2,871 research outputs found
An audit of risk assessments and management for self-harm and suicide in patients with depressive symptoms at a primary care practice in the UK
No full textAims
Over 5 million adults in England are living with depression, with the highest prevalence rates recorded in the North West and North East of England, 12.88% and 11.53%, respectively (NHS Digital, 2019). Depression is also associated with the highest rates of self-harm and suicide (SH&S) (Singhal, Ross, Seminog, Hawton, & Goldarce, 2014). The impact of SH&S on a family ranges from shock and horror to, blame, secrecy and shame. Survivors may also be negatively judged or self-stigmatise (Cerel, Jordan, & Duberstein, 2008). Managing self-harm episodes has a significant financial implication for the NHS (Tsiachristas, et al., 2017). If high-risk individuals are identified and intervened early, it would not only save lives but also potentially reduce financial strains. The aim of the audit is to evaluate the performance of risk assessment and management of self-harm and suicide at the Reedyford Healthcare Group, Nelson, England, and to determine whether the primary care practice is meeting the standards of the National Institute for Health and Care Excellence (NICE) guidelines for adults with depression.
Method
A retrospective audit of 62 patients presenting with depressive symptoms over 3 months was performed at the Reedyford Healthcare Group.
Two criteria from the NICE guidelines for adults with depression were included with associated standards of 100%:
All patients with depression should be assessed for suicidal ideation and intent by asking direct questions.
A patient presenting with significant risk to self/others should be referred to specialist mental health services the same day, as soon as possible.
Result
42 patients were asked direct questions about SH&S. 2 patients presenting with immediate risk were urgently referred to specialist services. Nonetheless, all those patients at increased risk of suicide were given an increased level of support by the practice. The results indicated that the practice could improve, and a quality improvement approach has been planned.
Conclusion
The assessment of risk in patients presenting with depression is vital. This audit shows that it is not always done in practice. The author has not found other published audits on this topic and suggests that this may be appropriate for a national audit. This is particularly prudent with the current concern regarding mental health in the COVID-19 pandemic
The rise and fall of the Labour league of youth
No full textThis thesis charts the rise and fall of the Labour Party’s first and most enduring youth organisation, the Labour League of Youth. The history of the League, from its birth in the early nineteen twenties to its demise in the late nineteen fifties, is placed in the context of the Labour Party’s subsequent fruitless attempts to establish and maintain a vibrant and functional youth organisation. A narrative is incorporated that illuminates the culture, organisation and political activism of the League and establishes it as a predominantly working class radical organisation. The reluctance on the part of the Labour Party to grant autonomy to its youth sections resulted in the history of the League of Youth being one of control, suppression and tension. This state of affairs ensured that subsequent youth groups, the Young Socialists and Young Labour, would be established in an atmosphere of reservation and scepticism.
The thesis places the prime responsibility for the failure of the party’s youth organisations with the party leadership but also considers the contributory factors of changing social and political circumstances. A number of themes are explored which include the impact of structure and agency factors, the power of the Parliamentary Labour Party, the political socialisation of leading figures within the party, the social context in which each of the groups emerged and the extent to which the youth groups were prey to intra-party factionalism.
The thesis redresses the balance of research where most accounts have focussed on the Young Socialists and traces the common characteristics that are prevalent in the way the party leadership has approached its relationship with its youth organisations. Use has been made of previously unpublished primary source material, the major source being the League of Youth members themselves whose recollections have helped to demonstrate the arguments put forward in this thesis
Papua New Guinea’s refugee track record and its obligations under the 2013 Regional Resettlement Arrangement with Australia
No full textThis paper examines Papua New Guinea\u27s track record in assessing and resettling asylum seekers, its current obligations under the 2013 Regional Resettlement Arrangement, and the sustainability of this arrangement.
Introduction
In the lead-up to the Australian Federal Election in September 2013, public attention focused dramatically on Papua New Guinea (PNG) in terms of the joint PNG–Australia Regional Resettlement Arrangement, the subject of a memorandum of understanding (MOU) signed on 6 August 2013. In short, Australia would transfer asylum seekers who arrived in Australia by boat after 19 July 2013 to PNG where their claim for refugee status would be assessed, under PNG law, and those found to be refugees would be resettled in PNG ‘and in any other participating regional, including Pacific Island, states’. (Nauru is the only other current participating regional state, with Cambodia considering resettlement of asylum seekers at the time of publication.) While the Migration Legislation Amendment (Regional Processing and Other Measures) Act 2012 provided for assessment of asylum seekers by PNG, it was the August 2013 Regional Resettlement Arrangement (mentioned as the 2013 Arrangement) that provided for resettlement in PNG, of asylum seekers determined to be refugees. In accordance with the 2013 Arrangement, the full cost of implementing the arrangement in PNG, that is, transfer, assessment, and resettlement, would be met by Australia.
PNG has a track record related to the assessment and resettlement of asylum seekers. The discussion paper begins with a brief outline of PNG policy responses to West Papuan asylum seekers from neighbouring Indonesian Papua. It focuses on the permissive residence system (part of a PNG ‘Limited Integration’ policy) offered to West Papuan refugees living at the former United Nations High Commissioner for Refugees (UNHCR) resettlement site at East Awin in Western Province since 1997. Limitations of the permissive residence permit, particularly issues related to eligibility and permit renewal, illustrate challenges faced by the PNG government and bureaucracy to design and administer a visa system. PNG’s track record of assessing and resettling West Papuan asylum seekers since 1984 is looked at against the terms of the 2013 Arrangement, which requires PNG to determine the refugee status of asylum seekers transferred by Australia to the offshore processing centre on Manus Island, review negative determinations, and resettle in PNG those determined to be refugees.
The second section considers PNG’s obligations under the terms of the 2013 Arrangement. In relation to status determination, an efficient and procedurally fair determination process requires legislation i.e., domestic refugee law, and an effective immigration bureaucracy. It can be argued that neither of these elements were present at the time of the 2013 Arrangement. However, at the time of publication of this paper in mid-2014, some status determinations and a review process had been announced. In relation to resettlement, ongoing disagreement by the PNG government over the terms of resettlement (which refugees are to be resettled, how many refugees will be resettled) threatens to undermine the terms of the 2013 Arrangement. Australia has underwritten the costs of implementing resettlement under the Arrangement, although the details are not explicit. Nor are details available about any social planning being undertaken for the resettlement of refugees. The author takes up UNHCR’s charge of a ‘xenophobic phenomenon’ in relation to the reception of non-Melanesian refugees in PNG, and offers some context. It is argued that social planning that works towards minimising inter-community tension is critical to resettlement.
The 2013 Arrangement is subject to annual review by the Australian–PNG Ministerial Forum. The sustainability of the Arrangement in terms of legal challenges and security issues is the subject of the third section. Responding to the announcement of the first status determination decisions at the time of publication of this paper, the conclusion summarises some of the major issues related to PNG’s responsibilities under the Arrangement: procedurally fair assessment and review processes, and resettlement planning
"Infrastructure Investment for Tomorrow, A Financing Plan to Eliminate the Deferred Maintenance on the Nation's Roads"
No full textRegan presents a long-term public investment proposal to preserve and upgrade the nation's infrastructure system. He offers a unique financing plan to eliminate much of the backlog of deferred maintenance that plagues America's roads and bridges. The plan would allow states and municipalities to get out from under this burden with a one-time upgrading program and then attain a new capacity to maintain and improve their infrastructure networks. Regan concludes that the goal of long-term investing is "to make possible sustained growth, improved productivity, and a strengthened private sector" for the next generation. A program to upgrade the nation's infrastructure base could help the United States achieve this goal.
Generating female freedom among women's relationships in rugby union: Narratives of sexual difference
No full textThis thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Women's rugby relationships are generally analysed from the point of view of men's rugby, otherwise they are overlooked, or treated as incidental. By contrast, the overall aim of this study is to make sense of women's rugby experiences and relations to rugby as a sport in terms of the feminine friendship relationships they forge and develop through on-field play and the informal culture surrounding the game. This research was conducted and written from the perspective of an active participant as both observer and "research subject". Within the framework of Italian sexual difference thought, it is a dialogue between the main concepts which ground this thought and data concerning women's rugby experiences as gathered from my recollection of personal experiences; participant observation in one team in Barcelona and two in London; twelve conversational interviews with my best rugby friends from Barcelona and London; as well as innumerable informal conversations with friends and other rugby women. I have chosen sexual difference theory to make sense of women's rugby relationships because it allows me to approach women's experiences in rugby from the premise that women are not required to imitate or reverse men's rugby meanings in order to make sense of their experiences. This theory derives from Irigaray's premise that women and men are two irreducible subjects. Thus, this study challenges the existence of a neutral or abstract human being. In short, one of the central aims of this research is to challenge the belief that men's rugby experiences are neutral and abstract and, therefore, can be unproblematically applied to women's rugby. The premise that underpins this investigation is a belief in women's rugby experiences as both illustrative and creative extensions, through on-field play and off-field friendships, of the biological, historical and socially interwoven specificity of women's relationships. Thus, another purpose of this study is to engage the reader with the world of women's rugby and at the same time to delve into the analysis of the significant consequences engendered by women's intense relationships in rugby. The ultimate goal of this project is to show how meaningful relationships in women's rugby can strengthen women's beliefs in themselves and dissolve the doubts that women have about their specific ways of perceiving, organizing and "wording" the world (Richardson, 1996). This research is devoted to strengthening and supporting the concept of female existence as original in itself and capable of taking symbolic form. This research also explores the possibilities that alternative ways of writing about women's rugby experiences and relationships offer to sport feminists' sociology. For this reason, throughout the data chapters I have combined sexual difference theoretical concepts with creative non-fiction narratives of women's rugby relationships and experiences. This means that, inspired by my own experiences, recollections and conversational interviews with other rugby women about their experiences, I have created stories that interweave my subjectivity as a rugby player and as a listener with the experiences of others as narrated to me
Big Data, Big Libraries, Big Problems?: the 2014 LibTech Anti-talk?
No full textThe desire to create automatons is a familiar theme in human history, and during the age of the Enlightenment mechanical automatons became not only an “emblem of the cosmos”, but a symbol of man’s confidence that he would unlock nature’s greatest mysteries and fully harness her power. And yet only a century later, automatons had begun to represent human repression and servitude, a theme later picked up by writers of science fiction. Man’s confidence undeterred, the endgame of the modern scientific and technological mindset, or MSTM, seems to be increasingly coming into view with the rise of “information technology” in general and “Big data” in particular. Along with those who wield them, these can be seen as functioning together as a “mechanical muse” of sorts – surprisingly alluring – and, like a physical automaton can serve as a symbol – a microcosm – of what the MSTM sees (at the very least in practice) as the cosmic machine, our “final frontier”. And yet, individuals who unreflectively participate in these things – giving themselves over to them and seeking the powers afforded by the technology apart from technology’s rightful purposes – in fact yield to the same pragmatism and reductionism those wielding them are captive to. Thus, they ultimately nullify themselves philosophically, politically, and economically – their value increasingly being only the data concerning their persons, and its perceived usefulness. Likewise libraries, the time-honored place of, and symbol for, the intellectual flowering of the individual, will, insofar as they spurn the classical liberal arts (with the idea that things are intrinsically good, and in the case of humans, special as well) in favor of the alluring embrace of MSTM-driven “information technology” and Big data - unwittingly contribute to their irrelevance and demise as they find themselves increasingly less needed, valued, wanted. Likewise for the liberal arts as a whole, and in fact history itself, if the acid of a “science” untethered from what is, in fact, good (intrinsically), continues to gain strengt
La marine impériale dans l’expédition de Chine
No full textL’auteur étudie le développement de la présence navale française dans les mers de Chine durant les guerres de l’opium. Si le soutien aux missions lui apparaît comme un prétexte pour ne pas laisser la Grande-Bretagne gagner seule des avantages en Chine, la marine impériale est la condition du succès de l’intervention.The author examines the development of the French naval presence in the seas of China during the Opium Wars. If supporting the [religious] missions seems an excuse not to let Britain alone win advantages in China, the Imperial Navy was a prerequisite for the success of the intervention
Disease and melancholy as a source of inspiration? : the case of Virginia Woolf
No full textThe phenomenon of Virginia Woolf is still alive; she fascinates readers and literary critics. Her work and life are transformed and re-intrepretated by popular culture. Her mental illness and suicide are now mythologized. But research on Virginia Woolf's inspirations always encounters certain pitfalls. Researchers of her life and writing argue about the role of her mental disorder and melancholy in the creative process. The main aim of this essay is to find the philosophical attitude towards life and creativity that let Virginia Woolf win in the fights with her illness and words. Her melancholy could be, according to the author, the source of creativity, sensitivity, that allowed her to write and fascinate people also today
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