The impact of legal aid cuts on access to justice in the UK

Lawyers would argue that this is an epochal moment for access to justice in the UK. Time will judge in due course; for now it worth simply setting a marker down to capture what has passed. The date to note is 1 April 2013: this was when the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (LASPO), an Act of Parliament of the United Kingdom, came into affect. LASPO changed the landscape of civil legal aid in England and Wales not only in how and by whom legal aid was administered; LASPO profoundly altered what remained within scope for legal aid, taking private family law disputes such as divorce and child custody, immigration, housing, debt and social welfare and employment out of the provision of legal aid save for those cases where ‘domestic violence is involved, life or liberty are at stake or people risk losing their home’ (BBC 2013). The cuts were introduced with the aim to shave off £350 million from the £2 billion civil and criminal legal aid budget, primarily in civil legal aid with proposals for eventual cuts in criminal legal aid. For a nation in financially difficult times following the banking crisis of 2008 and subsequent recession, the retrenchment of the public services was bitter surgery the nation would have to endure. Why would the provision of legal aid be immune from excision

The adolescent asthma action program: ‘Triple A Program’

Asthma is a major public health problem in Australia. With up to 1 in 4 children and adolescents having symptoms of asthma, there is a high toll not only on the individual with asthma and their care-givers but also on the health care delivery system. Adolescents with asthma are particularly vulnerable to serious asthma attacks and sudden death. For many adolescents, this is a particularly risky period, as compliance with therapy may decrease and medical supervision becomes less consistent. As behaviours and life style are primary contributers to morbidity and mortality in adolescents, education appears to be a potential way to have an impact on behaviour change. The challenge is to develop a program which will not only have a considerable impact, but is acceptable and relevant to the school community. This treatise examines the relevant literature and psychosocial theories and models applicable to asthma health promotion and management in adolescents. It provides a health promotion model for addressing barriers to optimum asthma management and an Intervention Model to increase knowledge and improve behaviour in high school students. The aims of this treatise are: to establish the impact of asthma on high school students; to justify asthma health promotion in high schools; to identify behavioural and psychosocial factors relevant to adolescents asthma management; to describe an asthma health promotion intervention in a girls high school, based on the conceptual model. The Adolescent Asthma Action Program is an innovative asthma health promotion intervention program for high schools. The aim of the program is to promote optimum management of asthma through peer-led education and creative student presentations. Students are active in both learning and teaching and are the catalysts for behaviour change and supportive school environment. The Program is undertaken in a socially disadvantaged area, where a significant proportion of high school students come from non-English speaking backgrounds (NESS). A common health issue in the school is addressed through positive peer modelling and social reinforcement. The models can also be applied to other health issues and have potential for a wide range of applications in schools

Inspection and instrumentation of bridges

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Civil and Environmental Engineering, 1996.Includes bibliographical references (leaves 95-102).by Smita Niranjan Shah.M.S

Helicobacter pylori eradication: A randomised comparative trial of 7-day versus 14-day triple therapy

Background. Helicobacter pylori is associated with several upper gastrointestinal conditions including chronic gastritis, peptic ulcer disease, and gastric malignancy. Proton pump inhibitor-based triple therapies are considered the standard regimens for H. pylori eradication, but the optimal duration of therapy is controversial. To prevent infection and complications, local studies should be undertaken to evaluate H. pylori eradication rates in a country.Objectives. We compared 7-day and 14-day regimens to determine the optimum duration of triple therapy for H. pylori eradication.Methods. We undertook a prospective randomised comparative trial of 7-day and 14-day triple therapy regimen for H. pylori eradication at the Aga Khan University Hospital, Nairobi; 120 patients with dyspepsia and H. pylori infection were randomised to receive esomeprazole, amoxicillin and clarithromycin for either 7 days (EAC 7) or 14 days (EAC 14). Compliance and side-effects were assessed 2 weeks after the start of therapy and H. pylori eradication was assessed by stool antigen tests 4 weeks after treatment.Results. Both the intention-to-treat (ITT; N=120) and per protocol (PP; N=97) analyses showed no significant differences between the eradication rates of EAC 7 (ITT 76.7%; PP 92%) and EAC 14 (ITT 73.3%; PP 93.6%) (ITT p=0.67; PP p=0.76). Poor compliance was reported in one patient in the EAC 14 group. The incidence of adverse events was comparable in the two groups.Conclusion. One-week and 2-week triple treatments for H. pylori eradication are similar in terms of efficacy, safety and patient compliance.S Afr Med J 2012;102(6):368-371

Extraskeletal myxoid chondrosarcoma of thigh: a rare case report

Extraskeletal myxoid chondrosarcoma (EMC) are a rare entity of soft tissue tumors that occur predominantly in soft tissue of lower extremities. Here we present a case of 45-year-old female presented with left thigh swelling. MRI finding suggested primary neoplastic lesion. Fine needle aspiration cytology (FNAC) suggested myxoid soft tissue neoplasm/sarcoma. Morphological examination revealed typical extraskeletal myxoid chondrosarcoma with strong immunoreactivity for vimentin and focal immunoreactivity for epithelial membrane antigen (EMA)

Prevalence of gastric mucosal interleukin-1 polymorphisms in Kenyan patients with advanced gastric cancer

Helicobacter pylori is the main cause of peptic ulceration, distal gastric adenocarcinoma, and gastric lymphoma.1 Worldwide, gastric cancer is the second most common malignancy in men and women.1 According to data from the Nairobi Cancer Registry, gastric cancer is the fourth most common malignancy in adult males and the fifth most common in adult females. However, this may not represent the true situation because of under-reporting of cases. In the development of gastric cancer, environmental factors such as smoking, diet and, in particular, infection with H. pylori are significant.1 Based on epidemiological studies, the International Agency for Research on Cancer (IARC) identified H. pylori as a ‘group 1 agent (definite carcinogen)’.2 H. pylori infection can result in decreased acid secretion with subsequent mucosal atrophy and intestinal metaplasia.1 Another precondition for mucosal atrophy is autoimmunity against parietal cells, which can mimic classic autoimmune gastritis with the presence of various autoantibodies in up to 40% of H. pylori-infected individuals.1 The occurrence of intestinal metaplasia, for which a relationship with gastric cancer is strongly suggested, has been demonstrated in approximately 60% of patients with H. pylori infection.1 The metaplasia may then progress to gastric cancer, especially to tumours of the intestinal type.1 Findings by Uemura et al. support the importance of these histological findings as a precancerous condition in H. pyloriassociated gastritis.3 However, only a minority of H. pyloriinfected patients develop gastric cancer, which underscores the notion that the host genetic background could be of critical importance. Data strongly suggest that the susceptibility to infection from H. pylori is mainly conferred by genes involved in inflammatory processes following colonisation with H. pylori.1 Chronic gastritis is characterised by the release of pro-inflammatory cytokines such as interleukin-1β (IL-1β) or tumour-necrosis factor alpha (TNFα), which are potent inhibitors of gastric acid secretion.1 Advanced-stage gastric cancer has been repeatedly associated with polymorphisms of the IL-1 gene cluster on chromosome 2q, which contains 3 related genes within a 430 kb region (IL-1A, IL-1B, and IL-1RN), encoding for IL-1α , IL-1β, and the endogenous receptor antagonist IL-1ra, respectively. It was hypothesised that genetic differences within these genes could influence the immune response against pathogens such as H. pylori and the development of premalignant histological alterations in the gastric mucosa.1 In patients with advanced-stage gastric cancer, an increased frequency of the IL-1B-31C and IL-1B-511T alleles and the uncommon IL-1B-31C/IL-1B-511T haplotype was demonstrated. In addition, the IL-1RN*2 allele and the homozygous genotype IL-1RN*2/2 were found in increased prevalence in gastric cancers.1 Subsequent studies confirmed these genetic associations.1 El-Omar et al. genotyped patients with gastric cancer according to tumour localisation (cardia v. non-cardia) and oesophageal cancers (adenocarcinomas v. squamous cell carcinomas) for various polymorphisms of genes encoding for pro- and anti-inflammatory cytokines.4 They described an increased risk for non-cardia gastric cancer in carriers of the IL-1B-511T allele, IL-1RN*2 homozygotes, carriers of the TNF-A-308A allele and the haplotype IL-10- 1082A/-819T/-592A. The cumulative risk depends on the number of high-risk alleles or genotypes per patient.4 A previous study confirmed the risk increase for development of gastric carcinoma in carriers of multiple proinflammatory genotypes.1 The alleles IL-1RN*2 and IL-1B-511T are associated with increased synthesis of the proinflammatory cytokine IL-1ß, and the allele TNFA-308A results in an increased production of the proinflammatory cytokine TNF.

A survey on Data Extraction and Data Duplication Detection

Text mining, also known as Intelligent Text Analysis is an important research area. It is very difficult to focus on the most appropriate information due to the high dimensionality of data. Feature Extraction is one of the important techniques in data reduction to discover the most important features. Processing massive amount of data stored in a unstructured form is a challenging task. Several pre-processing methods and algorithms are needed to extract useful features from huge amount of data. Dealing with collection of text documents, it is also very important to filter out duplicate data. Once duplicates are deleted, it is recommended to replace the removed duplicates. This Paper review the literature on duplicate detection and data fusion (remov e and replace duplicates).The survey provides existing text mining techniques to extract relevant features, detect duplicates and to replace the duplicate data to get fine grained knowledge to the user

'Y Health - Staying Deadly' : an Aboriginal youth focussed translational action research project

Aboriginal & Torres Strait Islander youth are at-risk health consumers, being over-represented in social and health disadvantage and under-represented as seekers of health care. Young people have very different developmental and health needs and causes of illness compared to children or adults. Adolescence is also a period of risk taking and experimentation which has potential for serious adverse health outcomes. In addition, young people are future parents; health promotion activities in this group have the potential for impacting on the next generation. Through the Medicare Benefits Schedule (MBS), Aboriginal & Torres Strait Islander Health Checks have been in place to ensure that primary health care is matched to needs, by identifying and addressing problems at an early stage. The current MBS Item 715 (Health Check) covers children (0 - 14 yrs), adults (15 - 54 yrs) and older persons (>55 yrs). All of these categories are unsatisfactory in their ability to address youth health needs. Furthermore, though there is some research available regarding youth assessment, there is no comprehensive health screening tool available for Aboriginal youth. Using a Community Based Participatory and Translational Action Research approach, this project has developed and implemented an evidence informed, culturally valid, strengths based and user friendly Youth Health Check and accompanying Youth Health Audit tool.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy