The Nearest Relative and Nominated Person: A Tale of Parliamentary Shenanigans

The nearest relative (NR) has proved to be a resilient feature of mental health legislation. The powers and the rules for the identification of the NR remain largely unchanged since the role was introduced in the Mental Health Act 1959, with the Mental Health Acts 1983 and 2007 only having made relatively minor modifications. The NR has even survived two attempts to abolish it, in the draft Mental Health Bills of 2002 and 2004.Few would doubt that the NR provides an important legal safeguard for the rights of mental health patients. However, the rules for establishing the identity of the NR relative are, by common consent, deeply flawed. The identification rules are rooted in the 1950s and reflect many of the assumptions about the structure and role of the family that were prevalent in the immediate post-war period. As such, they fail to reflect the lives and circumstances of mental health patients in the twenty-first century.This paper outlines, briefly, the role of the NR and the changes introduced by the Mental Health Act 2007, and the main criticisms of the rules for identifying the NR. Its main purpose, however, is to set out the reforms to those rules that were nearly achieved by the Mental Health Alliance during the passage of the Mental Health Bill 2006 and to document the ensuing Parliamentary debates. The paper concludes by considering the future of the NR

Generalised Swan modules and the D(2) problem

We give a detailed proof that, for any natural number n, each algebraic two complex over C_n \times C_\infty is realised up to congruence by a geometric complex arising from a presentation for the group.Comment: This is the version published by Algebraic & Geometric Topology on 24 February 200

Rapid Re-Housing of Families Experiencing Homelessness in Massachusetts: Maintaining Housing Stability

The American Recovery and Reinvestment Act of 2009 (“Recovery Act”) provided $1.5 billion for the Homelessness Prevention and Rapid Re-Housing Program (HPRP), a temporary program that addressed both homelessness prevention and rapid re-housing of families already experiencing homelessness. The U.S. Department of Housing and Urban Development (HUD) allocated$44.5 million, including $26.1 million to individual Massachusetts communities and$18.4 million to the Commonwealth of Massachusetts. Of its funds, the state allocated $8.3 million for rapid re-housing of families who were living in shelters or motels. This report explores the experiences of 486 of these families who received rapid re-housing assistance from six agencies in four regions of the state. The Center for Social Policy (CSP) at the University of Massachusetts Boston analyzed data about these families to develop a profile of the characteristics of participant families, their assets and barriers related to housing and economic stability, and housing outcomes after 12 to 18 months of program participation. In addition, CSP also completed interviews with staff of each agency, a focus group of Boston area staff, and a detailed review of a selection of case files to provide additional, rich details about the circumstances of individual families

Detection rates of recurrent prostate cancer : 68Gallium (Ga)-labelled prostate-specific membrane antigen versus choline PET/CT scans. A systematic review

Background: The aim of this work was to assess the use of prostate-specific membrane antigen (PSMA)-labelled radiotracers in detecting the recurrence of prostate cancer. PSMA is thought to have higher detection rates when utilized in positron emission tomography (PET)/computed tomography (CT) scans, particularly at lower prostate-specific antigen (PSA) levels, compared with choline-based scans. Methods: A systematic review was conducted comparing choline and PSMA PET/CT scans in patients with recurrent prostate cancer following an initial curative attempt. The primary outcomes were overall detection rates, detection rates at low PSA thresholds, difference in detection rates and exclusive detection rates on a per-person analysis. Secondary outcome measures were total number of lesions, exclusive detection by each scan on a per-lesion basis and adverse side effects. Results: Overall detection rates were 79.8% for PSMA and 66.7% for choline. There was a statistically significant difference in detection rates favouring PSMA [OR (M–H, random, 95% confidence interval (CI)) 2.27 (1.06, 4.85), p = 0.04]. Direct comparison was limited to PSA < 2 ng/ml in two studies, with no statistically significant difference in detection rates between the scans [OR (M–H, random, 95% CI) 2.37 (0.61, 9.17) p = 0.21]. The difference in detection on the per-patient analysis was significantly higher in the PSMA scans (p < 0.00001). All three studies reported higher lymph node, bone metastasis and locoregional recurrence rates in PSMA. Conclusions: PSMA PET/CT has a better performance compared with choline PET/CT in detecting recurrent disease both on per-patient and per-lesion analysis and should be the imaging modality of choice while deciding on salvage and nonsystematic metastasis-directed therapy strategies.Peer reviewedFinal Published versio