Implications of the Mental Healthcare Act, 2017 on the Rights of Women with Mental Illnesses in India

The Mental Healthcare Act, 2017 aims to provide for mental health care and services for persons with mental illness in India and to protect, promote and fulfill the rights of such persons during delivery of mental health care and services. Chapter V of the Act enumerates the rights of persons with mental illness, including the right to equality, right to confidentiality, the right to protection from cruel, inhuman and degrading treatment in any mental health establishment (which includes the right to proper clothing so as to protect such person from exposure of his/her body to maintain his/her dignity, and the right to be protected from all forms of physical, verbal, emotional and sexual abuse), right to community living, etc. This paper analyses the provisions of the Act from the perspective of rights of women with mental illness in need of mental health care, and draws a comparison with the relevant provisions of the United Nation Convention of Rights of Persons with Disabilities. Comparison is also made with the existent reality reported in legal literature, the media and the field work undertaken by the author in India

The Effect of Natural Extracts on Border Cell and Centripetal Cell Migration in the Developing Drosophila melanogaster Egg Chamber

Cancer is one of the leading causes of death in the world. Although targeted therapies that specifically inhibit pathways that are activated in cancer cells are becoming more common, often times the specific cancer-causing pathways are not known, or a treatment targeting that pathway has not been developed. In the absence of a targeted therapy, most common cancer treatments target proliferating cells, which can cause many unwanted adverse side effects. Therefore, researchers are testing whether natural extracts or dietary supplements could reduce the growth or metastasis of cancer cells without as many negative side effects. This study uses the Drosophila melanogaster egg chamber as a model system to test the effect of two natural extracts (walnut extract and green tea extract) on invasive cell migration. During normal egg formation, two groups of cells - the border cells and the centripetal cells - migrate from the outer epithelial layer into the germ cell cluster. Because cancer cell metastasis involves invasive cell migratory behavior, these normal cellular behaviors can be used as a model for metastasis. To monitor these invasive migratory behaviors, the border cells and centripetal cells were marked with a green fluorescent protein (GFP), and the extent of migration was monitored using fluorescence microscopy. Data collected from these experiments suggest that walnut extract and green tea extract treatment could cause a modest defect in centripetal cell migration, without significantly affecting border cell migration. Future experiments will assess effect of walnut or green tea extract on specific pathways implicated in centripetal cell migration, as well as extend this model to test other natural extracts

A generic framework for hybrid simulation in healthcare

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University, 11/01/2010.Healthcare problems are complex; they exhibit both detail and dynamic complexity. It has been argued that Discrete Event Simulation (DES), with its ability to capture detail, is ideal for problems exhibiting this type of complexity. On the other hand, System Dynamics (SD) with its focus on feedback and nonlinear relationships lends itself naturally to comprehend dynamic complexity. Although these modelling paradigms provide valuable insights, neither of them are proficient in capturing both detail and dynamic complexity to the same extent. It has been argued in literature that a hybrid approach, wherein SD and DES are integrated symbiotically, will provide more realistic picture of complex systems with fewer assumptions and less complexity. In spite of wide recognition of healthcare as a complex multi- dimensional system, there has not been any reported study which utilises hybrid simulation. This could be attributed to the fact that due to fundamental differences, the mixing of methodologies is quite challenging. In order to overcome these challenges a generic theoretical framework for hybrid simulation is required. However, there is presently no such generic framework which provides guidance about integration of SD and DES to form hybrid models. This research has attempted to provide such a framework for hybrid simulation which can be utilised in healthcare domain. On the basis of knowledge induced from literature, three requirements for the generic framework have been established. It is argued that the framework for hybrid simulation should be able to provide answers to Why (why hybrid simulation is required), What (what information is exchanged between SD and DES models) and How (how SD and DES models are going to interact with each other over the time to exchange information) within the context of implementation of hybrid simulation to different problem scenarios. In order to meet these requirements, a three-phase generic framework for hybrid simulation has been proposed. Each phase of the framework is mapped to an established requirement and provides guidelines for addressing that requirement. The proposed framework is then evaluated theoretically based on its ability to meet these requirements by using multiple cases, and accordingly modified. It is further evaluated empirically with a single case study comprising of Accident and Emergency department of a London district general hospital. The purpose of this empirical evaluation is to identify the limitations of the framework with regard to the implementation of hybrid models. It is realised during implementation that the modified framework has certain limitations pertaining to the exchange of information between SD and DES models. These limitations are reflected upon and addressed in the final framework. The main contribution of this thesis is the generic framework for hybrid simulation which has been applied within healthcare context. Through an extensive review of existing literature in hybrid simulation, the thesis has also contributed to knowledge in multi-method approaches. A further contribution is that this research has attempted to quantify the impact of intangible benefits of information systems into tangible business process improvements. It is expected that this work will encourage those engaged in simulation (e.g., researchers, practitioners, decision makers) to realise the potential of cross-fertilisation of the two simulation paradigms

Reproducing Oppression: A Discourse Analysis of OFP Funding for IVF Through the Lens of Reproductive Justice

Canada has long been viewed as a beacon of progressive universal healthcare. However, a closer look into reproductive healthcare services at the provincial level reveals some services are not as accessible as they are portrayed to be. The existing literature demonstrates the ways in which the bodily autonomy of marginalized groups has been restricted through reproductive oppression, as well as how the discourses surrounding infertility have influenced health policy. Using Reproductive Justice (RJ) theory, this research contributes to this literature by examining what discourses are employed in relation to the Ontario Fertility Program (OFP) funding model for IVF in the province, and the implications of these discourses for the accessibility of reproductive health care services in Ontario. The OFP is a government-run program that funds IVF treatment in the province. The primary question this research sought to address is as follows: Through the lens of reproductive justice, who does the state support in becoming parents via in vitro fertilization? To answer this question, a critical discourse analysis informed by Foucauldian and feminist methodological approaches was conducted on a foundational report on infertility and IVF in Ontario and current OFP policy documents. The themes that emerged from this analysis were: (1) the use of gendered language and (2) IVF policy shifting accountability for services away from the Ontario government. In terms of the first theme, this discourse analysis finds that the foundational report used to inform Ontario’s IVF policy viewed fertility services as a means to achieve the goal of building a family through conceiving children with government assistance. The lack of gender-inclusive language and conflation of sex and gender in the report resulted in the erasure of those outside the gender binary as well as reinforced gendered assumptions that bodies assigned female are passive towards their fertility. This culminated in the report emphasizing the need for women to “protect” their fertility from the dangers of infertility, and the need for the state to fund IVF for the betterment of Ontarians. The second theme focuses on shifting accountability. Within various documents that communicated how OFP funding and IVF delivery operate, this study finds that the Ontario government presented the OFP as a progressive government-run, state sponsored program that is similar to other forms of healthcare in the province. However, documents about the IVF program were often unclear regarding how IVF funding actually operates, which includes a significant reliance on private fertility clinics, creating the impression that the funding for fertility treatment was being increased through OHIP rather than a separate program known as the OFP. The use of language within these documents also emphasized the government’s contributions to the OFP and allowed it to present itself as progressive for increasing support for fertility services while obfuscating how and how much support is provided. The lack of clarity within these documents is significant because it plays into assumptions that IVF is covered under universal healthcare. In actuality, fertility clinics must deliver IVF services while not having to meet the standards set by the Canada Health Act (CHA). This paper concludes with a discussion on IVF and the right to have a child, and employs the principles of RJ to further interrogate how OFP funding actually restricts the right to have a child for those seeking to get pregnant through assisted reproduction rather than fully supporting it. The report used to inform IVF policy in Ontario also used a singular view of identity that did not take into account the barriers to IVF for those with intersecting identities. As a result, the OFP was not designed with these considerations in mind, and therefore, primarily supports white, cisgender, heterosexual couples with financial privilege in becoming parents through IVF