Third sector organizations and earthquake recovery planning in Christchurch, New Zealand

On September 4, 2010, an earthquake struck rural Canterbury and the most deadly of over 2,000 aftershocks devastated the Christchurch Central Business District on February 22, 2011 (Ardagh et al. 2012). Questions have arisen regarding population dynamics (Love 2011), marginalized groups, health and social care, and overall recovery efforts. Addressing some of these concerns are various non-profit, non-governmental, and faith based groups, collectively referred to as Third Sector Organizations (TSOs). By providing an alternative to and back-stopping government and private health and social services, TSOs are able to build resiliency following a natural disaster, and are especially able to identify and address unmet needs within their target audiences and maintain a sense of community within their operating areas. The nature of community recovery, also changes the role of TSOs in formal and grassroots efforts over time. In New Zealand, TSOs have shared community health burdens with government and private practices since the 1990s (Larner and Craig 2005) and have championed healthcare policy measures for ethnic minorities (Came 2014). Nevertheless, the earthquakes have presented challenges to TSOs. An inventory of 92 TSOs four months after the earthquakes, 106 one year after, and 454 two years after by Carlton and Vallance (2013) shows that although many TSOs have emerged to address earthquake related issues, other TSOs may have been unable to re-establish themselves outside areas with earthquake damage found to be too severe to inhabit by the Canterbury Earthquake Recovery Authority (CERA). Others reported “burn-out” and 52 were inactive or closed because of shifting needs during recovery. This research identifies shared experiences across the third sector in Canterbury to illuminate shifting roles in mid to long-term earthquake recovery

Helping patients discuss CINV management : development of a patient charter

In April 2012, an Expert Group of specialist cancer nurses working in a variety of settings (e.g. chemotherapy delivery, chemotherapy service design, research, nurse leadership and patient information/advocacy) participated in telephone/web-based meetings, with the aim of sharing current experience of chemotherapy-induced nausea and vomiting (CINV) management, and reaching a consensus on the development of a Patient Charter, designed to help patients understand CINV management, and setting out key questions they may wish to ask their healthcare professionals

The impact of LASPO on routes to justice

This research underlines the emotional, social, financial and mental health impacts for individuals who have attempted to resolve their legal problems without legal aid, following the implementation of the Legal Aid, Sentencing and Punishment of Offenders Act (LASPO) in 2013. LASPO introduced funding cuts to legal aid and narrowed the scope and financial eligibility criteria, with the result that fewer people could access legal advice and representation for problems in areas such as family, employment and welfare benefits law. We interviewed over 100 people in the Liverpool City Region, with problems in at least one of these areas of law, to understand how LASPO had affected their options for resolving those issues. We also interviewed a number of advice providers and legal aid practitioners, and analysed national data from Citizens Advice. Many participants reported significant financial deprivation as a result of trying but not being able to resolve their legal issues. Some were unable to afford food, adequate housing or other essentials. A lack of preventive legal help led to delays in resolution, which often made problems worse. There was also evidence that costs were passed to other parts of the public sector, including an increased reliance on welfare benefits as a result of unresolved employment issues. Family law • The high cost of legal fees is a key barrier to justice. Some participants who paid for legal advice or representation reported going into debt as a result. • People’s inability to pay for expert or specialist evidence without legal aid may have led to courts making decisions on the basis of insufficient information. • Cuts to legal aid have had a negative impact on children’s lives, especially in relation to child contact cases. Employment law • The main barriers to justice are the high cost of legal representation, the difficulty of navigating the tribunal process without support and a low level of knowledge about employment rights. • Many participants reported that the costs of bringing their claims to tribunal were disproportionate to the value of the claims. This deterred them from bringing claims and made it harder to find a solicitor willing to take their case. • Participants had fewer options for accessing third-sector specialist advice and representation. Those participants who went to tribunal had to represent themselves as a result, and in general they lacked the skills or experience to do this competently. Welfare benefits law • LASPO has significantly reduced the capacity of voluntary sector organisations to provide welfare law advice. There is almost no specialist advice left to provide support to appeal benefits decisions. • The removal of welfare benefits law from the scope of legal aid has exacerbated the impact of recent welfare reforms, which is likely to have affected disabled people disproportionately. Most participants tried multiple routes to resolve a single issue: attempting to resolve problems on their own, trying to access free advice and taking steps to get paid advice or representation before courts or tribunals. But without legal aid, almost all the participants struggled to solve their problems

Atomic data from the IRON Project. I. Electron-impact scattering of Fe17+ using <I>R</I>-matrix theory with intermediate coupling

We present results for electron-impact excitation of F-like Fe calculated using R-matrix theory where an intermediate-coupling frame transformation (ICFT) is used to obtain level-resolved collision strengths. Two such calculations are performed, the first expands the target using 2s2 2p5, 2s 2p6, 2s2 2p4 3l, 2s 2p5 3l, and 2p6 3l configurations while the second calculation includes the 2s2 2p4 4l, 2s 2p5 4l, and 2p6 4l configurations as well. The effect of the additional structure in the latter calculation on the n=3 resonances is explored and compared with previous calculations. We find strong resonant enhancement of the effective collision strengths to the 2s2 2p4 3s levels. A comparison with a Chandra X-ray observation of Capella shows that the n=4 R-matrix calculation leads to good agreement with observation</p

Remunerating private psychiatrists for participating in case conferences

BACKGROUND: On 1 November 2000, a series of new item numbers was added to the Medicare Benefits Schedule, which allowed for case conferences between physicians (including psychiatrists) and other multidisciplinary providers. On 1 November 2002, an additional set of numbers was added, designed especially for use by psychiatrists. This paper reports the findings of an evaluation of these item numbers. RESULTS: The uptake of the item numbers in the three years post their introduction was low to moderate at best. Eighty nine psychiatrists rendered 479 case conferences at a cost to the Health Insurance Commission of $70,584. Psychiatrists who have used the item numbers are generally positive about them, as are consumers. Psychiatrists who have not used them have generally not done so because of a lack of knowledge, rather than direct opposition. The use of the item numbers is increasing over time, perhaps as psychiatrists become more aware of their existence and of their utility in maximising quality of care. CONCLUSION: The case conferencing item numbers have potential, but as yet this potential is not being realised. Some small changes to the conditions associated with the use of the item numbers could assist their uptake

A novel role for syndecan-3 in angiogenesis.

Syndecan-3 is one of the four members of the syndecan family of heparan sulphate proteoglycans and has been shown to interact with numerous growth factors via its heparan sulphate chains. The extracellular core proteins of syndecan-1,-2 and -4 all possess adhesion regulatory motifs and we hypothesized that syndecan-3 may also possess such characteristics. Here we show that a bacterially expressed GST fusion protein consisting of the entire mature syndecan-3 ectodomain has anti-angiogenic properties and acts via modulating endothelial cell migration. This work identifies syndecan-3 as a possible therapeutic target for anti-angiogenic therapy.This work was funded by Arthritis Research-UK (Grant No. 19207) and funds from the William Harvey Research Foundation both to JRW

Causes of death among homeless people: a population-based cross-sectional study of linked hospitalisation and mortality data in England. [version 1; peer review: 2 approved]

Background: Homelessness has increased by 165% since 2010 in England, with evidence from many settings that those affected experience high levels of mortality. In this paper we examine the contribution of different causes of death to overall mortality in homeless people recently admitted to hospitals in England with specialist integrated homeless health and care (SIHHC) schemes.  Methods: We undertook an analysis of linked hospital admission records and mortality data for people attending any one of 17 SIHHC schemes between 1st November 2013 and 30th November 2016. Our primary outcome was death, which we analysed in subgroups of 10th version international classification of disease (ICD-10) specific deaths; and deaths from amenable causes. We compared our results to a sample of people living in areas of high social deprivation (IMD5 group). Results: We collected data on 3,882 individual homeless hospital admissions that were linked to 600 deaths. The median age of death was 51.6 years (interquartile range 42.7-60.2) for SIHHC and 71.5 for the IMD5 (60.67-79.0).  The top three underlying causes of death by ICD-10 chapter in the SIHHC group were external causes of death (21.7%; 130/600), cancer (19.0%; 114/600) and digestive disease (19.0%; 114/600).  The percentage of deaths due to an amenable cause after age and sex weighting was 30.2% in the homeless SIHHC group (181/600) compared to 23.0% in the IMD5 group (578/2,512). Conclusion: Nearly one in three homeless deaths were due to causes amenable to timely and effective health care. The high burden of amenable deaths highlights the extreme health harms of homelessness and the need for greater emphasis on prevention of homelessness and early healthcare interventions