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In this commentary, the authors offer a call to action in the long-standing fight to prevent clinicians from dying by suicide. In April 2020, the nation was shocked by the suicide of New York City emergency physician Dr. Lorna Breen, who died while recovering from COVID-19. She joins an unknown number of clinicians who have taken their lives over the past year. The authors introduce Dr. Breen, a highly talented physician working on the frontlines of the COVID-19 pandemic, and examine how pervasive distress and suicide are in clinicians. Then, they explain the lived experience movement and highlight how clinicians speaking openly about their mental illness and treatment are making it easier for their colleagues to seek lifesaving help, despite the stigma still surrounding mental illness and treatment in medicine. The authors sort through the science of clinician distress; critique how the COVID-19 pandemic is affecting the lives of clinicians; and describe existing national initiatives to address clinician stress, burnout, and suicide. Finally, they recommend evidence-based actions to prevent clinician suicide that multiple stakeholder groups can take, including regulatory agencies, licensing boards, and hospital privileging boards; specialty boards, professional associations, and continuing education organizations; medical educators; and individual clinicians. Suicide is a complex but generally preventable cause of death. Those in medicine must forge ahead with collective momentum. Dr. Breen, so many other clinicians, and those they have left behind deserve nothing less.

In this commentary, the authors offer a call to action in the long-standing fight to prevent clinicians from dying by suicide. In April 2020, the nation was shocked by the suicide of New York City emergency physician Dr. Lorna Breen, who died while recovering from COVID-19. She joins an unknown number of clinicians who have taken their lives over the past year. The authors introduce Dr. Breen, a highly talented physician working on the frontlines of the COVID-19 pandemic, and examine how pervasive distress and suicide are in clinicians. Then, they explain the lived experience movement and highlight how clinicians speaking openly about their mental illness and treatment are making it easier for their colleagues to seek lifesaving help, despite the stigma still surrounding mental illness and treatment in medicine. The authors sort through the science of clinician distress; critique how the COVID-19 pandemic is affecting the lives of clinicians; and describe existing national initiatives to address clinician stress, burnout, and suicide. Finally, they recommend evidence-based actions to prevent clinician suicide that multiple stakeholder groups can take, including regulatory agencies, licensing boards, and hospital privileging boards; specialty boards, professional associations, and continuing education organizations; medical educators; and individual clinicians. Suicide is a complex but generally preventable cause of death. Those in medicine must forge ahead with collective momentum. Dr. Breen, so many other clinicians, and those they have left behind deserve nothing less.

A model outline and evaluation of a group for parents of children with autistic spectrum disorder (ASD) in a specialist child and adolescent mental health service (CAMHS) is presented. Evaluation demonstrates multiple benefits including increased undertanding of ASD, easy access to multidisciplinary clinical advice and support from other parents.

To reduce the risk of infections associated with indwelling central venous catheters (CVCs), practices for hub disinfection have been widely promoted. The objective of this study was to design and implement a standardised tool to monitor compliance with 'scrub the hub' practices at an Australian centre.Review of existing literature and recommendations regarding scrub the hub practices was performed to identify nine key components that could be audited by direct observation of staff in clinical areas. The tool was reviewed by stakeholders in infection prevention, infectious diseases and senior nursing roles prior to pilot evaluation.Twenty attempts to access a CVC were audited. In all instances, scrub the hub practices were commenced. However, a 15-second scrub was performed in only 60% of cases, and the hub was permitted to dry in only 65% of instances. With respect to maintaining an aseptic field, the overall compliance was 40%, and compliance was lowest for maintenance of a non-touch technique for key parts and sites, and hand hygiene practices following CVC access.A standardised clinical audit tool for monitoring aseptic access of CVCs enabled identification of practices amendable to targeted intervention and education, such as duration of hub disinfection. This tool would be readily utilised to facilitate quality improvement initiatives in a range of healthcare contexts, including high-risk inpatient and ambulatory care settings.

Highlights National recommendations are for 2 influenza vaccine doses in immunocompromised patients receiving vaccine for the first time. We report experience in implementing a nurse-led vaccination program for ambulatory immunocompromised patients with cancer. 44/183 (24.0%) patients were vaccine-naive, with 1 of the 2 vaccines administered by a general practitioner in 11 instances. Optimally, hospital programs for influenza vaccination of cancer patients must also engage primary care clinicians.

The enzyme 5-enolpyruvylshikimate-3-phosphate (EPSP) synthase catalyzes the sixth step of the seven-step shikimate pathway. Chorismate, the product of the pathway, is a precursor for the biosynthesis of aromatic amino acids, siderophores and metabolites such as folate, ubiquinone and vitamin K. The shikimate pathway is present in bacteria, fungi, algae, plants and apicomplexan parasites, but is absent in humans. The EPSP synthase enzyme produces 5-enolpyruvylshikimate 3-phosphate and phosphate from phosphoenolpyruvate and shikimate 3-phosphateviaa transferase reaction, and is the target of the herbicide glyphosate. TheAcinetobacter baumanniigene encoding EPSP synthase,aroA, has previously been demonstrated to be essential during host infection for the growth and survival of this clinically important drug-resistant ESKAPE pathogen. Prephenate dehydrogenase is also encoded by the bifunctionalA. baumannii aroAgene, but its activity is dependent upon EPSP synthase since it operates downstream of the shikimate pathway. As part of an effort to evaluate new antimicrobial targets, recombinantA. baumanniiEPSP (AbEPSP) synthase, comprising residues Ala301–Gln756 of thearoAgene product, was overexpressed inEscherichia coli, purified and crystallized. The crystal structure, determined to 2.37 Å resolution, is described in the context of a potential antimicrobial target and in comparison to EPSP synthases that are resistant or sensitive to the herbicide glyphosate.

The representation by male authors of relations between European women and black men in fiction is often stereotypically favourable to the imaginative interests of men. V. S. Naipaul’s The Mimic Men (1967), for example, epitomises a masculine conception of a mixed-race marriage in which the female European partner, Sandra, is portrayed as the cynical and knowing vamp, who entraps sexually the naive and misguided Indian student narrator: She had failed a qualifying examination for the second time. That was the end of her government grant, the end of the School. No degree for her now; no escape by that route … What awaited her? The secretarial course, the librarian’s course, the common employer. She went on, railing at her society, bitter at her lack of protection and patrons within it. A job in the bank; the typing pool; the Woolworth’s counter. She was working herself up to a pitch of hysteria. Tears of anger came to her eyes. Then suddenly, fixing those moist eyes on me, she said, almost ordered, with a look of total hatred: ‘Why don’t you propose, you fool?’ … for the first time since our talk had begun, I thought of her painted breasts.1

In fiction by men this century, representations of heterosexual behaviour have often been nothing more than an increasingly detailed vulgarisation of entrenched beliefs and prejudices about women’s sexual roles as servicer and victim of men. In Sexual Politics, Kate Millett’s analyses of fiction by Henry Miller, Norman Mailer and D. H. Lawrence reveal in their work a consistent dehumanising of women in men’s sexual behaviour towards them.1 Their fiction could be said to act as a partial mirror of life which is tarnished by bias and prejudice. Gaps and blind spots, which feminists such as Millett have tried to expose, abound in their work. Yet, although women this century have become increasingly free to write openly in fiction about sexual relations, not many have used this possibility to advantage in order to reveal the inequality of women’s sexual roles vis-a-vis those of men.

What is a ‘feminine’ novel? By ‘feminine’, I mean not the more trivial constructions of what is considered ‘feminine’ in such areas of popular culture as make-up, perfumery, or soft porn videos, but those usually underrated qualities which convention now adduces to women: receptivity, diffuseness of emotionality, and intuitive thinking. Yet these conventions are by no means universal: Anthony Burgess finds ‘clarity and common sense as essentially feminine properties in the novel’ and cites Storm Jameson, Lettice Cooper, Vita Sackville-West and Nancy Mitford as illustrations of this definition of the ‘feminine’. These women writers, he avers, ‘have made our sweating male experimentalists look gauche and uncomfortable’. Burgess, as well as being selective in his reading of women’s fiction, confuses ‘feminine’ with qualities that he projects into women.1

Masculine responses in fiction to the gestation and delivery of babies are few. William Blake, however, in ‘Infant Sorrow’ (Songs of Experience, 1794), gives a lyrical representation of childbirth from the point of view of the baby. The emergence from secure womb to ‘dangerous world’; the travails of the mother; the emotionality of the father; the feeling of being circumscribed by restrictive clothing; the sulking upon the ‘mother’s breast’ — Blake encapsulates what the psychoanalyst Carl Rogers called the ‘birth trauma’. But the word ‘trauma’ — ‘emotional shock’ (The Concise Oxford Dictionary) — exaggerates what is after all only a stage in growth.

To what extent have our women novelists written about any alternatives to the pursuit of the heterosexual ‘marital bliss’ that is so often at the heart of some fiction? Do women find more freedom by taking lovers, living in communes, or making homes with their own sex? In recent twentieth-century fiction, some women are represented as wanting to cut themselves off completely from the dominance of men, especially from that male craving for power which is often evident in sexual relationships. Celibacy and lesbianism, are, for some women, the only responses to the problem of how to free themselves from male power.

Married women in fiction have been traditionally presented as non-career-making as well as prone to engaging in extramarital affairs. Molly Bloom in James Joyce’s Ulysses, for example, is constructed characteristically as a women with the freedom and time to foster her sexual life outside marriage. Although she is a part-time singer, in her consciousness this work is represented as peripheral to her lust for men. Elvira, in Stead’s The Beauties and the Furies, gives up her aspirations towards independent employment and settles for marriage with affairs on the side. Kate Chopin’s The Awakening, Barbara Pym’s The Sweet Dove Died, Margaret Drabble’s The Waterfall, and A. S. Byatt’s Still Life are among the legion of novels which give us bored housewives finding excitement in attracting and maintaining a lover outside marriage.

‘The personal is political.’ By adopting this slogan, which originated in the ‘permissive’ 1960s, women have turned their own interest in the personal to their advantage. In theories about ‘sexual politics’, the personal sexual relationship is shown to hold overtones of domination and submission, with generally the male dominating the female. Kate Millett claims that, until the balance of power shifts, especially in sexual relationships, to equality between the sexes, no change in systematised male supremacy will occur: unless the ideology of real or fantasized virility is abandoned, unless the clinging to male supremacy as a birthright is finally foregone, all systems of oppression will continue to function simply by virtue of their logical and emotional mandate in the primary human situation.1

Part 1 Anna Seward, (1742-1809): sonnet - "By Derwent's rapid stream as oft I strayed,", "An Evening in November", "Autumn", "To Colebrooke Dale". Part 2 Anna Laetitia Barbauld (nee Aikin) (1743-1825): from "Corsica" "Ode to spring" "A Summer Evening's Meditation" "Autumn. A Fragment". Part 3 Hannah More, (1745-1833): from "The Search after Happiness" from "The Search after Happiness". Part 4 Mary Hays, (1760-1843): "An Invocation to the Nightingale" "The Consolation" sonnet - "Ah! let not hope fallacious, airy, wild,". Part 5 Charlotte Smith (nee Turner) (1749-1806): sonnet - "To a Nightingale", "To The South Downs", "On the Departure of the Nightingale", "Composed during a Walk on the Downs". Part 6 Eliza Knipe (later Cobbold) (1767-1824): "On the Lake of Windermere" "Keswick". Part 7 Anne Hunter (nee Home) (1742-1821): "November, 1784" "To the Nightingale". Part 8 Helen Maria Williams, (1762-1827): sonnet - "To Twilight", "To Expression" "An Address to Poetry" sonnet - "To Hope". Part 9 Mary Hunt, (1764-1834): "Written on visiting the Ruins of Dunkeswell Abbey ....". Part 10 Ann Yearsley (nee Cromartie) (1752-1806): "To Mr. ***, an Unlettered poet, on Genius Unimproved" "Anarchy" "Peace" "Dedicated to Louis XIV". Part 11 Mary O'Brien, (fl. 1785-1790): "Ode to Milton". Part 12 Joanna Baillie, (1762-1851): from "A Winter Day" from "A Summer Day" from "Thunder" from "Wind". Part 13 Anna Maria Jones, (nee Shipley) (1748-1829): "Sonnet to Echo" stanzas - "Marie Antoinette's Complaint in Prison" "Ode to Fancy" "Adieu to India". Part 14 Mary Robinson, (nee Darby) (1758-1800): "Ode to the Nightingale" stanzas - "Written between Dover and Calais", "Written after Successive Nights of Melancholy Dreams" "Ode to my Beloved Daughter". Part 15 Ann Radcliffe (nee Ward) (1764-1823): "To the visions of Fancy" "Song of a Spirit" "Morning, on the Sea Shore" "Rondeau". Part 16 Amelia Alderson, (later Opie) (1769-1853): "To Twilight" "Ode to Borrowdale" "Ode on the Present Times, 27th January 1795" "Stanzas Written under Aeolus's Harp". Part 17 Jane West (nee Iliffe) (1758-1852): "Ode to Imaginations" sonnet - "'Her hair disheveled, and her robe untied,'", "To May". Part 18 Anna Maria Porter (1780-1832)?: "Address to poetry, sonnet to a Sea-Gull". Part 19 Mary Tighe (nee Blachford) (1772-1810): "Written at Scarborough" sonnet - "For me would Fancy now her chaplet twine", "Ye dear associates of my gayer hours" from Psyche - "The Island of Pleasure". Part 20 Barbara Hoole (nee Wreaks, later Hofland) (1770-1844): "Cumberland Rocks" sonnet - "Composed on the Banks of Ulswater" "Composed in a cell, (commonly called the Giant's Cave)" "Lines composed while Climbing some Rocks in Derbyshire". Part 21 Jane Taylor, (1783-1824): "A Town" from "A pair" from "The World in the House". Part 22 Felicia Dorothea Hemans (nee Browne) (1793-1835): "The Voice of Spring" "The Treasures of the. (Part contents)..