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Here, we offer a synthesis of recent evidence and new developments in relation to three broad aspects of Black and minority ethnic (BAME) students’ participation in UK higher education (HE). First, we examine recent trends in ethnic group differences in rates of access to, success within, and positive destinations beyond HE. Secondly, we examine the nature of UK universities as exclusionary spaces which marginalise BAME students in a myriad of ways, not least through curricula that centre Whiteness. Finally, we consider the impact of the marginalisation of BAME students on mental health. We argue that progress towards race equality in each domain has been hampered by white-centric discourses which continue to identify BAME students and staff as ‘other’. We highlight the important roles that academic communities and HE policy-makers have to play in advancing ethnic equality in UK universities.
Telehealth has the potential to address health disparities, but not without deliberate choices about how to implement it. To support vulnerable patients, health policy leaders must pursue creative solutions such as public-private partnerships, broadband infrastructure, and value-based payment. Without these initiatives or others like them, health disparities are likely to persist despite telehealth’s tantalizing potential.
Women from ethnic minorities who experience mental health problems during the perinatal period are disproportionately represented in involuntary care. They have poorer access to community care but have higher engagement with services once accessed. Their pathways to accessing perinatal mental health care remain underexplored.
To investigate the pathways to perinatal mental health services for women across different ethnic groups, including number of caregivers encountered and time elapsed between referrals.
Analysis of patient records and routine service data from community and inpatient perinatal mental health services in the United Kingdom. Use of an adaptation of the WHO’s pathway encounter form.
Women from ethnic minority groups experience increased levels of complexity on their journey to accessing perinatal mental health care. We will present a detailed analysis of patient and service characteristics.
Referral pathways to perinatal mental health services need to be optimised for women from underrepresented groups.
This article argues that the now-widespread US practice of residency-based tuition differentials for public higher education institutions is a twentieth-century form of higher education exceptionalism carved out in law and state policy, contradicting otherwise cherished and protected rights of free movement. This contradiction has been enabled in part by the vague standard of constitutional protection for the right to interstate mobility and in part by fiscal deference to public universities that quickly recognized the potential benefits of higher nonresident tuition rates. By both defining higher education as outside of the “necessities of life” and upholding a narrative that the children of state residents had a special entitlement to lower tuition as a kind of “legacy” taxpayer inheritance, courts, legislatures, and educational institutions built a modern higher education finance structure that discriminates against the mobility of “newcomers” and any student with a complicated family structure or residency status.
Chapter 5 considers issues related to colonialism, language, and law. Colonial policies have had a sustained impact in the language arena. Language policies also play a critical role in law. Language choices initially made during colonialism continue to shape questions of access, justice, and fairness in legal and other contexts in African countries.
The feminisation of ageing observed across the world is a significant challenge in many societies. Women's greater longevity is associated with the increased likelihood of age-related disability and morbidity. Furthermore, gendered disadvantage and poverty can make access to health care increasingly problematic in later years. Among the Indian states, Kerala has the highest number of residents above the age of 60 and many are older widows. Given this context, this paper explores what promotes access to health care for older widows living alone in the south Indian state of Kerala. Thirty-two in-depth interviews, eight focus group discussions and eight units of participant observation were carried out among widows, health-care providers and key informants. Applying a reflexive inductive approach to our analysis, the main barriers to access that emerged were altered family structures and loneliness, whilst enablers included good social networks and access to neighbourhood clinics. Our participants’ social networks were drawn from three levels: family, neighbourhood and the wider community. The ability to form a personal community from their social networks and the quality of relationships within this community strongly predicted the capacity to access health care. Efforts to improve access to health care for older widows requires a response that is rooted in the socio-cultural context of the community. Comprehensive social protection policies that promote initiatives to engender social capital among the older population, decentralised primary health-care services, and the training and sensitisation of health service staff would be key to promote equitable access for older widows.
This study sought to identify coronavirus disease 2019 (COVID-19) risk communication materials distributed in Jamaica to mitigate the effects of the disease outbreak. It also sought to explore the effects of health risk communication on vulnerable groups in the context of the pandemic.
A qualitative study was conducted, including a content analysis of health risk communications and in-depth interviews with 35 purposively selected elderly, physically disabled, persons with mental health disorders, representatives of government agencies, advocacy and service groups, and caregivers of the vulnerable. Axial coding was applied to data from the interviews, and all data were analyzed using the constant comparison technique.
Twelve of the 141 COVID-19 risk communication messages directly targeted the vulnerable. All participants were aware of the relevant risk communication and largely complied. Barriers to messaging awareness and compliance included inappropriate message medium for the deaf and blind, rural location, lack of Internet service or digital devices, limited technology skills, and limited connection to agencies that serve the vulnerable.
The vulnerable are at increased risk in times of crisis. Accessibility of targeted information was inadequate for universal access to health information and support for vulnerable persons regardless of location and vulnerability.
This paper concerns mental health services in The Gambia. It describes local concepts, experiences and knowledge about mental illness and the implications of such beliefs and attitudes for access to mental health services. A pretested questionnaire and interview guide were administered to a sample of patients/family members. Barriers to accessing mental health services were identified. These included beliefs about the causes of mental illness; family decision-making; the scarcity and high cost of services. Obtaining access to mental health services in The Gambia is currently challenging. Importantly, increased community and family education about the causes and treatment of mental illnesses will be required to address these issues.
Access and allocation firmly ground the concept of human security in the larger context of social justice, posing serious challenges for equitable earth system governance. The focus on capabilities brings together a range of ideas addressed inadequately in traditional approaches to the economics of welfare. The capabilities approach highlights the importance of real freedoms in the assessment of persons’ relative level of advantage, promoting a more realistic balance of materialistic and non-materialistic factors in evaluating human welfare and a concern for the distribution of substantive opportunities within society. Research on access to and allocation of environmental resources in a deliberative system of democratic governance builds on and extends an existing limited research literature on the implications of deliberative democratic practices for environmental justice policy and governance. More equitable access to and allocation of environmental “goods” should be a focus for a next generation of environmental research characterized by improved normative understanding as well as more meaningful and reflexive potential for sustainability transformation.
We began with the observation that technology law, as defined by this text, is now an important field in its own right. This importance will continue to grow as the progress of technology and its application in society continues to create gaps in the legal framework that require regulation. No-one can predict exactly what new technologies are coming, what their implications will be, or what laws will be needed, but by studying theoretical approaches to ethics and regulation and the legal problems that have arisen to date, and how these have been responded to, we are better prepared to deal with future challenges. The COVID-19 pandemic of 2020 provides a stark reminder that unanticipated events can change the societal landscape in a matter of weeks and provide compelling reasons for technologies to be quickly applied in new ways. This concluding chapter will consider the future directions of technology law by reflecting on technology and society, noting the areas of law and regulation that have been covered, and reflecting on themes that have arisen.
Enhancing research and development and ensuring equitable pricing and access to cutting-edge treatments are both vital to a biopharmaceutical innovation system that works in the public interest. However, despite delivering numerous therapeutic advances, the existing system suffers from major problems: a lack of directionality to meet key needs, inefficient collaboration, high prices that fail to reflect the public contribution, and an overly-financialized business model.
This article assumes a balanced position between two contrasting views regarding the accessibility, quality, efficiency and financial sustainability of the Cuban healthcare system. It evaluates those issues in the 2006–20 period by identifying strengths and weaknesses based on a comprehensive statistical compilation of health indicators, physical infrastructure trends, availability of physicians and other elements to assess the system's long-term financial sustainability. Finally, it examines the likely consequences of population ageing on healthcare, including potential policies.
How institutional manuscript collections and archives emerged, and how some of the idiosyncratic systems in place within these establishments were created, helping to anchor the new manuscript scholar.
Strauss’s written correspondence consists of many thousands of documents. The publicly-known portion is extensive indeed, even without approximating the total inventory: edited today are some 8,000 letters, postcards, and telegrams to and from the composer, the bulk of which have not been translated. Hitherto untapped, however, is more than that amount of material in various archives and libraries. Particularly noteworthy here is the family-owned Richard-Strauss-Archiv in Garmisch, which houses the largest share of Straussiana worldwide, including the largest collection of letters to the composer. An official, even if not fully complete catalog of Strauss’s correspondence, both published and unpublished, is still an urgent research desideratum. This chapter contextualizes the extant materials by focusing on issues such as access, chronology, editorial standards, and dissemination, while calling for all materials to be made accessible via modern edition principles.
Access to timely care is a quality standard underpinning many international healthcare models, and long waiting times for child and adolescent mental health services are often reported as a barrier to help-seeking.
The aim of this study was to examine whether young people with more severe problems have shorter waiting times for mental health services.
Multilevel multinomial regression analysis controlling for service-area deprivation, age, gender, ethnicity, referral source and contextual factors was conducted on N = 21 419 episodes of care (mean age 12.37 years (s.d. = 3.71), 11 712 (55%) female) using data from child and adolescent mental health services.
There was high variation in waiting times, which ranged from 0 days to 1629 days (mean 50.65 days (s.d. = 78.03), median 32 days). Compared with young people with less severe problems young people with severe problems, self-harm, psychosis or eating disorders were less likely to experience longer waiting times. Moreover, referrals from sources other than primary care were generally less likely to have longer waiting times than referrals from primary care sources, especially referral from accident and emergency services.
The findings suggest that young people with more severe problems had shorter waiting times. Intermediary information and resources for support before access to services is needed to prevent escalation of problems and to support individuals and families while waiting for care. Interventions to reduce waiting times should be considered without compromising on the quality and experience of care that young people and families deserve when seeking help.
This article began as a blog post with the title ‘Grammar-Translation: Not Really A Method…’ (Piantaggini, 2020). Of course, that choice of title was intended to hook the reader rather than actually make such a claim. Without a doubt, Grammar-translation (GT) is a language teaching method recognised for its historical significance (Musumeci, 1997), its role amongst other emerging language teaching methods (Shrum & Glisan, 2005), as well as its shortcomings (Richards & Rodgers, 2014). This article investigates the method, and its effect on teachers and students.
Tyler Burge first introduced his distinction between epistemic entitlement and epistemic justification in ‘Content Preservation’ in 1993. He has since deployed the distinction in over twenty papers, changing his formulation around 2011. His distinction and its basis, however, is not well understood in the literature. This chapter distinguishes two uses of ‘entitlement’ in Burge and then focuses on the contrast between justification and entitlement, two forms of warrant, where warrants consists in the exercise of a reliable belief-forming competence. Since he draws the distinction in terms of reasons, this chapter brings his account of reasons altogether in one place. The chapter introduces a decision-procedure for classifying warrants as justifications or entitlements. The distinction is not the same as the inferential vs. non-inferential distinction. Inference is distinguished from processing, thinking, reasoning, and critically reasoning. Burge’s new formulation of the distinction was driven by the recognition of non-accessible modular reasons. Three kinds of access are distinguished.
People with dementia can face barriers when trying to access care after a diagnosis, particularly in young-onset dementia (YOD). Little is known about the effects of ethnicity on the use of anti-dementia medication and variations between age groups. The aim of this study was to analyze national data on variations in the uptake of anti-dementia medication between people with YOD and late-onset dementia (LOD).
Cross-sectional longitudinal cohort study.
Data from the U.S. National Alzheimer’s Coordinating Centre were obtained from September 2005 to March 2019.
First visits of people with a diagnosis of Alzheimer’s disease (AD) dementia, Lewy body dementia (LBD), and Parkinson’s disease dementia (PDD) were included.
Logistic regression was used to analyze the effects of education and ethnicity on use of cholinesterase inhibitors and memantine, accounting for YOD/LOD, gender, living situation, severity stage, and comorbidities.
In total, 15,742 people with AD dementia and LBD/PDD were included, with 11,019 PwD having completed a first follow-up visit. Significantly more people with YOD used memantine than those with LOD, while fewer used cholinesterase inhibitors. PwD from minority ethnic backgrounds used memantine and cholinesterase inhibitors less often than those from a White ethnic background. Logistic regression analysis showed that ethnicity was a significant determinant of both memantine and cholinesterase inhibitors usage, while education was only a significant determinant for memantine usage.
Findings highlight the impact of social factors on current usage of anti-dementia medication and the need for more resources to enable equitable use of anti-dementia medication.
This article reports on an evaluation of the Keeping Children Safe parent education programme run in Central West New South Wales. The programme, conducted since 2004, and continuing today, primarily targets parents of children at risk and other vulnerable and disadvantaged families. The evaluation covers a 13-year period, from the first group held in May 2004 to February 2017. From the beginning, the authors strategically endeavoured to recruit and retain parents from the target group. Findings from the literature indicate that this group is difficult to engage and retain in parent education groups. Parents targeted for the groups in this study were generally not receiving parent education elsewhere. Using mixed methods, the facilitators have continuously evaluated the programme in terms of attendance rates, process and impact. The results of these evaluations show successful recruitment and retention of participants from the target group over the 13 years of the evaluation reporting period and indicate that the programme’s immediate impact on participants has been favourable. The findings complement other programme evaluations focusing on recruitment and retention to programmes in the child protection context and on hard-to-reach clients. The authors also argue the importance of education for parents about child abuse and neglect.