Legal needs of adults with life-limiting illness: what are they and how are they managed? A qualitative multi-agency stakeholder exercise

Objective: Little is known about legal needs in the context of life-limiting illness, particularly the need for advice concerning legal arrangements, rights and entitlements. This UK-based multiagency stakeholder engagement exercise scoped legal needs associated with life-limiting illness and identified support structures, gaps and opportunities for practice improvement. / Method and analysis: Snowball sampling generated a stakeholder group from a wide range of regional and national organisations involved in care of people with life-limiting illness, spanning health, social care, legal support, advice, charities, prison services as well as patient and carer representatives. A coproduced survey of three open questions generated qualitative data, interpreted by thematic analysis. Results Stakeholders reported a broad spectrum of problems and needs raising legal issues, with no consistency of definition. A classification is proposed, identifying matters concerning rights and entitlements of patients/carers in day-to-day life and decisions around care, both immediate and in the future, as well as professional responsibilities in delivering personalised care. The support structures identified were predominantly online literature, although there was some availability of remote and face-to-face services. Limited awareness of the issues, variable service configuration, fragmentation of care and inequitable access were identified as barriers to support. Stakeholders recognised the need for education and closer multiagency working. / Conclusions: ‘Legal needs’ incorporate wide-ranging issues, but there is inconsistency in perceptions among stakeholders. Practice is variable, risking unmet need. Opportunities for improvement include more formal integration of social welfare legal services in the health context, generating clearer pathways for assessment and management

Health Justice Partnerships: An International Comparison of Approaches to Employing Law to Promote Prevention and Health Equity

This article traces the development and growth of health justice partnerships (HJPs) in three countries: the United States, Australia and the United Kingdom

International Evidence on the Impact of Health-Justice Partnerships: A Systematic Scoping Review

BACKGROUND: Health-justice partnerships (HJPs) are collaborations between healthcare and legal services which support patients with social welfare issues such as welfare benefits, debt, housing, education and employment. HJPs exist across the world in a variety of forms and with diverse objectives. This review synthesizes the international evidence on the impacts of HJPs. METHODS: A systematic scoping review of international literature was undertaken. A wide-ranging search was conducted across academic databases and grey literature sources, covering OECD countries from January 1995 to December 2018. Data from included publications were extracted and research quality was assessed. A narrative synthesis approach was used to analyze and present the results. RESULTS: Reported objectives of HJPs related to: prevention of health and legal problems; access to legal assistance; health improvement; resolution of legal problems; improvement of patient care; support for healthcare services; addressing inequalities; and catalyzing systemic change. There is strong evidence that HJPs: improve access to legal assistance for people at risk of social and health disadvantage; positively influence material and social circumstances through resolution of legal problems; and improve mental wellbeing. A wide range of other positive impacts were identified for individuals, services and communities; the strength of evidence for each is summarized and discussed. CONCLUSION: HJPs are effective in tackling social welfare issues that affect the health of disadvantaged groups in society and can therefore form a key part of public health strategies to address inequalities

Urticária Crônica espontânea e estresse psicológico: Spontaneos Chronic Urticaria and phychological stress

Introdução: A urticária crônica espontânea ou idiopática (UCE) é caracterizada pelo aparecimento espontâneo de placas urticadas, prurido e/ou angioedemas, sendo de causa desconhecida na maioria dos casos. Diversos estudos mostram que o estresse pode ser um gatilho para UCE ou que a presença de doenças crônicas da pele podem aumentar o sofrimento psicológico e causar distúrbios psiquiátricos. Objetivos: Compreender a influência do estado emocional no desenvolvimento da urticária crônica espontânea. Métodos: Trata-se de uma revisão bibliografia da literatura existente através da busca de artigos indexados em distintas bases de dados bibliograficas: PubMed, Scielo, BVS e Google Scholar. Discussão: Uma revisão sistemática evidenciou relação direta ou indireta da UCE com inflamação neuroimune e o estresse; 5 estudos mostraram que o estresse pode estar implicado no mecanismo e na intensificação da enfermidade e 8 estudos mostraram relação de fatores neuroimunes cutâneos de inflamação ou neurotransmissão e a patologia em questão. O estresse é um fator precipitante nos pacientes com urticária crônica espontânea, sendo importante o manejo precoce para limitar a morbidade e aumentar qualidade de vida. Conclusão: O estresse pode ser um fator facilitador ou predisponente para ativação de mastócitos. Ademais, a UCE pode ser fator de risco para diversas patologias psiquiátricas devido a característica crônica da doença. De modo geral, fatores psiquiátricos podem estar envolvidos no desenvolvimento e no agravamento da patologia

Social welfare [law] advice provision during the pandemic in England and Wales: a conceptual framework

An ambitious reform programme in the UK to digitalize the justice system has been underway since 2016. The report on Digitisation and accessing justice in the community (based on the Digitalisation Welfare Advice Survey), on how prepared advice providers were for digital assistance for welfare benefits, found that organisations were unable to meet the demand for services across all levels of social welfare law, and that there is a high demand for digital assistance. This was just before the pandemic. This paper explores the technical capability of the advice sector to provide remote social welfare delivery during the pandemic. It is based on a Pandemic Welfare Advice survey to help understand how advice providers have been working during the first seven months of the pandemic in 2020 and how the migration to remote advice delivery has changed their services and impacted their clients. A conceptual framework of needs is offered as a lens though which to think about the new sets of demands on advisers and clients

Mediation in the Law Curriculum

Cited by Lord Neuberger in ‘Educating Future Mediators’ at the 4th Civil Mediation Council National Conference, May 201

Resistance and the paradox of legal entitlement – A theoretical analysis of migrant women’s responses to domestic abuse in the host country

This article provides a theoretically informed examination of migrant women’s responses to domestic abuse in the host country. It departs from an analysis of research on South Asian women in England, on Portuguese women in England and on Portuguese women in Canada to suggest that women’s apparent lack of mobilisation of law (primarily by eschewing contact with the justice system of the host country and preferring informality), both perpetuates hegemonic discourses and presents a possibility for change. The theoretical approach undertaken combines literature on legal consciousness, power and resistance, and on socio-cultural structures and barriers that affect migrant women. The article ultimately suggests that, rather than an acceptance of hegemonic discourses, women’s behaviour is best understood as a form of resistance to, and from within, socio-cultural pressures encountered in everyday life; as a form of “entrenched” resistance

Students' perception of the learning environment in a distributed medical programme

Background : The learning environment of a medical school has a significant impact on students’ achievements and learning outcomes. The importance of equitable learning environments across programme sites is implicit in distributed undergraduate medical programmes being developed and implemented. Purpose : To study the learning environment and its equity across two classes and three geographically separate sites of a distributed medical programme at the University of British Columbia Medical School that commenced in 2004. Method : The validated Dundee Ready Educational Environment Survey was sent to all students in their 2nd and 3rd year (classes graduating in 2009 and 2008) of the programme. The domains of the learning environment surveyed were: students’ perceptions of learning, students’ perceptions of teachers, students’ academic self-perceptions, students’ perceptions of the atmosphere, and students’ social self-perceptions. Mean scores, frequency distribution of responses, and inter- and intrasite differences were calculated. Results : The perception of the global learning environment at all sites was more positive than negative. It was characterised by a strongly positive perception of teachers. The work load and emphasis on factual learning were perceived negatively. Intersite differences within domains of the learning environment were more evident in the pioneer class (2008) of the programme. Intersite differences consistent across classes were largely related to on-site support for students. Conclusions : Shared strengths and weaknesses in the learning environment at UBC sites were evident in areas that were managed by the parent institution, such as the attributes of shared faculty and curriculum. A greater divergence in the perception of the learning environment was found in domains dependent on local arrangements and social factors that are less amenable to central regulation. This study underlines the need for ongoing comparative evaluation of the learning environment at the distributed sites and interaction between leaders of these sites