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The elevated risk of suicide in prison and after release is a well-recognised and serious problem. Despite this, evidence concerning community-based offenders' suicide risk is sparse. We conducted a population-based nested case–control study of all people in a community justice pathway in England and Wales. Our data show 13% of general population suicides were in community justice pathways before death. Suicide risks were highest among individuals receiving police cautions, and those having recent, or impending prosecution for sexual offences. Findings have implications for the training and practice of clinicians identifying and assessing suicidality, and offering support to those at elevated risk.
To describe the clinical and demographic characteristics of all in-patients experiencing delayed discharge over 3 months in an English urban mental health National Health Service trust. We carried out a cross-sectional case record study with care coordinator questionnaire.
Overall, 67 in-patients with delayed discharge occupied 18.6% of acute beds. Older in-patients were White, diagnosed with dementia and experienced relatively short admissions. Younger in-patients were often of Black and minority ethnic background with a psychotic diagnosis and long service contact, and sometimes experienced very long admissions. They were similar to a long-stay comparison group. The whole cohort was socially isolated and marginalised, and frequently misused alcohol.
People with complex mental health problems can experience long stays in acute care settings. This particularly affects people with psychosis who are isolated in the community. Alcohol misuse is the most common complicating factor. There are insufficient community-oriented rehabilitation services to meet these patients' diverse needs.
The study of manuscripts is one of the most active areas of current research in medieval studies: manuscripts are the basic primary material evidence for literary scholars, historians and art-historians alike, and there has been an explosion of interest over the past twenty years. Manuscript study has developed enormously: codices are no longer treated as inert witnesses to a culture whose character has already been determined by the modern scholar, but are active participants in a process of exploration and discovery. The articles collected here discuss the future of this process and vital questions about manuscript study for tomorrow's explorers. They deal with codicology and book production, with textual criticism, with the material structure of the medieval book, with the relation of manuscripts to literary culture, to social history and to the medieval theatre, and with the importance to manuscript study of the emerging technology of computerised digitisation and hypertext display. The essays provide an end-of-millennium perspective on the most vigorous developments in a rapidly expanding field of study. Contributors: A.I. Doyle, C. David Benson, Martha W. Driver, J.P. Gumbert, Kathryn Kerby-Fulton, Linne R. Mooney, Eckehard Simon, Alison Stones, John Thompson. DEREK PEARSALL is former Professor and Co-Director of the Centre for Medieval Studies, York, and Professor of English at Harvard University.
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