Suicide prevention in primary care: General practitioners' views on service availability

BackgroundPrimary care may be a key setting for suicide prevention. However, comparatively little is known about the services available in primary care for suicide prevention. The aims of the current study were to describe services available in general practices for the management of suicidal patients and to examine GPs views on these services. We carried out a questionnaire and interview study in the North West of England. We collected data on GPs views of suicide prevention generally as well as local mental health service provision.FindingsDuring the study period (2003-2005) we used the National Confidential Inquiry Suicide database to identify 286 general practitioners (GPs) who had registered patients who had died by suicide. Data were collected from GPs and practice managers in 167 practices. Responses suggested that there was greater availability of services and training for general mental health issues than for suicide prevention specifically. The three key themes which emerged from GP interviews were: barriers accessing primary or secondary mental health services; obstacles faced when referring a patient to mental health services; managing change within mental health care servicesConclusionsHealth professionals have an important role to play in preventing suicide. However, GPs expressed concerns about the quality of primary care mental health service provision and difficulties with access to secondary mental health services. Addressing these issues could facilitate future suicide prevention in primary care

The syntax of ‘-cā’ (*-kwe) in Ahunavaiti Gāthā

This paper seeks to provide a full description of the syntactic behaviour of the enclitic co-ordinate conjunction -cā in the earliest stage of the Avestan language. By studying the occurrences of the particle in Ahunavaiti Gāthā, a distributive analysis is provided together with an interpretative hypothesis of its distributive dynamics. Two syntactic levels, phrase and sentence, are taken into consideration. Finally, a syntactic domain-based variation is argued and two clitic functional variants are identified as synchronically operating conjunction strategies

Politics of nanotechnologies in food and agriculture

The chapter discusses the reasons for the delay in the regulatory intervention concerning nanotechnologies used in the agriculture and food sectors. The main finding is that unregulated introduction of nanoinnovation into the food system is due to the current neoliberal food policy and to the power struggles that characterize the economic, social and political dynamics within the global supply chain. Therefore, it is necessary to put the ‘question concerning technology’ at the center of the regulatory debate in order to implement a regulatory system able to face nanorisks. Which means looking at the way in which technology controls power relationships within society. Attention should be shifted from efficiency to power issues, and new technologies should be assessed from a political rather than an economic or ethical perspective

Examining parent and child agreement in the diagnosis of adolescent depression

Background: The diagnosis of depression in adolescents relies on identifying the presence of specific core and additional symptoms. Symptoms can be identified using structured or unstructured interviews and a range of questionnaire measures, which are completed by the young person and by a parent or carer. The aim of this research was to examine the inter- and intra-rater reliability of parent report and adolescent self-report of depression symptoms. Method: In a sample of parent-child dyads, where young people aged 13-17 were referred to a mental health service for depression, we examined adolescents’ (n = 46) and parents’ (n = 46) independent responses to the Schedule for Affective Disorders and Schizophrenia in School-Age Children (Kaufman et al., 1997) and the Mood and Feelings Questionnaire (Costello & Angold, 1988). Results: In the clinical interview, diagnostic criteria were more often met based on the adolescent’s report, and adolescents endorsed more symptoms of depression than their parents. Tentative results also suggest that parent-child agreement about specific symptoms was low. Comparing different measures of depression revealed that adolescent report on the questionnaire and interview was significantly correlated. However, there was no significant correlation between parent questionnaire and interview report. Conclusion: These results suggest that relying solely on parents to identify depression in their children may result in young people with depression being missed and therefore untreated. Young people themselves should be encouraged and enabled to recognise the symptoms of depression, and have an established pathway to services that offer assessment and treatment