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Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [ABSTRACT FROM AUTHOR]

Background: Research and clinical outcomes that matter to people with lived experience can significantly differ from those outcomes studied by researchers. To inform a future Cochrane review of suicide and self‐harm prevention interventions, we aimed to work with young people with relevant lived experience to agree on priority outcomes. Design: Four participatory codesign workshops were completed across two sites (New Zealand, United Kingdom) with 28 young people in total. We iteratively adapted the methods over the course of the study. Results: 'Improved coping' and 'safer/more accepting environment to disclose' were the final top‐rated outcomes. 'Reduction of self‐harm' was considered a low priority as it could be misleading, stigmatizing and was considered a secondary consequence of other improvements. In contrast to typical research outcomes, young people emphasized the diversity of experience, the dynamic nature of improvement and holistic and asset‐based framing. Methodologically, dialogue using design materials (personas) to thematically explore outcomes was effective in overcoming the initial challenge of disparate quantitative ratings. Discussion: The results will directly inform the development of a Cochrane review, enabling identification of whether and how outcomes of most importance to young people are measured in trials. Rather than producing discrete measurable outcomes that could be easily added to the systematic review, the young people challenged the academic conceptualization of outcomes, with implications for future evidence synthesis and intervention research, and for future codesign. Patient or Public Contribution: Young people with lived experience were codesigners of the outcomes, and their feedback informed iterative changes to the study methods. [ABSTRACT FROM AUTHOR]

Aim: To explore the health workforce responses to COVID‐19. Design: Analysis of job advertisements. Methods: We collected advertisements for healthcare jobs which were caused by and in response to COVID‐19 between 4 March–17 April 2020 for the United States, Canada, United Kingdom, Australia and New Zealand. We collected information on the date of the advertisement, position advertised and location. We categorized job positions into three categories: frontline, coordination and decision support. Results: We found 952 job advertisements, 72% of which were from the United States. There was a lag period between reported COVID‐19‐confirmed cases and job advertisements by several weeks. Nurses were the most advertised position in every country. Frontline workers were substantially more demanded than coordination or decision‐support roles. Job advertisements are a novel data source which leverages a readily available information about how workforces respond to a pandemic. The initial phases of the response emphasise the importance of frontline workers, especially nurses. [ABSTRACT FROM AUTHOR]

ABSTRACT Most organized religions have indicated a level of support for organ donation including the diagnosis of death by the brain criterion. Organ donation is seen as a gift of love and fits within a communitarian ethos that most religions embrace. The acceptance of the determination of death by the brain criterion, where it has been explained, is reconciled with religious views of soul and body by using a notion of integration. Because the soul may be seen as that which integrates the human body, in the absence of any other signs of human functioning, loss of integration is considered to be an indication that soul and body have separated. To some extent this view would seem to be informed by an Aristotelian notion of the soul, but it fits well enough with religious notions of the person continuing after death. There have been several developments internationally that indicate that the acceptance of so-called 'brain death' by organized religions has been challenged by new developments including the acceptance of a lesser standard than loss of all brain function and a rejection by the US President's Council on Bioethics of the notion of loss of integration as an explanation of death by the brain criterion. [ABSTRACT FROM AUTHOR]

Aim Species attributes, biogeographic features and human factors have all been shown to discriminate between invasive and non-invasive plant species. However, the relative importance of these factors, their generality in determining invasion outcomes across different regions and their ability to discriminate success and failure at different stages of the invasion process have not been established. Location New Zealand ( NZ) and Great Britain ( GB). Methods For species in the genus Pinus, we used boosted regression trees to identify factors associated with success or failure at the introduction and naturalization stages in each region. Results Human factors, notably the forestry use index, were the strongest determinants of which species from the global pool were introduced to both NZ and GB. Species with a close climate match were also more likely to be introduced to NZ but not to GB. Human factors and climate match were also the strongest determinants of which introduced species became naturalized in both NZ and GB, although the order of importance differed (human factors followed by climate match for NZ and vice versa for GB). Species attributes (life-history traits and the Z-score) had much less ability to discriminate successful and failed species at both the introduction and naturalization stages in these two regions. Main conclusions We show for the first time that human factors are more important than either species or biogeographic traits in determining the likelihood of a species being introduced or becoming naturalized. The similarity between two different regions in the factors found to be important in success at both these invasions stages points to potentially general mechanisms underlying these processes. The strong human component to introduction and naturalization highlights a potential conflict between future afforestation using alien species with conservation and management aims in the surrounding landscape, given that the factors desirable for forestry species are also those that may promote invasion. [ABSTRACT FROM AUTHOR]

The job description for legislators in western democracies includes constituency-focused activities such as casework and district visits. Unfortunately we have a limited theoretical and empirical understanding of the factors affecting legislators' constituency-oriented activities, in large part because most studies focus on single nations; even studies that are comparative do not span a variety of electoral systems. In this article we examine the constituency focus of MPs in six chambers that do provide such variance: the Australian House and Senate, Canadian House, Irish Dáil, New Zealand House, and the British House of Commons. We find that electoral considerations and incentives provided by different electoral systems, as well as other factors, affect the priority that MPs place on constituency service. [ABSTRACT FROM AUTHOR]

Theories of democratic government traditionally have relied on a model of organization in which officials act impartially, accept clear lines of accountability and supervision, and define their day-to-day activities through rules, procedures, and confined discretion. In the past 10 years, however, a serious challenge to this ideal has been mounted by critics and reformers who favor market, network, or "mixed-economy" models. We assess the extent to which these new models have influenced the work orientations of frontline staff using three alternative service types—corporate, market, and network—to that proposed by the traditional, procedural model of public bureaucracy. Using surveys of frontline officials in four countries where the revolution in ideas has been accompanied by a revolution in methods for organizing government services, we measure the degree to which the new models are operating as service-delivery norms. A new corporate-market hybrid (called "enterprise governance") and a new network type have become significant models for the organization of frontline work in public programs. [ABSTRACT FROM AUTHOR]

Revolutionary changes have occurred in the conduct of monetary policy in New Zealand and Great Britain over the last decade; Australian arrangements, too, have changed, albeit in an evolutionary fashion. In all three countries the description of the central bank's objectives is effectively in two parts: an Act of Parliament that sets out the constitutional and legal basis for the central bank and spells out general objectives; and an agreement or remit that gives more precise content to those objectives. In both Australia and Great Britain operational decisions on interest rates are taken by a nine-member committee, whereas in New Zealand the burden of decision making rests entirely on the Governor. Holding the central bank to account is not as straightforward as it looks. Given the fact that all three have numerical inflation targets, it would seem that all that is required is to look at inflation outturns and evaluate whether the targets have been achieved. Ex post accountability also needs to be complemented by ex ante accountability in which the central bank's view of the economic situation is compared with that of independent outsiders.

The article provides information on Epilobium nerterioides. It refers to a small creeping tufted perennial forming spreading matted patches. Its stems are slender and elongated with roots at the nodes and branches frequently ascending to their tips. Epilobium nerterioides is a naturalized alien, native of New Zealand and introduced into Great Britain as a rock garden plant. Epilobium nerterioides is commonly found in open habitats in regions of high precipitation and where cloud and mist are prevalent.

The article presents a discussion on the vegetation of grass verges and explores the grass habitats which are regarded as excessively trodden places. It is implied that a considerable degree of similarity exist between the vegetation of the trampled grass verge found on highways and that of the grassy footpath or the sheep track situated whether on lowlands or at high elevation. The article is supplemented with details regarding the botanical composition of the plant communities, ecological distribution, climatic and edaphic backgrounds, and observations drawn from investigating samples coming from Great Britain, Australia, and New Zealand.

Treatment with new and/or innovative drugs with uncertain safety and efficacy profile is associated with substantial ethical concerns. The main objective of this paper is to present guidance on the use of such drugs contained in: (i) major international codes and guidelines pertaining to medical ethics and biomedical research; (ii) national codes of medical ethics and professional conduct of the USA, Canada, Australia, New Zealand, the UK, Ireland, France and Germany. Out of the four international codes and guidelines analysed, only the Declaration of Helsinki addresses the question of the use of unproven drugs. Among national codes, only two (USA and New Zealand) explicitly allow for use of new or innovative drugs. Moreover, treatment with unproven drugs seems to be permissible under the French code, though this is not stated explicitly. The remaining codes do not contain any articles on the use of new and innovative drugs. An update of existing articles, as well as the addition of new guidelines to the codes, should be considered in view of the rapid pace of development and introduction to clinical practice of new drugs. This work is relevant to innovative off-label applications of approved drugs and expanded access to investigational drugs., (© 2018 The British Pharmacological Society.)