Predicting risk of suicide attempt using history of physical illnesses from electronic medical records

BACKGROUND: Although physical illnesses, routinely documented in electronic medical records (EMR), have been found to be a contributing factor to suicides, no automated systems use this information to predict suicide risk.

OBJECTIVE: The aim of this study is to quantify the impact of physical illnesses on suicide risk, and develop a predictive model that captures this relationship using EMR data.

METHODS: We used history of physical illnesses (except chapter V: Mental and behavioral disorders) from EMR data over different time-periods to build a lookup table that contains the probability of suicide risk for each chapter of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) codes. The lookup table was then used to predict the probability of suicide risk for any new assessment. Based on the different lengths of history of physical illnesses, we developed six different models to predict suicide risk. We tested the performance of developed models to predict 90-day risk using historical data over differing time-periods ranging from 3 to 48 months. A total of 16,858 assessments from 7399 mental health patients with at least one risk assessment was used for the validation of the developed model. The performance was measured using area under the receiver operating characteristic curve (AUC).

RESULTS: The best predictive results were derived (AUC=0.71) using combined data across all time-periods, which significantly outperformed the clinical baseline derived from routine risk assessment (AUC=0.56). The proposed approach thus shows potential to be incorporated in the broader risk assessment processes used by clinicians.

CONCLUSIONS: This study provides a novel approach to exploit the history of physical illnesses extracted from EMR (ICD-10 codes without chapter V-mental and behavioral disorders) to predict suicide risk, and this model outperforms existing clinical assessments of suicide risk.

Casey: four decades in the making of Australian foreign policy

Richard Casey was involved in shaping Australian foreign policy for over four decades. Casey's attitudes, ideas, policies and actions towards the rest of the world are therefore an important part of a Liberal tradition in Australian foreign policy. To examine Casey's place in the Liberal tradition this article explores Casey's positions on the great international issues of two periods: the 1930s and the 1950s. The conclusion of the article is that three key ideas shaped Casey's foreign policy, and therefore also lie at the centre of the Liberal tradition; firstly, a strong attachment to the idea of the English speaking alliance; secondly, a realist perspective on international affairs; and, thirdly, a consistent strand of anti-communism.

Ritualising residency: territory cults and a sense of place in Southern Lao PDR

Territory cults in southern Lao PDR exemplify the importance of ritual for the production of locality in an era of mobility. Here, the idea of village expressed in ritual incorporates scattered members who have ties of history and affection to village households—a view of residency that is extra-verted, inclusive and traverses space.

A house in history, heritage and tourism : shifting times at Blundell's Cottage, Canberra

The history of history's institutions can offer a gritty context in which to understand historical production. A wide spectrum of influences, from the personal to the intellectual to the political, can be seen at work in shaping the history made and communicated at Blundell's Cottage over the years. Even though it has always been a humble participant in the project of history, its products probably reach some of history's larger audiences. Hence it is worthwhile to review fifty years of historio-museography.

Playing with time: history and the extended present

In this paper we consider how the concept of time is developed in schools. We argue that the teaching and learning of history (despite the emergence of the new history in the 1970s) is still taught and learnt with a temporal bias and it is often positioned in the past. So too, history/SOSE1 student-teachers are exposed to temporal bias in their tertiary education (as is evidenced in ‘Arts Faculty’ history courses). We suggest that there needs to be greater connectedness and balance between the dimensions of time in the teaching of SOSE with specific reference to the teaching of history and futures perspectives. We offer a new conceptualisation of history which we refer to as ‘history as the extended present’ this conceptualisation positions history in multiple temporal domains (the past, present and possible, probable and preferable futures) and emphasises the relevance of teaching and learning history to students life worlds.

Whose history? Whose heritage? Positing a sustainable future for Point Nepean, Victoria

Australia's national heritage comprises exceptional natural and cultural places which help give Australia its national identity. This paper reports on work in progress. It critically and reflectively explores the bonds and  limitations between the work of historians, heritage professionals and ‘free thinkers’ – architects, artists and writers – in the task of identifying, protecting and interpreting the possibilities and opportunities presented by our cultural heritage at Point Nepean, Victoria. Underway is the development of an extensive knowledge database, as historians grapple with the problem of understanding the complex history of Point Nepean. Historians and heritage professionals aspire to recreate the past; they search for the patterns of history; they use historical evidence to gain political objectives; they distil insights from the historical record itself. While scholarship and rigorous procedures are generally adhered to, much hangs on interpretation and perspective; how documentation and imagination are interwoven; on how and by whom the story is told. Once a place is listed on National and/or State registers, the conservation process is invoked for transferring information about the past into the future, using current skills, knowledge and  techniques. In Australia conservation is underpinned by the principle that change to a heritage place should not occur at the expense of its special character and qualities, by what is described as its heritage significance. This requires that approval be obtained before any action takes place which has, will have, or is likely to have, a significant impact on the national heritage values of a listed place. Conflict in heritage management arises because there are many different views on how different values are  managed. It is the role of the architectural historian, conservation architect and architect to creatively reveal the inherent values, to interpret them and sustain the place into the future, never losing sight of Point Nepean’s unique ‘sense of place’.

'Particularly happy' arrangement?: Idealism, pragmatism and the enclosed open spaces of Perth garden suburbs

One of the hallmarks of many planned garden suburbs of the early twentieth century is the internal reserve: open space at the rear of residences, without street frontage. An idealistic conception with direct links to overseas planning theory, these spaces were not always well received by either local councils or residents; despite this, many survive today as legacies of early suburban reformism. Perth’s highest-profile planning advocates of the interwar years, most notably town clerk William Bold and the progressive surveying  partnership of Hope and Klem, embraced and encouraged the idea and a number of middle-ring suburbs in Perth feature internal reserves which have survived both encroachment and resubdivision. Some have been given heritage status in recognition of their importance to the history and fabric of particular suburban communities; others remain neglected and essentially unacknowledged. All raise ongoing usage, maintenance and management issues for the councils that have inherited them.

The perceptions of expert coaches about effective leadership in sport

Research on effective leadership in sport has identified a number of characteristics and situations that impact on coaching effectiveness. These include coach effect on athlete satisfaction and performance, self-esteem and trait anxiety. This research has focused on athletes' perceptions of or preferences for specific leadership behaviors and actual coach behaviors identified by observing coaches. Few studies have recognized the views of the expert coach as a potentially valuable source of information regarding effective leadership and the coaching process. The present study investigated expert coaches' perception and interpretation of the leadership process. Twenty successful coaches working with Australian junior elite sport participants were purposefully sampled to cover a diversity of sports (team and individual) and provide a gender balance across sports. Through in-depth interviews, based on Grounded Theory, the study examined three aspects of coaching, which provided the basis of the interview guide. These were coaching history and influences, effective coaching behaviors, and coach training and accreditation. Eight major themes emerged: (a) influence of history on coaching behaviors, (b) knowledge of the sport, (c) pedagogy skills, (d) coaches' personal qualities, (e) coach-athlete relationships, (f) coaches' evaluation of the athlete, (g) coach and athlete outcomes, and (h) enjoyment of the coaching process. The results highlight the important role coaches play in future coach development, the impact of coach self-efficacy attributed to athlete self-efficacy, and how coach-related outcomes drive the coaching process. These results have noteworthy implications for coach education programs.

Cinema of (coming) attractions : Bruce Conner's a movie and documentary display

Bruce Conner's film 'Movie' (1958) constructs an argument concerning popular media and history within and through a radical juxtaposition of images to release new and productive meanings. It also comments on the media's representation of history as violence and analyses the consequences of aggression and violence.

Marginalising the marginal in holocaust films : fictional representations of jewish policeman

This paper explores the issue of how Jewish victims who occupied so-called 'privileged' positions during the Holocaust are represented in fictional films. Such figures, particularly Jewish policemen in the ghettos, may be seen to inhabit the 'marginal' in two ways, both in terms of the unprecedented ethical dilemmas they faced, and the relative lack of attention such figures have received. Taking Primo Levi's paradigmatic essay on the 'grey zone' as a point of departure, this paper analyses how Jewish policemen are represented in mainstream, 'Hollywood' fictional films, namely Steven Spielberg's Schindler's List, in order to reveal that the narrative concerns of such works preclude any serious engagement with themes of moral ambiguity and 'compromise'. Attention will also be given to a more recent trend in the genre of Holocaust film that directly confronts these issues, nonetheless such films may themselves be viewed as marginalised due to their subject matter.

Why there is reason to remain sceptical of Durston's scepticism

In this reply I argue that Durston's defence of his argument from the complexity of history ought to be unacceptable to the theist as it undermines not only common theistic attitudes towards God, such as gratitude and praise, but also the rationality of our ordinary moral practices.

Strategic significance of the island state of Sri Lanka

The study is focused on an analysis of the major diplomatic documents from the mid eighteenth century to the present as regards Sri Lanka, or Ceylon as it was known till 1972. The objectives of the study are to identify the issues underlying these diplomatic documents. These include the political and strategic factors and other subsidiary issues like trade and commerce relevant at the time these treaties, agreements, and proposed treaties were formulated. It is also a geopolitical study as it relates to Sri Lanka's geographical position in the Indian Ocean, and her possession of the Trincomalee Harbour on its east coast, which is one of the great natural harbours of the world. Over the centuries this harbour has had significant strategic value for naval deployments. The case study of the eighteenth and nineteenth centuries studies the diplomatic documents against the political and strategic background for the French Revolution and actions of Napoleon, and the Anglo/French rivalry, spreading from Europe to North America and Asia. In the twentieth century the environment for studying the place of Sri Lanka in the Indian Ocean was created by the Russian Revolution, the failure to keep the peace of Versailles after World War I, the conflict and horrors of World War II which led to the disintegration of European colonial empires in Asia and Africa, and the tensions generated by the Cold War. A study of the documents would reveal that in international relations what matters is the ability of a party to promote its interests, and this depends on its power. This realist approach contrasts to the idealist approach where policies are based on moral and ethical principles. For the realist the states should follow to protect their interests and to survive. To achieve this is to strive for a ‘balance of power’. To do so is to form a favourable alliance system. As the documents examined cover a period from the mid-eighteenth century to the later part of the twentieth century, they reflect the changing technologies that have had an influence on naval and military matters. For example, this period witnessed great changes in technology of energy utilized to propel warships, from wind, to steam, to fuel and finally to nuclear power. These changes had an influence in determining strategic policies involving weapon systems and communications within a global and regional setting. The period covered was the beginning of the process described a ‘globalisation’. Its idea is not unique to this century; there were many attempts, in various times of history, to integrate societies within a global context. Viewed in this light, the Anglo-French rivalry of the eighteenth and nineteenth centuries was the indication of a global naval strategy, in which Sri Lanka was a major factor in the Indian Ocean region. This process was associated with the phenomena called the ‘expansion of Europe’. It covered all the oceans of the world and in the nineteenth and twentieth centuries led to the founding of the largest maritime empire the world has ever seen: The British Empire. After World War I, the British naval strength (the basis of the British Empire) and her consequent position as a great power, was challenged by other powers like the United States of America and Japan. After World War II, the US Navy was supreme: and there was a close alliance between Britain and the USA. The strength of the US/British alliance was based on the navy and its bases, which were spread throughout the globe; to project power, and act as deterrence and balancing force. Sri Lanka, due to her strategic position, was a part of this evolving process, and was tied to a global strategy (with its regional connotations) from the eighteenth century to the present.

Identity and autonomy of the indigenous community within Christianity

[No Abstract]