved one represents a tuition, significant and usually painful moment, in the case of a young person it is In even more profound. There are some differences regarding the cause of death, such as suicide, accidents or diseases. The way death is communicated in 2023 the school setting is important, as it can have long-term effects on the mental and physical health of the bereaved and those affected. There are several models for addressing death in the classroom or school setting. However, peers are not the only group that needs in-depth support: teachers (especially classroom teachers), counsellors, and principals are often deeply affected by such news. In order for them to provide appropriate support to grieviclas-smates or friends (adolescents), debriefing and support interventions must be implemented. 10 https://doi.org/10.26493/978-961-293-251-0.2 e nc Next Steps in Survivor Research: Studying ree Survivors in the Community at Large onfC to Gain Better Insights Into Their Characteristics and Grieving Problems Invited lecture · William Feigelman Suicidology in Prof. William Feigelman, PhD, is Professor Emeritus Professor of Sociology from Nassau Community College (Garden City, New York), where he taught for 50 ye-tiona ars. He is the author or co-author of seven books and more than 80 journal ar-v ticles and has written on a wide variety of social science subjects including child adoptions, youth alcohol and drug abuse, problem gambling, tobacco use and Inno cessation, and intergroup relations. Since 2002, after his son Jesse’s suicide, Dr nd Feigelman has focused his professional writings on youth suicide and suicide be-a reavement. His bereavement and suicide writings have appeared in Suicide and Life-Threatening Behavior, Death Studies, Omega: Journal of Death and Dying, tion Archives of Suicide Research, Crisis, and Illness, Crisis and Loss. He is one of the authors of Devastating Losses: How Parents Cope with the Death of a Child to Suicide or Drugs (NY: Springer, 2012). He is a member of the American Associa-Imagina tion of Suicidology, the International Association of Suicide Prevention and the Association for Death Education and Counseling, a frequent presenter at bereavement conferences in the U.S., Canada, Australia, Norway and Japan, and a co-tuition, facilitator of a suicide survivors’ support group. In 2019 Bill and his wife Beverly In were chosen to receive the Farberow Award by IASP for their service and accomplishments in the field of suicide postvention. Bill feels greatly humbled to be a 2023 recipient of this award and deeply honoured to be chosen to serve as a SIG co-chair. Abstract. The field of suicide bereavement research has moved with glacial slowness to acquire an understanding of the characteristics and extent of suicide bereavement. It took nearly 40 years to dispel the myth of six ‘survivor-victims’ affected by any single suicide, posited by Edwin Schneidman in 1973. Numerous quantitative studies such as Crosby and Sacks (2002) with national data and Cerel et al. (2013) with Kentucky data found evidence of much higher rates of suicide exposures and bereavements than those claimed by Schneidman. Yet, the myth still held firm for another five years until it was finally demolished by a great many more studies documenting mental heal-https://doi.org/10.26493/978-961-293-251-0.3 11 e ncre th difficulties experienced by the suicide exposed and bereaved. Today, the e slowness to acquire information on the suicide bereaved still remains, wi-onf th the vast majority of studies of the bereaved based on convenience sam-C ples of treatment-involved survivors. We know very little about the bereaved from the community at large who may not be seeking treatment. We need to know how numerous are those who may not be seeking treatments; how are they managing; what are they relying upon to help them cope with the inhe-rent difficulties associated with suicide survivorship. We are now embarked Suicidology on completing a national study of 1,000 suicide-bereaved adults, examining in their use of healing aids, mental health difficulties and post-loss adjustments to better illuminate this less well understood realm. tionav Inno nda tion Imagina tuition,In 2023 12 e nc Eye of the Survivor: Continuing Bonds, ree Storytelling and Healing for People onfC Bereaved by Suicide Invited lecture · Sally Spencer-Thomas Suicidology Dr. Sally Spencer-Thomas holds a deep commitment to not only help prevent su-in icide, but also to encourage people to sustain a passion for living. As a clinical psychologist, mental health advocate, and researcher, she sees the issues from tion many perspectives. Her heart, however, is called, and her dedication to the missi-av on unwavering due to the suicide death of her brother. Her goal is to give voice to people who have lived through depression, addiction, and the impacts of suicide Inno and leverage their wisdom to develop bold, gap-filling strategies and programmes – approaches that empower cultural and systems change in our workplaces, nda education systems and communities. Internationally she is a Farberow Award recipient and currently Sally is the president of United Suicide Survivors Internatio-tion nal. She is an accomplished speaker with a popular TEDx talk and a White House address to her credits. Abstract. Too many people bereaved by suicide feel alone in a ‘Canyon of Imagina Why.’ What are ways we can support people in their time of grief and trauma and help them turn their pain into purpose? In the first part of the presentation, Dr. Sally Spencer-Thomas will share grief and trauma recovery pa-tuition, thways through the devastation that the tsunami of suicide leaves behind. In She begins by sharing her personal story of the trials and tribulations she faced after losing her brother to suicide. She then helps participants appreciate 2023 the complexities that arise after a suicide and shares research on ‘continuing bonds’ after suicide. For the second part of the presentation, she argues that storytelling can be a powerful meaning-making tool for people bereaved by suicide. At the heart of any community change effort are the stories. The ba-sic narrative is this: ‘This is me. This is how my life and others like me have been systematically destroyed. This is how I see change is possible.’ We are hardwired for storytelling – stories move our hearts and build community. As part of a suicide prevention and mental health promotion strategy they let others know they are not alone and collectively, they can tell a powerful tale of hope, recovery and change. https://doi.org/10.26493/978-961-293-251-0.4 13 e ncre Turning a Personal Tragedy Into a Triumph: e Grief and Growth Among Suicide-Loss onfC Survivors Invited lecture · Yossi Levi-Belz Suicidology Prof. Yossi Levi-Belz is a clinical psychologist and clinical scientist, working at The in Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Israel. He is interested in the psychological mechanisms that can help us un-tiona derstand and prevent suicide in different at-risk populations (veterans, soldiers, v adolescents, ex-prisoners of war, medically serious suicide attempters, etc.). His primary research topic includes moral injury, suicidal ideation and behaviour, Inno suicide-loss survivors, recovery and growth. Other research areas are interper-nd sonal interaction in both real life and in therapy sessions, and attitudes of the a public toward psychotherapy. He merges clinical, social, and research work and considers the integration of these three aspects as the central value of his work. tion Abstract. Bereavement after suicide is an acute and painful phenomenon. The consequences of suicide on family members and close friends are broad, and include prolonged grief symptoms, guilt, shame, loneliness and much Imagina more. On the other hand, traumatic events may also be an engine for positive psychological changes and growth. In the upcoming lecture we will try to shed a light on the complex psychological journey of family members who tuition, have lost a loved one to suicide; we will delve deeper into a series of studies In that present the deleterious consequences of suicide alongside the possibility of post-traumatic growth in the aftermath of suicide loss. In particular, we 2023 will focus on the series of longitudinal studies we conducted in Israel which highlights the factors that moderate the experiences of loss and may facilitate psychological changes and growth among suicide-loss survivors. 14 https://doi.org/10.26493/978-961-293-251-0.5 e nc Temporal Risk Factors for Suicide ree After Suicide Bereavement onfC Invited lecture · Alexandra Pitman Dr. Alexandra Pitman is an Associate Professor in General Adult Psychiatry in the UCL Division of Psychiatry and an Honorary Consultant Psychiatrist at Camden Suicidology & Islington NHS Foundation Trust. She gained her undergraduate degree in Hu-in man Sciences from the University of Oxford, her MSc in Health Policy, Planning and Financing from the London School of Hygiene and Tropical Medicine and the tion London School of Economics, and her undergraduate medical degree at Imperial av College. She completed her core training in psychiatry on the West London rotation, and her higher training in General Adult Psychiatry as an NIHR Academic Cli-Inno nical Fellow on the North London/UCL rotation. She chose to focus on studying nd the impact of suicide bereavement as this was an issue that seemed relatively a unexplored in British clinical or research settings. Her PhD at UCL was funded by the Medical Research Council, and was followed by an MRC Centenary Early Cation reer Award and a Guarantors of Brain post-doctoral fellowship. Her clinical and research interests are the care of people who feel suicidal; the links between loneliness, social isolation and mental illness; and the prevention of suicide attempt. Imagina Abstract. Temporal risk factors for suicide are under-investigated but have the potential to identify time points at which suicide prevention interventions could be targeted. This presentation will describe well-established tem-tuition, poral risk factors for suicide at the population level (such as seasonality) befo-In re reporting the findings of new research on temporal risk factors in specific groups. The first set of findings are from an analysis of the National Confiden-2023 tial Inquiry into Suicide and Safety in Mental Health (NCISH) dataset, describing the characteristics of patients who die by suicide on or near a significant date and the implications for clinical care. The second set of findings are from an analysis of Danish population registry data to investigate whether suicide and suicide attempt risk are elevated at specific emotionally salient time points after suicide loss: anniversaries of the suicide, birthdays of the deceased, and reaching the age at which a parent died by suicide. The presentation will conclude by considering the implications for support provided after suicide bereavement. https://doi.org/10.26493/978-961-293-251-0.6 15 e ncre The Beginning of the Nightmare: e The Communication of a Suicide Death onfC Invited lecture · Diego De Leo Prof. Diego De Leo (the head of the Slovene Centre for Suicide Research and pro-Suicidology fessor of Psychiatry at the Griffith University in Brisbane, Australia), is considered in as one of top five world leading experts in suicidology by the international professional and scientific public. His research expertise includes definitional issues tion in suicidology, culture and suicide, international trends and national suicide pre-av vention programmes. He has received numerous world-renowned awards for his scientific work. His bibliography includes over 420 peer-reviewed articles and 180 Inno book chapters. nd Abstract. Reporting the death of a loved one is a delicate task. How this is do-a ne can have a significant impact on both the recipient and the notifier, espe-tion cially in the case of sudden, violent and traumatic death. If the death to be communicated concerns a case of suicide, emotional involvement and reactions can be particularly complex and disturbing. An empathetic, sensitive and attentive communication to the needs of the survivors can represent a first Imagina opportunity to support the bereavement process. The acquisition of specific skills for the delivery of the death notification is necessary for the professional who carries out the communication to increase self-efficacy, knowledge tuition, and perception of competence in this area. The declaration of death is con-In figured as a process divided into sequential phases; the act of notification constitutes its central phase. Adequate preparation on the part of the com-2023 municator would be appropriate to contain the impact of the trauma both on the notifier and on the recipient of the notification. For the latter, appropriate assistance and follow-up protocols should be defined. An overview of best practices in the task of reporting sudden, violent and traumatic death is presented, and guidance is provided for formulating practices appropriate to different professions and for developing effective educational programmes. 16 https://doi.org/10.26493/978-961-293-251-0.7 e nc Suicide Loss as a Crisis of Meaning: ree Basic Concepts onfC Invited lecture · Robert A. Neimeyer Robert A. Neimeyer, PhD, is Professor Emeritus of the Department of Psychology, University of Memphis, and maintains an active consulting and coaching prac-Suicidology tice. He also directs the Portland Institute for Loss and Transition, which provides in online training internationally in grief therapy. Neimeyer has published 35 books, including New Techniques of Grief Therapy: Bereavement and Beyond and tiona The Handbook of Grief Therapies, and serves as Editor of the journal Death Stu-v dies. The author of over 600 articles and book chapters and a frequent workshop presenter, he is currently working to advance a more adequate theory of grieving Inno as a meaning-making process. Neimeyer served as President of the Association nd for Death Education and Counseling (ADEC) and Chair of the International Work a Group for Death, Dying, & Bereavement. In recognition of his scholarly contribu-tions, he has been granted the Eminent Faculty Award by the University of Mem-tion phis, made a Fellow of the Clinical Psychology Division of the American Psychological Association, and given Lifetime Achievement Awards by both ADEC and the International Network on Personal Meaning. Imagina Abstract. Research suggests that much of the complicated and prolonged grief that frequently follows bereavement by suicide is mediated by its as-sault on the survivor’s world of meaning, and the attendant struggle to ma-tuition, ke sense of (a) the relationship to the deceased, (b) the death itself, and (c) In the survivor’s own identity in its aftermath. Viewing this struggle through the lens of the Tripartite Model of Meaning Reconstruction in Loss, we will first 2023 consider common obstacles to integrating such loss adaptively within survivors’ meaning systems, and the implications this carries for the construction of the therapeutic relationship as well as specific interventions to address each impasse. Paradoxically, however, the same effort after meaning can be a catalyst for posttraumatic growth, which studies suggest is facilitated by identifiable psychological and social conditions. Illustrating these concepts with brief client videos, we conclude with general guidelines for conducting therapy with this traumatically bereaved population. https://doi.org/10.26493/978-961-293-251-0.8 17 I follow my intuition, I imagine more than ever, I love to innovate … University of Primorska Press www.hippocampus.si Document Outline 2023 Intuition, Imagination and Innovation in Suicidology Conference Table of Contents Welcome Address Organizers Programme Outline Understanding Grief and Effective Support, with Special Reference to Suicide Bereavement Sudden Deaths in Schools: Breaking Bad News and Interventions of Support Next Steps in Survivor Research: Studying Survivors in the Community at Largeto Gain Better Insights Into Their Characteristics and Grieving Problems Eye of the Survivor: Continuing Bonds, Storytelling and Healing for People Bereaved by Suicide Turning a Personal Tragedy Into a Triumph: Grief and Growth Among Suicide-Loss Survivors Temporal Risk Factors for Suicide After Suicide Bereavement The Beginning of the Nightmare: The Communication of a Suicide Death Suicide Loss as a Crisis of Meaning: Basic Concepts