Search

The marketisation of European home care has given rise to significant private for-profit providers growth. However, little research has focused directly on commercial companies to examine the mechanisms through which they emerge, grow and shape long-term care policy – this is this paper's task. Drawing on the literature on business power, the recent concept of "institutional business power" is introduced, defined as the power flowing from the entrenched position of business actors in the provision of public social services. The paper identifies the mechanisms through which private providers have grown and assesses the extent of their institutional power by examining their influence on policy and the support they obtain from relevant home care stakeholders. The limits of providers' institutional power are also discussed. The paper relies on semi-structured interviews with representatives of public, private and non-profit home care providers. [ABSTRACT FROM AUTHOR]

Paid carers play an important role in helping older adults with care needs to remain living in their own homes. This paper examines changes in the home care field, specifically the emergence of self‐employed care entrepreneurs ('microentrepreneurs'). To do this, it employs Bourdieu's concepts of field, capital and habitus. Drawing on 105 semi‐structured interviews with stakeholders working in home care, the paper describes how the interaction of changes to field structures, and altered practices of care have challenged the taken‐for‐granted acceptance of traditional, transactional forms of care provision. This process has been highly dependent on local state actors, their ability to mobilise relevant forms of capital and the factors which shaped their habitus. It should be seen within the context of changes to local field structures and the hierarchical classification processes which underpin them. These changes threaten the distribution of capital in the home care field in ways that are beneficial to microentrepreneurs. Bourdieu might categorise these developments as 'partial revolutions', which do not challenge the fundamental axioms of the field. However, for care entrepreneurs, formerly employed as low‐paid home‐care workers, a revolution that is only partial may be better than none at all. [ABSTRACT FROM AUTHOR]

This paper examines the atmosphere of mistrust that permeated the response to the tenth Ebola epidemic in Eastern DRC (2018–2020). The concept of an 'atmosphere of mistrust' that we develop in this article directs attention to the elusive-yet-pervasive presence of mistrust in interactions between responders and communities during the Ebola epidemic. This analysis focuses on the popular notion that 'Ebola is a business'. Our interviewees frequently used this saying during our research on the Ebola response to explain why mistrust had emerged, how it materialized, and against whom it was directed. Based on these interviews, we examine 'Ebola is a business' as a slogan that enabled people to voice mistrust. This slogan, as we aim to show, resonated with a wider atmosphere of mistrust that governed the emergency situation in Eastern DRC. In using it, people responded to their perceptions of mistrust whilst simultaneously perpetuating and extending this atmosphere of mistrust. Our analysis of the atmosphere of mistrust highlights the power of atmospheres in governing situations, mobilizing people, and disrupting structures of discrimination. It aims to contribute to a better understanding of the barriers inhibiting the collaborations between affected communities and responders, which are required to deliver effective epidemic responses. Moreover, we argue that voice and the atmosphere are important analytics for exploring the histories of mistrust that Ebola epidemics ask for. [ABSTRACT FROM AUTHOR]

Social enterprises, which are businesses with social objectives, have been championed by the UK government as an opportunity to deliver more innovative, socially oriented, and commercially sustainable public services. However, very little is known about them, especially in a social care context. This paper therefore aims to answer the following three questions: (1) What are care social enterprises?, (2) What are their distinctive qualities?, and (3) How can they contribute to the adult social care sector? It presents evidence from a "mapping" of care social enterprises in three English local authorities, and from interviews with 35 stakeholders from across the social care and social enterprise sectors. Drawing on an institutional logics framework, we explore the influence of different norms, goals, and practices on care social enterprises and the extent to which they are aligned with those of the public, private, and not-for-profit sectors. We found that their unique combination of business and social logics, along with an entrepreneurial mindset, may make them more flexible, innovative, and able to diversify their income than public and not-for-profit care organisations. They were also considered more trustworthy than private care services. However, their competing social and business logics can create internal tensions and bring uncertainty about what organisational model they are. These tensions can make it challenging for us to define what a care social enterprise is and in turn for social enterprises to promote themselves and attract funding. [ABSTRACT FROM AUTHOR]

Background & Aims: Innovation, which is the result of the joint work of university and industry, is an initiative that improves the efficiency of innovation. This type of cooperation, i.e. collaborative innovation between university and industry, is called collaborative innovation. Collaborative innovation brings dynamism and vitality to companies and causes economic growth and expansion. (1). In fact, one of the important factors in innovation, and one of the important factors in economic growth and development, is the transfer of knowledge that takes place between universities and industry because this cooperation makes commercialization in companies easier (2). On the other hand, one of the things that has always been very important in knowledgebased companies is the commercialization process. This process has three separate phases, the ideation phase, the technology/product development phase, and the commercialization phase. First, an idea that has a demand in the market is created and cultivated. In the development stage, this idea becomes a product or technology, and commercialization is technological knowledge that has entered the market (9). In our beloved country of Iran, knowledge-based companies active in the field of medical products have succeeded in reaching self-sufficiency in the field of medical products to almost 40% in the past few years, but they have been very unsuccessful in the discussion of commercializing medical products for export to other countries. . Now, according to the capacity of our country, we can earn up to two billion dollars a year from the commercialization of these types of goods, which has a positive impact on the national economy. Therefore, the researcher seeks to solve these problems by presenting a model for commercialization. Therefore, the main research question is, what is the commercialization model of medical products for knowledge-based companies? Methods: The current research is of an exploratory and expansion type, which was conducted using a qualitative method. The statistical population of this research is experts with practical experience in the field of commercialization of products of knowledgebased companies in the science and technology park of Mazandaran province, and professors of the University of Medical Sciences and management professors of management faculties of universities of Mazandaran province, who are aware of the subject of the research. 12 people were selected as samples from among them by snowball method until full saturation. Then a semi-structured interview was conducted to collect data from them. Interviews were held one by one with each expert. After conducting the interviews (audio recording), the texts of the interviews recorded from the experts, on the same day of the interview, were transcribed word by word on paper and typed as research data., was used. The research data are analyzed on two levels, the textual level and the conceptual level The textual level includes the coding of the data, the conceptual level emphasizes the construction of the research model including establishing a relationship between the codes based on the Strauss and Corbin model. Also, in order to ensure the validity of the model, the strategy of analysis and review by knowledgeable people (multi-view) has been used. Results: To design the model using the foundation data method in the first step; Initial coding was done using the text of the interviews. In this step, one hundred and nine primary codes were extracted. In the second step; Axial coding was done. In this step, thirty-two axial codings were obtained from a total of one hundred and nine initial codes. In the third step; Selective coding Selective coding was done based on the results of open coding and axial coding in this step, which is the main step of theorizing. Thirteen codes were obtained. Also, the validity of the research model was done by using the analysis and review method by knowledgeable people, in this method, to check the validity of the research model, all the data and primary extracted codes were sent to other experts who are familiar with the issue of commercialization of medical products in knowledge-based companies. They were informed and experts were given and they were asked to modify and approve the designed codes, and all the codes were approved, thus the validity of this research was proved. Also, the reliability of the research was checked with Kreppendorf's alpha method, and the agreement of five experts on the codes was equal to 89%. Considering that this amount is more than 60%, the reliability of the codings of this research is confirmed. Conclusion: In this research, the causal conditions for the commercialization of medical products, four factors of human capital, technology, digital transformability of the company and environmental factors have been stated. (Shirvani, Tulai and Delavi, 2019 limited the causal conditions to digital technology. Considering these factors by the companies residing in the science and technology park, they can take into account all the effective factors in creating a successful business for their products and Don't just focus on technology. The strategies of this research have been identified in three dimensions; Financial strategies, market orientation and attracting cooperation of the University of Medical Sciences. Every business unit needs capital in order to set up and start its activity, and in order to develop and continue its activity, it needs new investment, which must be provided through financial resources (24). Access to financial resources is one of the important factors in the success of companies and one of the important concerns of companies at different stages of their life (25). Market orientation can be defined as a stage of organizational growth or as a level that reflects organizational maturity (26). Kotler has looked at market orientation as the final stage of the development of a business organization and believes that the market orientation is created along the development of different business orientations. Market orientation is based on marketing thinking and marketing thinking forms its philosophical foundation. (26). However, marketing thinking as a foundation and philosophical foundation is not enough. Because market orientation focuses not only on customers, but also on competitors, different organizational issues and many external factors that affect the needs and preferences of customers. [ABSTRACT FROM AUTHOR]

Background: The Regional Economic Partnership Agreement (RCEP) is a mega regional trade agreement signed by fifteen countries on 15 November 2020 after 8 years of negotiation. Signatories include the ten members of the Association of South East Asian Nations (ASEAN) plus China, New Zealand, Japan, South Korea and Australia. India was a negotiating party until it withdrew from the negotiations in November 2019. The RCEP negotiations were initially framed as focused on the needs of low income countries. Public health concerns emerged however when draft negotiating chapters were leaked online, revealing pressures on countries to agree to intellectual property and investment measures that could exacerbate issues of access to medicines and seeds, and protecting regulatory space for public health. A concerted Asia Pacific civil society campaign emerged in response to these concerns, and in 2019, media and government reporting suggested that several of these measures had been taken off the table, which was subsequently confirmed in the release of the signed text in November 2020.Results: This paper examines civil society and health actors' views of the conditions that successfully contributed to the removal of these measures in RCEP, with a focus on intellectual property and access to medicines. Drawing on twenty semi-structured qualitative interviews with civil society, government and legal and health experts from nine countries participating in the RCEP negotiations, the paper reports a matrix of ten conditions related to actor power, ideas, political context and specific health issues that appeared to support prioritisation of some public health concerns in the RCEP negotiations.Conclusions: Conditions identified included strong low and middle income country leadership; strong civil society mobilisation, increased technical capacity of civil society and low and middle income negotiators; supportive public health norms; processes that somewhat opened up the negotiations to hear public health views; the use of evidence; domestic support for health issues; and supportive international public health legislation. Lessons from the RCEP can inform prioritisation of public health in future trade agreement negotiations. [ABSTRACT FROM AUTHOR]

Objectives: To assess the quality of evidence on the effectiveness of local US laws restricting the sale of flavored tobacco products.Methods: We conducted a systematic search and qualitative scoping review of English-language papers published through May 2020 that evaluated flavored tobacco sales policies implemented by US jurisdictions during 2010-2019. We constructed a conceptual model for flavored and menthol tobacco sales restriction outcomes, assigned GRADE quality of evidence ratings to policy outcomes evaluated through the included studies, and summarized factors that might explain weak or inconsistent findings.Results: We found moderate to high quality of evidence associating policy implementation with reduced availability, marketing, and sales of policy-restricted products, and decreased youth and adult tobacco use of these products; however, policy exclusions and exemptions, implementation challenges, tobacco industry actions (e.g., marketing of concept-named flavored products; exploiting policy exemptions for certain store types), and consumer responses (e.g., cross-border or illicit purchasing) might undermine or mitigate intended policy effects.Conclusions: Flavored and menthol tobacco product sales restrictions implemented and evaluated in US jurisdictions appear to have achieved some of their intended outcomes; however, deficiencies in study designs, methods, and metrics could contribute to equivocal findings on quality of evidence associating policy implementation and outcomes. Gaps in the evidence are beginning to be filled with research using more rigorous study designs, improved measurement and analytic methods, and longer-term follow-up.Implications: In the absence of comprehensive federal action, US jurisdictions have the obligation to restrict flavored and menthol product sales to protect vulnerable populations from tobacco-related harms. The considerable expenditure of financial resources, political will, and time dedicated to policy adoption and implementation argue for evaluation studies designed to maximize the quality of evidence. This review offers generalizable insights into evaluation findings that can inform efforts to enhance tobacco control policy implementation and impact in the US and globally. [ABSTRACT FROM AUTHOR]

Introduction: To review the geographic exposure measures used to characterize the tobacco environment in terms of density of tobacco outlets and proximity to tobacco outlets, and its association with smoking-related outcomes.Methods: We used PubMed and Google Scholar to find articles published until December 2019. The search was restricted to studies that (1) measured the density of and/or proximity to tobacco outlets and (2) included associations with smoking outcomes. The extraction was coordinated by several observers. We gathered data on the place of exposure, methodological approaches, and smoking outcomes.Results: Forty articles were eligible out of 3002 screened papers. Different density and proximity measures were described. 47.4% density calculations were based on simple counts (number of outlets within an area). Kernel density estimations and other measures weighted by the size of the area (outlets per square kilometer), population, and road length were identified. 81.3% of the articles which assessed proximity to tobacco outlets used length distances estimated through the street network. Higher density values were mostly associated with higher smoking prevalence (76.2%), greater tobacco use and smoking initiation (64.3%), and lower cessation outcomes (84.6%). Proximity measures were not associated with any smoking outcome except with cessation (62.5%).Conclusion: Associations between the density of tobacco outlets and smoking outcomes were found regardless of the exposure measure applied. Further research is warranted to better understand how proximity to tobacco outlets may influence the smoking outcomes. This systematic review discusses methodological gaps in the literature and provides insights for future studies exploring the tobacco environment.Implications: Our findings pose some methodological lessons to improve the exposure measures on the tobacco outlet environment. Solving these methodological gaps is crucial to understand the influence of the tobacco environment on the smoking outcomes. Activity spaces should be considered in further analyses because individuals are exposed to tobacco beyond their residence or school neighborhood. Further studies in this research area demand density estimations weighted by the size of the area, population, or road length, or measured using Kernel density estimations. Proximity calculations should be measured through the street network and should consider travel times apart from the length distance. [ABSTRACT FROM AUTHOR]

Abstract: Background: Internationally, pharmaceutical policy has heightened expectations for community pharmacies to act as healthcare professionals, increasing the need to understand the health professional–retailer nexus. Literature suggests that pharmacy involves a dichotomy of roles including both retailing and healthcare provision, yet it is unknown whether pharmacists themselves perceive a tension between these roles and how such a tension might be managed. Aim: To explore whether there is tension between being retailers and healthcare providers in community pharmacy and to understand how any such tension is perceived and managed. Methods: Ten in‐depth semi‐structured interviews were conducted with pharmacist owners and managers of community pharmacies in New Zealand. General inductive thematic analysis was undertaken to gain insight from the data. Results: Pharmacists experienced tension between being healthcare providers and being retailers. In total, eight themes were derived from this study. Four themes emerged to describe the tension: (i) balancing roles; (ii) tension – what tension?; (iii) we give a lot for free; and (iv) too much bureaucracy and paperwork. Four themes for managing tension were identified: (i) imparting of owner beliefs; (ii) use of incentives; (iii) effective business management skills; and (iv) being entrepreneurial. Conclusion: This paper is expected to assist in helping policy‐makers and practitioners be aware of the role of tensions when policies are implemented to move pharmacists from a retailer role to healthcare provider. This paper aids in policy development and should inform professional practice and forthcoming business management training programs for community pharmacy. [ABSTRACT FROM AUTHOR]

Concise and effective business English communication underpins successful organisations. During the 4th Industrial Revolution (4IR) much of the working day is spent in some form of communication, usually e-mails. This paper examines the effectiveness of English communication between integral parts of a business operation during the 4IR. A mixed methods approach utilising a non-experimental design was used to investigate effective business communication using e-mails in English in a medium sized organisation in South Africa. A questionnaire consisting of 10 Likert type scale questions and 5 open ended questions was used. Purposive sampling was utilised as the population was small (150 employees, final sample 55) thus results cannot be generalised. Certain barriers to communication were identified which were considered important. For instance, many staff members were second language English speakers and often misunderstand e-mails. As a result, they reported that they felt frustrated in their working life and were demotivated. It was concluded that many e-mails were challenging to staff and needed to be written in everyday English not business language. The authors recommended that workshops and initial training in business language skills when people enter the organisation should be undertaken. Human Resources could also audit the use of appropriate English. [ABSTRACT FROM AUTHOR]

Population aging is exacerbating the loss of competences in the workforce and simultaneously young people neither in employment nor in education and training (NEETs) are struggling to be reengaged in employment. These issues, which are deemed priorities for the European policy agenda, could be addressed by triggering active aging dimensions, valuing and exploiting older adult entrepreneurs' knowledge for enhancing youngsters' entrepreneurial attitudes, through mentoring. This paper reports the results of a study based on an intergenerational learning program, carried out in 2018 in Germany, Italy and Slovenia. The study was aimed at developing and testing one training on mentoring addressing 41 older adult entrepreneurs (55 and over), and two intergenerational learning trainings aiming at boosting entrepreneurial competences of 33 NEETs (aged 18–29). The impact of the program on older adult entrepreneurs and NEETs was assessed through a pre and post-evaluation using qualitative and quantitative tools. Findings at country level were treated as national case-studies and then the latter were compared by considering them as a multiple embedded case-study. Results indicated that, to different extent in the study countries, mentors learned and enhanced mentoring competences, e.g. active listening and the capability of orienting, improved well-being and self-esteem, social inclusion and active aging attitude. Moreover, NEETs acquired entrepreneurial and socio-relational competences by benefiting from the full exploitation of mentors' know-how and the trust relationship with them. Companies, trade unions, educational and voluntary organizations should cooperate to adopt intergenerational learning programs as good practices for older adults and NEETs' lifelong learning promotion. [ABSTRACT FROM AUTHOR]

This final report of the Lancet Commission into liver disease in the UK stresses the continuing increase in burden of liver disease from excess alcohol consumption and obesity, with high levels of hospital admissions which are worsening in deprived areas. Only with comprehensive food and alcohol strategies based on fiscal and regulatory measures (including a minimum unit price for alcohol, the alcohol duty escalator, and an extension of the sugar levy on food content) can the disease burden be curtailed. Following introduction of minimum unit pricing in Scotland, alcohol sales fell by 3%, with the greatest effect on heavy drinkers of low-cost alcohol products. We also discuss the major contribution of obesity and alcohol to the ten most common cancers as well as measures outlined by the departing Chief Medical Officer to combat rising levels of obesity-the highest of any country in the west. Mortality of severely ill patients with liver disease in district general hospitals is unacceptably high, indicating the need to develop a masterplan for improving hospital care. We propose a plan based around specialist hospital centres that are linked to district general hospitals by operational delivery networks. This plan has received strong backing from the British Association for Study of the Liver and British Society of Gastroenterology, but is held up at NHS England. The value of so-called day-case care bundles to reduce high hospital readmission rates with greater care in the community is described, along with examples of locally derived schemes for the early detection of disease and, in particular, schemes to allow general practitioners to refer patients directly for elastography assessment. New funding arrangements for general practitioners will be required if these proposals are to be taken up more widely around the country. Understanding of the harm to health from lifestyle causes among the general population is low, with a poor knowledge of alcohol consumption and dietary guidelines. The Lancet Commission has serious doubts about whether the initiatives described in the Prevention Green Paper, with the onus placed on the individual based on the use of information technology and the latest in behavioural science, will be effective. We call for greater coordination between official and non-official bodies that have highlighted the unacceptable disease burden from liver disease in England in order to present a single, strong voice to the higher echelons of government. [ABSTRACT FROM AUTHOR]

Using the case study approach, this paper examines the formation of a pan-Asian American ethnic agency between leaders of corporate employee resource groups and Asian American subgroup ethnic agencies. Themes found consist of 1) formation of the partnership to raise funds for a natural disaster; 2) moving forward as a united pan-Asian American nonprofit organization; and 3) challenges ahead that include utilization of funds and power 4t agency community members. A better-resourced organization can facilitate increased chances of success as well as access to its services by the community in which it serves. [ABSTRACT FROM AUTHOR]

Background: Cryptomarkets, or illegal anonymizing online platforms that facilitate drug trade, have been analyzed in a rapidly growing body of research. Previous research has found that, despite increased risks, cryptomarket sellers are often willing to ship illegal drugs internationally. There is little to no information, however, about the extent to which uncertainty and risk related to geographic constraints shapes buyers' behavior and, in turn, the structure of the global online drug trade network. In this paper, we analyze the structure of a complete cryptomarket trade network with a focus on the role of geographic clustering of buyers and sellers.Methods: We use publicly available crawls of the cryptomarket Abraxas, encompassing market transactions between 463 sellers and 3542 buyers of drugs in 2015. We use descriptive social network analysis and Exponential Random Graph Models (ERGM) to analyze the structure of the trade network.Results: The structure of the online drug trade network is primarily shaped by geographical boundaries. Buyers are more likely to buy from multiple sellers within a single country, and avoid buying from sellers in different countries, which leads to strong geographic clustering. The effect is especially strong between continents and weaker for countries within Europe. A small fraction of buyers (10%) account for more than a half of all drug purchases, while most buyers only buy once.Conclusion: Online drug trade networks might still be heavily shaped by offline (geographic) constraints, despite their ability to provide access for end-users to large international supply. Cryptomarkets might be more "localized" and less international than thought before. We discuss potential explanations for such geographical clustering and implications of the findings. [ABSTRACT FROM AUTHOR]

Research indicates that the evidential bases for many harm reduction policies targeting hazardous consumptions (including tobacco, alcohol and gambling) have been distorted by commercial industries that derive revenue from such commodities. These distortions are best illustrated by research on tobacco and alcohol, which indicates similar tactics used by industries to determine favourable policy environments through engineering of evidence, among other approaches. Although there is concern that gambling research is similarly vulnerable to commercial interests, the relevant literature lags far behind other fields and the aim of this paper is to increase familiarity with tactics used by industries for influencing research. It summarises the conceptual and empirical bases for expecting conflicts between goals of public health and companies that profit from hazardous consumptions. It also summarises evidence describing practices deployed by tobacco corporations, which include third-party techniques and the selective funding of research to manufacture doubt and deflect attention away from the consequences of smoking. It then reviews both early and emerging evidence indicating similar strategies used by alcohol industry, and uses this literature to view practices of the gambling industry. It argues that parallels regarding selective funding of research and third-party techniques provide grounds for strong concern about commercial influences on gambling research, and implementation of precautionary approaches to management of vested interests. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Since 2008, the National Certification Commission for Acupuncture and Oriental Medicine has performed job analyses on its member Diplomates by collecting relevant data, including demographics and income profiles as well as practice patterns and environment. These data have significantly contributed to the profession's application to the U.S. Bureau of Labor Statistics requesting that "Acupuncturists" be assigned an independent Standard of Occupational Classification. As a result of the applications submitted in 2008 and 2016, a new code for Acupuncturists, SOC - 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018. In addition to the demographic and clinical practice characteristics data identified by the periodic NCCAOM job analyses, the NCCAOM began collecting similar data from NCCAOM Diplomates during their 4-year recertification cycle. METHODS: Data collected from recertifying Diplomates (n=1047) collectively for the years 2014, 2015 and 2016 were analyzed for trends and to provide a benchmark for the profession. Upon completion of their recertification application, Diplomates were asked to voluntarily complete a 28-item survey questionnaire. RESULTS: The outcomes of these surveys demonstrated that the acupuncture and Oriental medicine workforce is 70% female, averaging 52 years of age and approximately 13 years of experience. Responding Diplomates were from 49 states and two territories, including a small sample from other countries. Initial evaluation and treatment fees averaged $112 among the respondents, with an average return visit costing $78. Roughly 45% of the respondents worked more than 32 hours per week and 26.1% worked less than 20 hours per week. The average Diplomate treated 24 patients per week. The median income of Diplomates was reported to be between $40,000 and $60,000 per year. DISCUSSION: This descriptive research paper summarizes selected demographic, economic and practice setting characteristics for NCCAOM Diplomates each year, between 2014 and 2016, at the time of recertification. While the demographic profile of the Diplomates remained consistent (70% women, an average of 13 years in practice, and the majority in solo practice), there were some subtle changes that occurred between 2014 and 2016. One change indicated a greater number of practitioners working in other practice settings besides solo practice, such as hospital-based practice. Although the median annual income is in the range of $40,000 to $60,000, there were fewer Diplomates making less than $20,000/year and more earning greater than $100,000/year between 2014 and 2016. CONCLUSION: There are a variety of business models employed among Diplomates across the country. These vary by location, employment status, and pay structures. Further information on the success and failure of acupuncture practices should be researched and distributed to students and practitioners to assist in supporting the acupuncture and Oriental medicine community. Additionally, government agencies, such as the Centers for Medicare and Medicaid Services, the Bureau of Labor Statistics, the Department of Veterans Affairs, and the National Center for Health Workforce Analysis, require nationwide data for policy decision-making and to publish annual reports as well as update their publications. [ABSTRACT FROM AUTHOR]

Background/aims/methods: Price comparison is an important and complex skill, but it lacks sufficient research attention in terms of educating secondary students with intellectual disability and/or autism spectrum disorder. This alternating treatment design study compared the use of a paper-based number line and audio prompts delivered via an audio recorder to support three secondary students with intellectual disability to independently and accuracy compare the price of three separate grocery items.Procedures/outcomes: The study consisted of 22 sessions, spread across baseline, intervention, best treatment, and two different generalization phases. Data were collected on the percent of task analysis steps completed independently, the type of prompts needed, students' accuracy selecting the lowest priced item, and task completion time.Results/conclusions: With both intervention conditions, students were able to independently complete the task analysis steps as well as accurately select the lowest priced item and decrease their task completion time. For two of the students, the audio recorder condition resulted in the greatest independence and for one the number line. For only one student was the condition with the greatest independence also the condition for the highest rate of accuracy.Implications: The results suggest both tools can support students with price comparison. Yet, audio recorders offer students and teachers an age-appropriate and setting-appropriate option. [ABSTRACT FROM AUTHOR]

Multiple layers of dealers connect international drug traffickers to users. The fundamental activity of these dealers is buying from higher-level dealers and re-selling in smaller quantities at the next lower market level. Each instance of this can be viewed as completing a drug dealing "cycle". This paper introduces an approach for combining isolated accounts of such cycles into a coherent model of the structure, span, and profitability of the various layers of the domestic supply chain for illegal drugs. The approach is illustrated by synthesizing data from interviews with 116 incarcerated dealers to elucidate the structure and operation of distribution networks for cocaine and heroin in Italy and Slovenia. Inmates' descriptions of cycles in the Italian cocaine market suggest fairly orderly networks, with reasonably well-defined market levels. The Italian heroin market appears to have more "level-jumpers" who skip a market level by making a larger number of sales per cycle, with each sale being of a considerably smaller weight. Slovenian data are sparser, but broadly consistent. Incorporating prices allows calculation of how much of the revenue from retail sales is retained by dealers at each market level. In the Italian cocaine market, both retail sellers and the international supply chain outside of Italy each appear to receive about 30-40% of what users spend, with the remaining 30% going to higher-level dealers operating in Italy (roughly 10% to those at the multi-kilo level and 20% to lower level wholesale dealers). Factoring in cycle frequencies permits rough estimation of the number of organizations at each market level per billion euros in retail sales, and of annual net revenues for organizations at each level. These analyses provide an approach to gaining insight into the structure and operation of the supply chain for illegal drugs. They also illustrate the value of two new graphical tools for describing illicit drug supply chains and hint at possible biases in how respondents describe their drug dealing activities. [ABSTRACT FROM AUTHOR]

Background: International drug law enforcement agencies have identified an apparent rise in high level drug traffickers choosing to deal in multiple different drugs. It is hypothesised that this may be a "deliberate modus operandi" and that the formation of "portfolios of trades" may make such traffickers more profitable, harmful and resilient to changes in drug supply and policing. In this paper we provide the first exploration of the extent, nature and harms of poly-drug trafficking at Australian borders.Methods: Two different methods were used. First, we used Australian Federal Police (AFP) data on all commercial level seizures at the Australian border from 1999 to 2012 to identify the proportion of seizures that were poly-drug and trends over time. Second, we used unit-record data on a sub-set of 20 drug trafficking cases and linked-cases (defined as the original drug trafficking case and all other criminal cases that were connected via common offenders and/or suspects) to compare the profiles of poly-drug and mono-drug traffickers, including: the total weight and type of drug seized, the value of assets seized, and the level of involvement in other crime (such as money laundering and corruption).Results: Between 5% and 35% of commercial importations at the Australian border involved poly-drug trafficking. Poly-drug trafficking occurred in almost every year of analysis (1999-2012), but it increased only slightly over time. Compared to mono-drug traffickers poly-drug traffickers were characterised by: larger quantities of drugs seized, larger networks, longer criminal histories and more involvement in other types of serious crime.Conclusion: Some fears about poly-drug traffickers may have been overstated particularly about the inherent escalation of this form of trafficking. Nevertheless, this suggests poly-drug traffickers are likely to pose added risks to governments and law enforcement than mono-drug traffickers. They may necessitate different types of policy responses. [ABSTRACT FROM AUTHOR]

Background: A growing body of literature aims to improve understanding of the operations of drug trafficking markets through conducting interviews with dealers and traffickers. Insight into how these individuals conduct business can provide evidence to inform the efforts by policy makers, law enforcement and practitioners to disrupt illicit markets. This paper aims to make a contribution to this evidence base by extending the number of European countries in which interviews have been conducted with incarcerated drug dealers and traffickers.Methods: It draws on interviews with 135 men convicted of offences related to the distribution or sale of heroin or cocaine and imprisoned in Italy, Slovenia and Germany. The research was conducted as part of the Reframing Addictions Project (ALICE-RAP) funded by the European Commission. The sample was diverse. It included a range of nationalities and some individuals who were members of organised crime groups. The majority of the interviewees were dealers who sold at the retail and street level, but there were some who were importers and wholesalers.Findings: Most dealers in each of the three countries reported having more than one regular supplier, and were able to respond to periods of over and under supply without losing customers. Supply arrangements varied in terms of frequency and quantities bought. Dealers engaged in repeated transactions and their relationships with customers were based on trust and reputation. Dealers aimed to sell to regular customers and to provide drugs of good quality. While dealers sought to maximise their profits by cutting drugs with cutting agents, the quality of drugs that they sold could affect their reputation and thus their profits and position in the market. Lastly, while there are some significant differences in the approach between those involved in organised crime groups and those who are not, and between street dealers and those operating at higher levels of the market, there were striking similarities in terms of the day-to-day operational concerns and modes of relationship management.Conclusions: Interviewees' arrangements for securing supplies of drugs provide support to the notion that drug markets are resilient and flexible. Our findings correspond with other empirical research in relation to the centrality of trust in the practical operation of supply and sale of drugs. The research highlights some differences, but important similarities between dealers who were part of organised crime groups and those who were not; dealers all faced some common challenges and adopted some common responses to these. [ABSTRACT FROM AUTHOR]

Background: Neighborhood characteristics are important determinants of individual health and well-being. For example, characteristics such as noise and pollution affect health directly, while other characteristics affect health and well-being by either providing resources (e.g. social capital in the neighborhood), which individuals can use to cope with health problems, or limiting the use thereof (e.g. crime). This also suggests that there might be age differentials in the impact of these characteristics, since individuals at different stages of life might need different resources. However, there is a lack of empirical evidence on age differentials in associations between well-being, health, and neighborhood characteristics.Objective: This paper studies associations between a wide range of neighborhood characteristics with the health and well-being of residents of the greater Berlin area. In particular, we focus on differences in the effects between younger (aged 20-35) and older (aged 60+) residents.Methods: We used data from the Berlin Aging Study II (312 younger and 993 older residents of the Berlin metropolitan area in Germany). We used survey data on health and well-being, combined these with subjective perceptions of the neighborhood, and geo-referenced indicators on the neighborhood, e.g. amenities (public transport, physicians, and hospitals).Results: The results show that access to public transportation is associated with better outcomes on all measures of health and well-being, and social support is associated with higher life satisfaction and better mental health. There are considerable differences between both age groups: while the associations between access to public transport and health and well-being are similar for both age groups, neighborhood social capital shows stronger associations for older residents. However, the difference is not always statistically significant.Conclusion: Having access to services is associated with better health and well-being regardless of age. Local policy makers should focus on lowering barriers to mobility in order to improve the health and well-being of the population. Since the social capital of a neighborhood is associated with better health and well-being among older residents, investments that increase social capital (e.g. community centers) might be warranted in neighborhoods with higher shares of older residents. [ABSTRACT FROM AUTHOR]

The public-health community views mandatory Front-of-Pack (FOP) nutrition labels and nutritional taxes as promising tools to control the growth of food-related chronic diseases. This paper uses household scanner data to propose an ex-ante evaluation and comparison of these two policy options for the fromage blanc and dessert yogurt market. In most markets, labelling is voluntary and firms display fat labels only on the FOP of low-fat products to target consumers who do not want to eat fat. We here separately identify consumer preferences for fat and for FOP fat labels by exploiting an exogenous difference in legal labelling requirements between these two product categories. Estimates of demand curves are combined with a supply model of oligopolistic price competition to simulate policies. We find that a feasible ad valorem fat tax dominates a mandatory FOP-label policy from an economic perspective, but both are equally effective in reducing average fat purchases. [ABSTRACT FROM AUTHOR]

Background: The pricing of illicit drugs is typically approached within the risks and prices framework. Recent sociological and economic studies of prices in online drug markets have stressed the centrality of reputation for price formation. In this paper, we propose an account of price formation that is based on the risks and prices framework, but also incorporates internal social organization to explain price variation. We assess the model empirically, and extend the current empirical literature by including payment methods and informal ranking as influences on drug pricing.Methods: We apply our model to estimate the prices of cannabis, cocaine, and heroin in two online drug markets, cryptomarkets (n = 92.246). Using multilevel linear regression, we assess the influence of product qualities, reputation, payment methods, and informal ranking on price formation.Results: We observe extensive quantity discounts varying across substances and countries, and find premia and discounts associated with product qualities. We find evidence of payment method price adjustment, but contrary to expectation we observe conflicting evidence concerning reputation and status. We assess the robustness of our findings concerning reputation by comparing our model to previous approaches and alternative specifications.Conclusion: We contribute to an emerging economic sociological approach to the study illicit markets by developing an account of price formation that incorporates cybercrime scholarship and the risks and prices framework. We find that prices in online drug markets reflect both external institutional constraint and internal social processes that reduce uncertainty. [ABSTRACT FROM AUTHOR]

Background: The Slovenian healthcare business model (BM) has largely failed to integrate information and communication technologies (ICT) into its operational context, instead maintaining its rigid structure and traditional 'way of doing business'. This situation often results in uncoordinated business operations, while additionally destabilising an already underfinanced healthcare system and compromising the general quality of healthcare. Aim: The aim of this study is to provide an analysis of the BM concept and its implications, and to identify the potential effects of informatisation on the existing healthcare BM in Slovenia. Based on the findings, the paper concludes by presenting a conceptualisation of a transformed healthcare BM adapted to the Slovenian healthcare environment. Method: The study employs a single explanatory/exploratory case study design, while the validation of the hypothesised constructs was undertaken through structured interviews with twelve prominent experts from the Slovenian healthcare system. Interviewees were: healthcare professionals (two general practitioners and two specialists), ICT experts from healthcare (one ICT consultant and three analysts), and healthcare managers (two managers of public healthcare centres and two managers of public clinics). Results: Findings present a roadmap for the redefinition of BM elements and the transformation of the Slovenian healthcare BM. It includes the specific reconfiguration of BM actors and their interactions, and the application of advanced ICT solutions, which could facilitate more effective utilisation of healthcare resources and promote an improved delivery of healthcare services and products. Conclusion: The presented development approach and derived conceptual solution could be transferable to other countries with similar socio-economic characteristics and comparable healthcare systems, subject to certain adjustments and inclusion of national specifics. [ABSTRACT FROM AUTHOR]

The introduction of lower strength alcohol products results in less absolute alcohol purchased. This paper estimates the potential impact of price in shifting British household purchases from higher to lower strength beers and ciders. Descriptive statistics and controlled interrupted time series analyses using Kantar Worldpanel's British household purchase data from 70,303 households during 2015–2018 and the first half of 2020. No and low-alcohol products were less likely to be on price promotion than higher strength products. No and low-alcohol beers were cheaper per volume than higher strength beers; the reverse was the case for ciders. With the exception of low strength ciders (which had very few purchases) a higher volume was purchased when the product was on price promotion than when not. Again, with the exception of low strength ciders, the cheaper the cost, the greater the volume of purchase, more so when the product was on price promotion. The introduction of minimum unit price in Scotland (when controlling for changes in Northern England) and in Wales (when controlling for changes in Western England) shifted purchases from higher to lower strength products, more so for ciders than beers. In relative terms, the alcohol by volume of beer dropped by 2% and of cider by 7%. Changes did not differ by household income or the age of the main shopper. There are opportunities for governments and alcohol producers and retailers to facilitate shifts of purchases from higher to lower alcohol strength products. Alcohol producers and retailers can ensure that the price of lower strength products is competitive vis a vis higher strength products. Governments can introduce minimum unit prices for the sale of alcohol, as has been done in Scotland and Wales. No funding was received for this study. • New no and low alcohol beers result in households buying less alcohol overall. • Alcohol-free and low alcohol beers and ciders are less likely to be on price promotion. • Price promotions increase volume of purchased alcohol-free and low alcohol products. • Cheaper prices increase volume of purchased alcohol-free and low alcohol products. • Setting a minimum unit price shifts purchases from higher to lower strength products. [ABSTRACT FROM AUTHOR]

Background: Reducing the retail availability of tobacco has been proposed as a component of tobacco endgame, yet it is not known whether retail availability has a direct impact on smoking behaviours. A narrative review and a meta-analysis have been undertaken to examine the density and proximity of tobacco retail outlets, but were limited in scope, exposure and outcome variables. The aim of this current study was to undertake a systematic review of the international literature on the density and proximity of tobacco retail outlets to homes, schools and communities and their association with smoking behaviours among youth.Methods: We reviewed and critically appraised the evidence documenting the association between density or proximity of tobacco retail outlets and smoking behaviours among school-age youth (18 and under), between 1 January 1990 and 21 October 2019. We reviewed original quantitative research that examined the associations of tobacco retail outlet density and proximity with individual smoking status or population-level smoking prevalence; initiation of smoking; frequency of tobacco use; sales to minors; purchasing by minors; susceptibility to smoking among non-smokers; perceived prevalence of smoking, and quitting behaviours.Findings: Thirty-five peer-reviewed papers met the inclusion criteria. This review provided evidence of a relationship between density of tobacco retail outlets and smoking behaviours, particularly for the density near youths' home. A study using activity spaces also found a significant positive association between exposure to tobacco retail outlets and daily tobacco use. The review did not provide evidence of an association between the proximity of tobacco retail outlets to homes or schools and smoking behaviours among youth.Conclusions: The existing evidence supports a positive association between tobacco retail outlet density and smoking behaviours among youth, particularly for the density near youths' home. This review provides evidence for the development and implementation of policies to reduce the density of tobacco retail outlets to reduce smoking prevalence among youth. [ABSTRACT FROM AUTHOR]

Background: Price-based policies are effective alcohol harm minimisation policy options. This paper examines public support for price-based policies based on patterns of consumption and expenditure, to determine if the extent to which an individual may be affected by a policy influences their support.Methods: The current study included 1,684 Australian residents (59.8% male, Mage 43.8 [SD=16.7]). Respondents who purchased and consumed alcohol in the past six months were asked about their support for potential changes in a series of price-based policies.Results: Increasing price was less likely to be supported than either implementing a minimum price or a tax-increase earmarked to pay for alcohol harms. Increasing price and taxing drinkers were more likely to be supported by older people and women. We found no relationship between income or perceived impact of price increases on purchasing and level of support.Conclusion: Contrary to the idea that public support might be partly influenced by ability to pay for alcohol, support for a minimum unit price was not related to price paid per drink or income, only amount consumed. Thus, heavier drinkers may be inherently unlikely to support price-based policies even when these policies would have little impact on their actual purchasing. [ABSTRACT FROM AUTHOR]

Background: The UK Government document 5 year forward view describes the need to move chronic disease management from secondary to primary care, which will require a significant increase in the numbers of General Practice Nurses (GPNs). Until recently, there has been no specific recruitment strategy to address this increased need. In recent times, a number of solutions have been suggested to address this impending GPN recruitment crisis. For example, Health Education England (HEE) commission General Practitioners (GPs), who are members of the Advanced Training Practice Scheme (ATPS), to provide placements for student nurses within general practice. Methods: A descriptive qualitative study was undertaken, in which data were collected using semi-structured interviews with 16 GPs and 2 GPN partners*. Qualitative analysis used a framework approach and themes were cross-checked within the team and member checking was undertaken with a convenience sample of GPs. The research had ethical approval and anonymity and confidentiality were maintained. Results: From the GP perspective, there were two key themes that emerged from the data. The first theme of ‘fishing in the same small pond’ included succession planning for the general practice workforce, the ‘merry go round’ of poaching staff from other practices, and the myths and misunderstandings that have grown up around general practice nursing. The second theme, ‘growing your own’, looked at the impact of the student nurse placements as a means to address the crisis in GPN recruitment. There was recognition of the need for cultural change in the way that GPNs are recruited, and that the ATPS was one way of helping to achieve that change. There were however a number of challenges to sustaining this cultural shift, such as the financial constrains placed upon the GP practice, and the need to function as a ‘small business’. Conclusions: Despite all the challenges, the evidence is that, through the Community of Practice (CoP), the ATPS scheme is beginning to ‘bear fruit’, and there is a subtle but discernible move by GPs from a ‘why would we?’ to ‘why wouldn’t we?’ invest in education and training for nurses in general practice. N.B. The term GPN partner* denotes a GPN who is a ‘full partner’ in the practice business, holding the same NHS contracts and the same status as a GP. For the purposes of the paper itself, the term GP will be used to denote both types of partner. [ABSTRACT FROM AUTHOR]