Activating lone parents: an evidence-based policy appraisal of welfare-to-work reform in Britain

The 2008 welfare reform introduced by the previous Labour government requires (most) lone parents with older children to be available for work. This article examines the potential effect of this reform on the employment rate of lone parents and whether the age of the youngest child is a good indicator of ‘ability to work’. The reform will not lead to the desired increase as the target group is too small and the levels of multiple disadvantages within the group too high. ‘Ability to work’ needs to be conceptualised more broadly if it is to mean ‘ability to get a job’

Reimbursement for Emergency Department Electrocardiography and Radiograph Interpretations: What Is It Worth for the Emergency Physician

Background: Physician reimbursement laws for diagnostic interpretive services require that only those services provided contemporaneously and /or contribute directly to patient care can be billed for. Despite these regulations, cardiologists and radiologists in many hospitals continue to bill for ECG and plain film diagnostic services performed in the emergency department (ED). The reimbursement value of this care, which is disconnected in time and place from the ED patient encounter, is unknown. In a California community ED with a 32,000 annual census, the emergency physicians (EPs) alone, by contract, bill for all ECG readings and plain film interpretations when the radiologists are not available to provide contemporaneous readings.Objectives: To determine the impact of this billing practice on actual EP reimbursement we undertook an analysis that allows calculation of physician reimbursement from billing data.Methods: An IRB-approved analysis of 12 months of billing data cleansed of all patient identifiers was undertaken for 2003. From the data we created a descriptive study with itemized breakdown of reimbursement for radiograph and ECG interpretive services (procedures) and the gross resultant physician income.Results: In 2003 EPs at this hospital treated patients during 32,690 ED visits. Total group income in 2003 for radiographs was $173,555 and$91,025 for ECGs, or $19/EP hour and$6/EP hour respectively. For the average full-time EP, the combined total is $2537/month or$30,444 per annum, per EP. This is $8/ED visit (averaged across all patients).Conclusion: As EP-reimbursement is challenged by rising malpractice premiums, uninsured patients, HMO contracts, unfunded government mandates and state budgetary shortfalls, EPs are seeking to preserve their patient services and resultant income. They should also be reimbursed for those services and the liability that they incur. The reimbursement value of ECGs and plain film interpretations to the practicing EP is substantial. In the ED studied, it represents$30,444 gross income per full-time EP annually. Plain film interpretation services produce three times the hourly revenue of ECG reading at the hospital studied.[WestJEM. 2009;10:178-183.

Adaptation of Prosodic Phrasing Models

There is considerable variation in the prosodic phrasing of speech between different speakers and speech styles. Due to the time and cost of obtaining large quantities of data to train a model for every variation, it is desirable to develop models that can be adapted to new conditions with a limited amount of training data. We describe a technique for adapting HMMbased phrase boundary prediction models which alters a statistical distribution of prosodic phrase lengths. The adapted models show improved prediction performance across different speakers and types of spoken material. 1

Craft Imaginaries – Past, Present and Future

This paper contributes to debates about craft authenticity by turning attention to the craft imaginary. We suggest that the significance of craft stems from its role in constructing an alternative social imaginary that challenges dominant, modernist imaginaries of industrial production and consumption. Our focus is on the role of imaginaries in determining how societies, communities, organizations and individuals embody temporal relations to the past that extend into the present and future. We show how the craft imaginary comprises histories, traditions, places and bodies and use this to develop a distinction between the imaginary of craft-in-the-past and future-oriented craft imaginaries. Through this, we seek to highlight the organizational possibilities of craft as a source of innovation, inclusivity and disruption

Improving the general health of people with learning difficulties in the UK: experiences of the implementation of Annual Health Checks

This paper offers a brief overview of the background to implementing a policy of offering Annual Health Checks (AHCs) to all people with a learning disability/difficulty in the UK. It outlines what has been developed through national policy and then offers an insight into the experiences of four people with learning difficulties in relation to understanding and accessing AHCs. All four people are members of The Lawnmowers Independent Theatre Company (ITC) a company that aims to lay solid foundations for people with learning disabilities to participate fully in their own society, shaping their own environment and controlling their own futures

Factors Influencing Sleep Difficulty and Sleep Quantity in the Citizen Pscientist Psoriatic Cohort.

IntroductionSleep is essential for overall health and well-being, yet more than one-third of adults report inadequate sleep. The prevalence is higher among people with psoriasis, with up to 85.4% of the psoriatic population reporting sleep disruption. Poor sleep among psoriasis patients is particularly concerning because psoriasis is independently associated with many of the same comorbidities as sleep dysfunction, including cardiovascular disease, obesity, and depression. Given the high prevalence and serious consequences of disordered sleep in psoriasis, it is vital to understand the nature of sleep disturbance in this population. This study was designed to help meet this need by using survey data from Citizen Pscientist, an online patient portal developed by the National Psoriasis Foundation.MethodsOur analysis included 3118 participants who identified as having a diagnosis by a physician of psoriasis alone or psoriasis with psoriatic arthritis. Demographic information, psoriasis severity and duration, sleep apnea status, smoking and alcohol consumption, itch timing, and sleep characteristics were included. Two separate multivariate logistic regression models in STATA were used to determine whether the presence of psoriatic arthritis, age, gender, body mass index, comorbid sleep apnea, psoriasis severity, timing of worst itch, smoking status, or high-risk alcohol consumption were associated with sleep difficulty or low sleep quantity, defined by the American Academy of Sleep Medicine as less than 7 h of sleep per night on average.ResultsResults from the multivariate logistic regressions found that sleep difficulty was associated with psoriatic arthritis (OR 2.15, 95% CI [1.79-2.58]), female gender (2.03 [1.67-2.46]), obese body mass index (BMI ≥ 30) (1.25 [1.00-1.56]), sleep apnea (1.41 [1.07-1.86]), psoriasis severity of moderate (1.59 [1.30-1.94]) or severe (2.40 [1.87-3.08]), and smoking (1.60 [1.26-2.02]). Low sleep quantity was associated with obese BMI (1.62 [1.29-2.03]), sleep apnea (1.30 [1.01-1.68]), psoriasis severity of moderate (1.41 [1.16-1.72]) or severe (1.40 [1.11-1.76]), and smoking (1.62 [1.31-2.00]). Sleep difficulty and low sleep quantity were not associated with age, alcohol consumption, or timing of worst itch.ConclusionThese results are potentially meaningful in several aspects. We identify an important distinction between sleep difficulty and sleep quantity in psoriatic disease, whereby having psoriatic arthritis and being female are each associated with sleep difficulty despite no association with low sleep quantity. Furthermore, there is conflicting evidence from prior studies as to whether psoriasis severity is associated with sleep difficulty, but this well-powered, large study revealed a strong, graded relationship between psoriasis severity and both sleep difficulty and low sleep quantity. Overall, our results show that both sleep difficulty and low sleep quantity were associated with multiple factors in this analysis of a large psoriatic cohort. These findings suggest that dermatologists may gather clinically useful information by screening psoriatic patients for trouble sleeping and low sleep quantity to identify potential comorbidities and to more effectively guide disease management

Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels.

BACKGROUND: Rhesus (Rh) disease and extreme hyperbilirubinemia (EHB) result in neonatal mortality and long-term neurodevelopmental impairment, yet there are no estimates of their burden. METHODS: Systematic reviews and meta-analyses were undertaken of national prevalence, mortality, and kernicterus due to Rh disease and EHB. We applied a compartmental model to estimate neonatal survivors and impairment cases for 2010. RESULTS: Twenty-four million (18% of 134 million live births ≥ 32 wk gestational age from 184 countries; uncertainty range: 23-26 million) were at risk for neonatal hyperbilirubinemia-related adverse outcomes. Of these, 480,700 (0.36%) had either Rh disease (373,300; uncertainty range: 271,800-477,500) or developed EHB from other causes (107,400; uncertainty range: 57,000-131,000), with a 24% risk for death (114,100; uncertainty range: 59,700-172,000), 13% for kernicterus (75,400), and 11% for stillbirths. Three-quarters of mortality occurred in sub-Saharan Africa and South Asia. Kernicterus with Rh disease ranged from 38, 28, 28, and 25/100,000 live births for Eastern Europe/Central Asian, sub-Saharan African, South Asian, and Latin American regions, respectively. More than 83% of survivors with kernicterus had one or more impairments. CONCLUSION: Failure to prevent Rh sensitization and manage neonatal hyperbilirubinemia results in 114,100 avoidable neonatal deaths and many children grow up with disabilities. Proven solutions remain underused, especially in low-income countries

Extending the boundaries of non-Indigenous science to embrace the cultural curriculum by creating a living compendium of practice

BACKGROUND Embedding cultural competence (CC) into science curricula is key to the University of Sydney’s commitment to producing students with skills and knowledge to work in cross-cultural settings. Within the Faculty of Science, there are eight disciplinary schools who have, to some extent, endeavoured to introduce CC into their delivery and content to ensure students achieve this graduate outcome. Cultural competence inclusion was initiated by the Wingara Mura-Bunga Barrabugu program, with a focus on integration of Indigenous knowledge systems (IKS) into non-Indigenous science. PLAN In 2018, we initiated a CC compendium to act as a bridging space between academics, to share content and explore collaborations laterally across the faculty. ACTIONS This paper documents the process of interviewing academic staff and collating the compendium by gathering teaching materials and CC teaching approaches, highlighting the points of highest resonance within each discipline. Academics are using creative and innovative ways to extend their disciplinary boundaries, are embracing personal and professional growth by taking on this challenge and are carving out new pathways in science. REFLECTION These boundary-pushing efforts are however, marginal, and are largely being introduced by non-Indigenous academics, which raises questions about IKS inclusion as a pathway for generating CC. ACKNOWLEDGEMENTS We thank the Wingara Mura-Bunga Barrabugu, Deputy Vice-Chancellor Indigenous Strategy and Services for funds for this project

Desiring Bollywood: Re-staging racism, exploring difference

In this article I engage with the insights that emerged through the making of Desiring Bollywood, a collaborative ethno-fiction project I produced in 2018. The project recruited academics, amateur actors, novice filmmakers, and enthusiastic university students to narrate the story of Jason, an aspiring actor and filmmaker from Nigeria who I first met in 2013 soon after his release from Tihar Prison in Delhi, India. My goals are two-fold: first, to share a few scenes from the film – embedded in this article as video clips – to broadly theorize the affordances and limits of what I call re-staging, the collaborative, performance-based multimodal method we devised and deployed to produce Desiring Bollywood. Second, and more central to the article, I aim to analyze these very same scenes to show how re-staging, as it offered participants involved in the project the opportunity to reflexively explore how Jason’s experiences of discrimination in Delhi and the aspirations and desires that led him there in the first place, create a rich site of analysis to engage with the nuances of anti-Black racism in India in a moment where ‘India-Africa’ economic relationships are on the rise. RESUMEN En este artículo examino el entendimiento que surgió a través de la producción de Desiring Bollywood, un proyecto colaborativo de etno-ficción que realicé en 2018. El proyecto reclutó académicos, actores amateurs, productores cinematográficos novicios y entusiastas estudiantes universitarios para narrar la historia de Jason, un aspirante a actor y productor cinematográfico, de Nigeria a quien conocí en 2013, poco después de su puesta en libertad de la Prisión Tihar en Delhi, India. Mi propósito es doble: primero, compartir algunas escenas del filme – embebidas en este artículo como video clips– para teorizar ampliamente las affordances y límites de lo que llamo remontaje, el colaborativo método multimodal basado en performance, que nosotros ideamos y utilizamos para producir Desiring Bollywood. Segundo, y más central al artículo, tengo como objetivo analizar estas mismas escenas para mostrar cómo el remontaje, en la medida que ofreció a los participantes involucrados en el proyecto la oportunidad de explorar reflexivamente cómo las experiencias de Jason de discriminación en Delhi y las aspiraciones y deseos que lo llevaron allí en primer lugar, crea un sitio profundo de análisis para abordar los matices del racismo anti-negro en India en un momento donde las relaciones económicas “India-África” están en aumento