Protecting the Children: Early Years of the King’s Orphan Schools in Van Diemen’s Land

In the second decade of the 21st century, the Australian government has encountered a barrage of criticism from people outraged by its treatment of refugees. The Immigration Minister, accused of failing in his obligation to act as guardian of asylum-seeking children, has talked ‘tough’. Nearly two hundred years earlier, when Lieutenant-Governor George Arthur confronted the problems of administering Australia’s second colony, Van Diemen’s Land (now Tasmania), his approach was radically different. This paper considers how the colony under Arthur struggled with the government’s responsibility to protect vulnerable children in its midst

Improving access to health care in a rural regional hospital in South Africa: Why do patients miss their appointments?

Background: Access to health services is one of the Batho Pele (‘people first’) values and principles of the South African government since 1997. This necessitated some changes around public service systems, procedures, attitudes and behaviour. The challenges of providing health care to rural geographically spread populations include variations in socio-economic status, transport opportunities, access to appointment information and patient perceptions of costs and benefits of seeking health care. George hospital, situated in a rural area, serves 5000 outpatient visits monthly, with non-attendance rates of up to 40%. Objectives: The aim of this research was to gain a greater understanding of the reasons behind non-attendance of outpatient department clinics to allow locally driven, targeted interventions. Methods: This was a descriptive study. We attempted to phone all patients who missed appointments over a 1-month period (n = 574). Only 20% were contactable with one person declining consent. Twenty-nine percent had no telephone number on hospital systems, 7% had incorrect numbers, 2% had died and 42% did not respond to three attempts. Results: The main reasons for non-attendance included unaware of appointment date (16%), out of area (11%), confusion over date (11%), sick or admitted to hospital (10%), family member sick or died (7%), appointment should have been cancelled by clerical staff (6%) and transport (6%). Only 9% chose to miss their appointment. The other 24% had various reasons. Conclusions: Improved patient awareness of appointments, adjustments in referral systems and enabling appointment cancellation if indicated would directly improve over two-thirds of reasons for non-attendance. Understanding the underlying causes will help appointment planning, reduce wasted costs and have a significant impact on patient care

The Impact of the Nottingham Workplace Parking Levy on Travel to Work Mode Share

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.A Workplace Parking Levy (WPL) scheme raises a levy on private non-domestic off-street parking provided by employers. In April 2012 Nottingham became the first UK City to implement such a scheme with the revenue generated hypothecated for funding two additional tram lines into the city, the refurbishment of the main railway station and enhancements to a number of bus services. Evaluations of similar Parking Space Levies schemes in Australia show that their introduction, along with any transport improvements they part fund, have been followed by mode switch to non-car based modes, a pre-requisite for congestion constraint. The aim of this paper is to investigate the impact the introduction of the Nottingham Workplace Parking Levy and its associated transport improvements has had on transport mode choice for commuters. This research however, does not directly demonstrate cause and effect leaving open the possibility that the observed mode shift could be caused by exogenous factors. The paper is based on data collected from a survey of 2,500 commuters in Nottingham, relating to their mode choice. The results indicate that 8.6% of commuters currently travelling by sustainable modes switched from the car between 2010 and 2016 at least in part due to the implementation of the WPL and/or the associated transport improvements. In the region of 50 per cent of those individuals gave the WPL as a stand-alone scheme as an important factor in their decision to shift away from the car via an increase in the cost of parking at work or because their employer had removed workplace parking spaces. However, this research has also revealed evidence of commuters switching to the car away from other modes demonstrating a significant suppressed demand for travel by car which in part offsets some of the beneficial impacts of the WPL package

Challenges of safeguarding via remote consulting during the COVID-19 pandemic:a qualitative interview study

BACKGROUND: The COVID-19 pandemic required general practice to rapidly adapt to remote consultations and assessment of patients, creating new, and exacerbating existing, vulnerabilities for many patients. AIM: To explore GP perspectives and concerns about safeguarding practice during the pandemic, focusing on challenges and opportunities created by remote consultation. DESIGN AND SETTING: Qualitative interview study. METHOD: Eighteen GPs from Oxford, London, Southampton, Liverpool, Manchester, and Reading were interviewed between June and November 2020, using a flexible topic guide and fictional vignettes to explore child and adult safeguarding scenarios. Interviews were audio-recorded, thematically coded, and analysed. RESULTS: GPs worried about missing observational information during remote consultations and that conversations might not be private or safe. Loss of continuity and pooled triage lists were seen as further weakening safeguarding opportunities. GPs experienced remote consulting as more ‘transactional’, with reduced opportunities to explore ‘other reasons’ including new safeguarding needs. However, they also recognised that remote consulting created opportunities for some vulnerable patients. While supporting known vulnerable patients was difficult, identifying new or unknown vulnerabilities was harder still. Most reported that remote consulting during COVID-19 was harder, riskier, and emotionally draining, contributing to increased GP anxiety and reduced job satisfaction. CONCLUSION: The GPs interviewed raised important concerns about how to identify and manage safeguarding in the context of remote consultations. Current guidance recommends face-to-face consultation for safeguarding concerns, but pressure to use remote forms of access (within or beyond the pandemic) and the fact that safeguarding needs may be unknown makes this an issue that warrants urgent attention

Targeting sexual health services in primary care: a systematic review of the psychosocial correlates of adverse sexual health outcomes reported in probability surveys of women of reproductive age

BACKGROUND: Women using primary care vary in need for sexually transmitted infections (STIs) testing and contraception. Psychosocial correlates of these needs may be useful for targeting services. We undertook a systematic review to identify psychosocial correlates of STI acquisition, unplanned pregnancy (UP), abortion and risky sexual behaviours in general population samples of women of reproductive age. METHODS: We searched bibliographic databases for probability surveys of women aged 16-44years in the European Union, USA, Canada, Australia, UK or New Zealand undertaken January 1994-January 2014. RESULTS: Eleven papers were included. Unplanned pregnancy was associated with smoking, depression, being single and sexual debut <16years. Abortion was associated with lack of closeness to parents, leaving home at an early age, and relationship break-up. Multiple partnerships were associated with intensity of marijuana and alcohol use, and smoking. STI diagnosis was associated with relationship break-up and younger partners. Non-use of contraception was associated with smoking, obesity, relationship status, sedentary lifestyles, fatalistic pregnancy attitudes and lower alcohol use. Condom non-use was higher (at first sex) with partners 5+years older and lower (at last sex) in less stable partnerships. CONCLUSION: Psychosocial variables, particularly relationship status and smoking, may help identify women in primary care for STI testing and contraception advice and supply

Impact of non-parabolic electronic band structure on the optical and transport properties of photovoltaic materials

The effective mass approximation (EMA) models the response to an external perturbation of an electron in a periodic potential as the response of a free electron with a renormalized mass. For semiconductors used in photovoltaic devices, the EMA allows calculation of important material properties from first-principles calculations, including optical properties (e.g., exciton binding energies), defect properties (e.g., donor and acceptor levels), and transport properties (e.g., polaron radii and carrier mobilities). The conduction and valence bands of semiconductors are commonly approximated as parabolic around their extrema, which gives a simple theoretical description but ignores the complexity of real materials. In this work, we use density functional theory to assess the impact of band nonparabolicity on four common thin-film photovoltaic materials—GaAs, CdTe, Cu2ZnSnS4 and CH3NH3PbI3—at temperatures and carrier densities relevant for real-world applications. First, we calculate the effective mass at the band edges. We compare finite-difference, unweighted least-squares and thermally weighted least-squares approaches. We find that the thermally weighted least-squares method reduces sensitivity to the choice of sampling density. Second, we employ a Kane quasilinear dispersion to quantify the extent of nonparabolicity and compare results from different electronic structure theories to consider the effect of spin-orbit coupling and electron exchange. Finally, we focus on the halide perovskite CH3NH3PbI3 as a model system to assess the impact of nonparabolicity on calculated electron transport and optical properties at high carrier concentrations. We find that at a concentration of 1020cm−3 the optical effective mass increases by a factor of two relative to the low carrier-concentration value, and the polaron mobility decreases by a factor of three. Our work suggests that similar adjustments should be made to the predicted optical and transport properties of other semiconductors with significant band nonparabolicity

The MH1 domain of Smad3 interacts with Pax6 and represses autoregulation of the Pax6 P1 promoter

Pax6 transcription is under the control of two main promoters (P0 and P1), and these are autoregulated by Pax6. Additionally, Pax6 expression is under the control of the TGFβ superfamily, although the precise mechanisms of such regulation are not understood. The effect of TGFβ on Pax6 expression was studied in the FHL124 lens epithelial cell line and was found to cause up to a 50% reduction in Pax6 mRNA levels within 24 h. Analysis of luciferase reporters showed that Pax6 autoregulation of the P1 promoter, and its induction of a synthetic promoter encoding six paired domain-binding sites, were significantly repressed by both an activated TGFβ receptor and TGFβ ligand stimulation. Subsequently, a novel Pax6 binding site in P1 was shown to be necessary for autoregulation, indicating a direct influence of Pax6 protein on P1. In transfected cells, and endogenously in FHL124 cells, Pax6 co-immunoprecipitated with Smad3 following TGFβ receptor activation, while in GST pull-down experiments, the MH1 domain of Smad3 was observed binding the RED sub-domain of the Pax6 paired domain. Finally, in DNA adsorption assays, activated Smad3 inhibited Pax6 from binding the consensus paired domain recognition sequence. We hypothesize that the Pax6 autoregulatory loop is targeted for repression by the TGFβ/Smad pathway, and conclude that this involves diminished paired domain DNA-binding function resulting from a ligand-dependant interaction between Pax6 and Smad3

Perspective: Theory and simulation of hybrid halide perovskites

Organic-inorganic halide perovskites present a number of challenges for first-principles atomistic materials modeling. Such “plastic crystals” feature dynamic processes across multiple length and time scales. These include the following: (i) transport of slow ions and fast electrons; (ii) highly anharmonic lattice dynamics with short phonon lifetimes; (iii) local symmetry breaking of the average crystallographic space group; (iv) strong relativistic (spin-orbit coupling) effects on the electronic band structure; and (v) thermodynamic metastability and rapid chemical breakdown. These issues, which affect the operation of solar cells, are outlined in this perspective. We also discuss general guidelines for performing quantitative and predictive simulations of these materials, which are relevant to metal-organic frameworks and other hybrid semiconducting, dielectric and ferroelectric compounds

Phonon anharmonicity, lifetimes, and thermal transport in CH₃NH₃PbI₃ from many-body perturbation theory

Lattice vibrations in CH$_3$NH$_3$PbI$_3$ are strongly interacting, with double well instabilities present at the Brillouin zone boundary. Analysis within a first-principles lattice dynamics framework reveals anharmonic potentials with short phonon quasi-particle lifetimes and mean-free paths. The phonon behaviour is distinct from the inorganic semiconductors GaAs and CdTe where three-phonon interaction strengths are three orders of magnitude smaller. The implications for the applications of hybrid halide perovskites arising from thermal conductivity, band-gap deformation, and charge-carrier scattering through electron-phonon coupling, are presented

Giant Huang–Rhys Factor for Electron Capture by the Iodine Intersitial in Perovskite Solar Cells

Improvement in the optoelectronic performance of halide perovskite semiconductors requires the identification and suppression of nonradiative carrier trapping processes. The iodine interstitial has been established as a deep level defect and implicated as an active recombination center. We analyze the quantum mechanics of carrier trapping. Fast and irreversible electron capture by the neutral iodine interstitial is found. The effective Huang–Rhys factor exceeds 300, indicative of the strong electron–phonon coupling that is possible in soft semiconductors. The accepting phonon mode has a frequency of 53 cm–1 and has an associated electron capture coefficient of 1 × 10–10 cm3 s–1. The inverse participation ratio is used to quantify the localization of phonon modes associated with the transition. We infer that suppression of octahedral rotations is an important factor to enhance defect tolerance