Risk assessment and suicide prevention in primary care

General practitioners (GPs) are assumed to occupy an important position in the prevention of suicide through the introduction of risk assessment techniques commonly used in psychiatric practice. Despite this theoretical role for primary care services, it remains unclear how frequently GPs implement risk assessment in patients who may be vulnerable to suicide. To address this, a retrospective survey of probable suicides was conducted within a primary care setting utilizing a questionnaire of GPs who had experienced a patient suicide and was augmented by hospital and coroners' records. 85% of questionnaires were returned and 61 deaths were adjudged as suicides during the year long census period. 75% of suicides were male and 54% were aged under 35.28% were in contact with psychiatric services prior to death, although 60% had some diagnosis of mental disorder. GPs had little knowledge of a patient's life circumstances in up to half of cases. Recording of risk assessment occurred in 38% of subjects, was positively associated with prior psychiatric contact (p = 0.001) but negatively associated with presence of physical illness (p = 0.004), older patient age (p = 0.04), and GPs length in practice (p = 0.05). One GP felt their suicide case was preventable. The low rate of risk assessment and limited knowledge of patient lifestyle point to the need for active engagement of GPs in future suicide prevention strategies and should influence the content of training programs in primary care.     

‘Philosophical vacuity and political ineptitude’: the freewoman's critique of the suffrage movement 1

The Freewoman has commonly been read as an example of New Woman periodical publishing, through its focus on women's sexuality and autonomy from men. The journal appears to offer a more daring, twentieth-century and modern ‘new woman’, more willing than even her 1890s counterpart to embrace free unions or sexual experimentation. The Freewoman's extraordinary discussions of sexuality have tended to distract historians' attention from other elements of the debates it engendered. In particular, the political argument found within its pages has received insufficient attention; the journal tends to be misread as a socialist publication. Placing the journal as part of the New Woman narrative lends itself to an alternative view of the political subject of The Freewoman; the New Woman focus on individuality, autonomy and creative genius plays an important part in the distinctive political debates found within the journal. Although the suffrage struggle dominated Edwardian feminist activism, many Freewoman contributors rejected the vote entirely. In aperiod when new liberal or Fabian conceptions of an increasingly interventionist state appeared to sit comfortably with feminist demands for a more inclusive and socially responsible state, The Freewoman took an anti-statist stance. Rejecting the common suffragist metaphor of the state as the home writ large, Freewoman contributors saw the state as machine-like. The author explores the motivations for these positions, and the development of an individualist-feminist, or even egoist stance. Specifically, she outlines contributors' rejection of militant suffrage activism, and their contestation of the citizen as a rights-holding and consenting political subject, and maps the alternative political structures suggested within The Freewoman, and the manner in which concepts of individuality found within New Woman discourse served to construct a disturbingly elitist and even coercive feminist politics.     

Estimation of the quantity of a drug in a consignment from measurements on a sample

A consignment of individual packages is thought to contain illegal material, such as drugs, in some or all of the packages. A sample from the consignment is inspected and the quantity of drugs in each package of the sample is measured. It is desired to estimate the total quantity of drugs in the consignment. Sampling variation is present in the original measurements and it is not sufficient just to adjust the sample mean pro rata. An analysis is described which takes account of the uncertainty concerning the proportion of the packages that contain drugs and provides a probabilistic summary of the quantity of drugs in the consignment. In particular, a probabilistic lower bound for the quantity of drugs in the consignment is given, which is dependent on the required standard of proof. This is in contrast to the approach based on confidence intervals which assumes that in the long run, the interval will contain the correct quantity the appropriate proportion of the time, but gives no measure of uncertainty associated with the particular consignment under consideration.     

Intercepting Disgrace: Lacuna and “Letter to John Coetzee”

ABSTRACT

This review article examines two palimpsest rewritings of J. M.Coetzee’s canonical but controversial novel, Disgrace (1999). Both rewritings are by women: Lacuna, a novel published in 2019, is by a white South African woman, Fiona Snyckers, and “Letter to John Coetzee” takes the form of a short story by Michelle Cahill, a woman of color living in Australia, published in Cahill’s collection Letter to Pessoa (2016). The article uses Cahill’s coinage of “interceptionality” to discuss how dominant narratives may be disrupted and subverted, particularly when it comes to representing gender-based violence in the arts. It concludes with a discussion of South African artist Gabrielle Goliath’s exhibition, “This song is for … ” (2019).