Search

This paper investigates the impact of student-centered teaching strategies (SCTS) on the educational attainment of econometrics students, at a university based in the UK. Theoretical foundations underlying the usage of SCTS suggest that SCTS is better for students' long-term recall, comprehension, problem-solving abilities and interest in the subject. Yet, most existing studies have only examined short-run outcomes, and none in technical social-science fields. We contribute to the literature by empirically analyzing whether SCTS affects the long-term learning outcomes for a STEM-related social-science subject like econometrics, by comparing the impact of SCTS with traditional teacher-centered strategies using a repeated cross-sectional sample spanning over four academic years. Our results provide robust evidence that SCTS is positively associated with students' grades in the long run. Heterogeneity analyzes additionally indicate that female students and those in the upper quantiles of the grade-distribution disproportionately benefit more from SCTS.

Education is the core of the factors that improved people for a better lifestyle and increases the level of society' development. Quality education is one of the most vital goals of Sustainable Development Goals (SDGs) due to actualizing these factors. Using relational network data envelopment analysis (DEA), which have three interrelated substages, this current paper computes the educational economy efficiency of the Organisation for Economic Co-operation and Development (OECD) countries bearing in mind the characteristics related to SDGs. The contribution of our study is the use of a novel approach to computing the educational economy efficiency using relational network DEA with GAMS. Even though some interesting differences reveal in the efficiency of the countries, the findings show that countries with high-efficiency scores are clustered around countries like Latvia, Slovenia, and Korea.

To date research and scholarship on privatisation in education lacks critical depth and intensity. Many accounts have been largely descriptive, focusing on how privatisation takes places, or on the threat of privatisation, or its insertion within education systems. Furthermore, work on educational commodification has been substantially dissociated from studies on privatisation in education. This paper builds on this last point. Writing and research on privatisation in education has largely avoided what it represents and calls forth: the development of capital, the deeper capitalisation of education. Furthermore, discussion on educational privatisation typically ignores its implication in the social production of labour-power. Therefore, with reference to Karl Marx, this contribution drives the critique of privatisation in education forward by focusing on commodity form(s) in education and their relations to the capitalisation of educational services and labour-power. Consequently, the points of resistance to privatisation in education are sharpened as anti-capitalist weapons. These points of resistance are derived from aspects of the capitalisation of education: marketisation, privatisation and other related aspects. On the basis of the analysis in the paper, anticapitalist education is only a first step, it is argued; anti-capitalism in education based on an anti-affirmationist outlook flowing from negativity toward the capitalisation of education, is also required.

Background. Between 2015 and 2020, 1,578 care homes in the UK closed, displacing nearly 50,000 older and disabled people with very significant care and support needs. It is widely thought that relocation can have a significant impact on the health and well-being of older people. Yet, evidence is limited due to sensitivity and logistical difficulties with data collection. This study aimed to review the published literature in order to (i) identify evidence on the costs, consequences, and wider impacts of care home closures, for older people, family members, care home staff, and local authorities and (ii) understand the causes of and processes surrounding the closure of residential care homes in the UK. Methods. Eight electronic databases (Medline, Embase, Web of Science, Scopus, ASSIA, HMIC, AgeInfo, and SPP) were searched from 1st January 2000 to 9th February 2023; Google and Google Scholar were searched for guidance/policy documents from the grey literature. Data on the objectives, methods, and main results were extracted, and the findings were narratively reported. Results. Eighteen records, comprising guidance documents and academic publications (quantitative, qualitative, and mixed-method approaches), met the inclusion criteria. We found a lack of good quality evidence on costs of closure and no consideration of outcomes for staff. Studies reporting on outcomes for residents suggest there may not be any long-term adverse effects on their health, in contrast to often-expressed views that care home closures result in harm. Conclusion. Future research should consider the stress and anxiety experienced by staff and families as relevant outcomes and show caution with respect to the use of proxy reporting of resident health outcomes. Given that a sizable portion of the costs associated with care home closure falls on local authorities, an evidence-based approach to closures that includes an assessment of cost-effectiveness will help to improve future outcomes and guide the most efficient use of limited public resources. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to document contributions to the early study and teaching of marketing at one of the first universities in Britain to do so and, in that way, to contribute to the literature about the history of marketing thought. Given that the first university business program in Britain was started in 1902, at about the same time as the earliest business programs in America, the more specific purpose of this paper was to explore whether or not the same influences were shared by pioneer marketing educators on both sides of the Atlantic. Design/methodology/approach – An historical method is used including a biographical approach. Primary source materials included unpublished correspondence (letterbooks), lecture notes, seminar minute-books, course syllabi and exams, minutes of senate and faculty meetings, university calendars and other unpublished documents in the William James Ashley Papers at the University of Birmingham. Findings – The contributions of William James Ashley and the Commerce Program at the University of Birmingham to the early twentieth-century study and teaching of marketing are documented. Drawing from influences similar to those on pioneer American marketing scholars, Ashley used an historical, inductive, descriptive approach to study and teach marketing as part of what he called “business economics”. Beginning in 1902, Ashley taught his students about a relatively wide range of marketing strategy decisions focusing mostly on channels of distribution and the functions performed by channel intermediaries. His teaching and the research of his students share much with the early twentieth-century commodity, institutional and functional approaches that dominated American marketing thought. Research limitations/implications – William James Ashley was only one scholar and the Commerce Program at the University of Birmingham was only one, although widely acknowledged as the first, of a few early twentieth-century British university programs in business. This justifies future research into the possible contributions to marketing knowledge made by other programs such as those at the University of Manchester (1903), University of Liverpool (1910) and University of London (1919). Originality/value – This paper adds an important chapter to the history of marketing thought which has been dominated by American pioneer scholars, courses, literature and ideas. [ABSTRACT FROM AUTHOR]

This paper devises and tests a statistical model (the PAM) to measure the financial and sporting performance of professional football clubs. The PAM has been applied to a longitudinal data set of English football clubs (21 clubs between 1992-2013) to identify trends in performance. The results show that a small number of clubs have created an imbalance within English football and that there has been evidence of a "financial crisis" at individual clubs. For the majority of clubs, overall performance appears to vary over time in cycles. In addition to measuring holistic performance of professional football clubs in England, the paper has developed a statistically robust model that progresses research in the field. This new model has the potential to be adapted to fit other professional team sports to test league viability. It can also be used by the clubs themselves to set objectives and to analyse performance against competitors. [ABSTRACT FROM AUTHOR]

The UK's automotive industry has been one of the ‘star performers’ of the UK economy in recent years – unlike most other manufacturing sectors. Output has increased by over 60 per cent since 2010 and there has been over £8 billion worth of investment in the industry in the past five years. The industry supports some 800,000 jobs in the UK. It is seen as having benefitted from EU membership. So what might Brexit mean for the UK automotive sector, and its workers? This paper considers short-run impacts, before turning to the impact of uncertainty on foreign direct investment inflows and then the nature of a possible trading relationship. Some brief reflections on policy implications round off the paper. [ABSTRACT FROM AUTHOR]

This paper studies local economic impacts of the increases in trade barriers associated with Brexit. Predictions of the local impact of Brexit are presented under two different scenarios, soft and hard Brexit, which are developed from a structural trade model. Average effects are predicted to be negative under both scenarios, and to be more negative under hard Brexit. The spatial variation in negative shocks across areas is higher in the latter case as some local areas are particularly specialised in sectors that are predicted to be badly hit by hard Brexit. Areas in the South of England, and urban areas, are harder hit by Brexit under both scenarios. Again, this pattern is explained by sector specialisation. Finally, the areas that were most likely to vote remain are those that are predicted to be most negatively impacted by Brexit [ABSTRACT FROM AUTHOR]

Physical inactivity has been identified as a leading risk factor for premature mortality globally, and adolescents, in particular, have low physical activity levels. Schools have been identified as a setting to tackle physical inactivity. Economic evidence of school-based physical activity programmes is limited, and the costs of these programmes are not always collected in full. This paper describes a micro-costing and cost-consequence analysis of the ‘Girls Active’ secondary school-based programme as part of a cluster randomised controlled trial (RCT). Micro-costing and cost-consequence analyses were conducted using bespoke cost diaries and questionnaires to collect programme delivery information. Outcomes for the cost-consequence analysis included health-related quality of life measured by the Child Health Utility-9D (CHU-9D), primary care General Practitioner (GP) and school-based (school nurse and school counsellor) service use as part of a cluster RCT of the ‘Girls Active’ programme. Overall, 1,752 secondary pupils were recruited and a complete case sample of 997 participants (Intervention n = 570, Control n = 427) was used for the cost-consequence analysis. The micro-costing analysis demonstrated that, depending upon how the programme was delivered, ‘Girls Active’ costs ranged from £1,054 (£2 per pupil, per school year) to £3,489 (£7 per pupil, per school year). The least costly option was to absorb ‘Girls Active’ strictly within curriculum hours. The analysis demonstrated no effect for the programme for the three main outcomes of interest (health-related quality of life, physical activity and service use).Micro-costing analyses demonstrated the costs of delivering the ‘Girls Active’ programme, addressing a gap in the United Kingdom (UK) literature regarding economic evidence from school-based physical activity programmes. This paper provides recommendations for those gathering cost and service use data in school settings to supplement validated and objective measures, furthering economic research in this field. Trial registration: -ISRCTN, . [ABSTRACT FROM AUTHOR]

Background: Research partnerships between high-income countries (HICs) and low- or middle-income countries (LMICs) are a leading model in research capacity strengthening activities. Although numerous frameworks and guiding principles for effective research partnerships exist, few include the perspective of the LMIC partner. This paper draws out lessons for establishing and maintaining successful research collaborations, based on partnership dynamics, from the perspectives of both HIC and LMIC stakeholders through the evaluation of a research capacity strengthening partnership award scheme.Methods: A mixed-method retrospective evaluation approach was used. Initially, a cross-sectional survey was administered to all award holders, which focused on partnership outputs and continuation. Fifty individuals were purposively selected to participate in interviews or focus group discussions from 12 different institutions in HICs and LMICs; the sample included the research investigators, research assistants, laboratory scientists and post-doctoral students. The evaluation collected data on critical elements of research partnership dynamics such as research outputs, nature of the partnership, future plans and research capacity. Quantitative data were analysed descriptively and qualitative data were analysed using an iterative framework approach.Results: The majority of United Kingdom and African award holders stated they would like to pursue future collaborations together. Key aspects within partnerships that appeared to influence this were; the perceived benefits of the partnership at the individual and institutional level such as publication of papers or collaborative grants; ability to influence 'research culture' and instigate critical thinking among mid-career researchers; previous working relationships, for example supervisor-student relationships; and equity within partnerships linked to partnership formation and experience of United Kingdom partners within LMICs. Factors which may hinder development of long term partnerships were also identified such as financial control or differing expectations of partners.Conclusions: This paper provides evidence of what encourages international research partnerships for capacity strengthening to continue past award tenure, from the perspective of researchers in high and LMICs. Although every partnership is unique and individual experiences subjective, this paper provides extension and support of key principles and mechanisms that can contribute to successful research partnerships between researchers. [ABSTRACT FROM AUTHOR]

This paper revisits the UK productivity puzzle using new data on outputs and inputs and clarifying the role of output mismeasurement, input growth and industry effects. Our data indicate an implied labour productivity gap of 13 percentage points in 2011 relative to the productivity level on pre‐recession trends. We find that: (a) the labour productivity puzzle is a TFP puzzle, since it is not explained by the contributions of labour or capital services; (b) the reallocation of labour between industries deepens rather than explains the puzzle (i.e. there has been a reallocation of hours away from low‐productivity industries and toward high productivity industries); (c) capitalization of R&D does not explain the productivity puzzle; (d) assuming increased scrapping rates since the recession, a 25% (50%) increase in depreciation rates post‐2009 can potentially explain 15% (31%) of the productivity puzzle; (e) industry data show that 35% of the TFP puzzle can be explained by weak TFP growth in the oil & gas and finance sectors; and (f) cyclical effects via factor utilization could potentially explain 17% of the productivity puzzle. Continued weakness in finance would suggest a future lowering of TFP growth to around 0.8% p.a. from a baseline of 0.9% p.a. [ABSTRACT FROM AUTHOR]

Purpose This paper aims to explain how thinking regarding multinationals, competitiveness and location in cities has evolved over the past five decades and how our current understanding and thinking about future challenges is contingent on these previous shifts.Design/methodology/approach The design of the paper is a conceptual piece linking different theoretical strands.Findings Global cities are not always necessarily the key locations for future multinational investments. It depends on the activities taking place. Knowledge and technology and how they interact with the firm’s capabilities and objectives are crucial.Research limitations/implications The implications are that future multinational location choices will be driven by diversity, demography, protectionism, automation and industrial policy.Originality/value This paper provides a roadmap for scholars in the international business and competitiveness fields to understand the current and future challenges facing multinationals and their location behavior. [ABSTRACT FROM AUTHOR]

Background The NHS Five Year Forward View identifies a range of approaches for addressing the NHS's challenges. The Transition movement helps communities to reframe and rebuild their world by working on issues such as climate change, food, community relationships and localizing the economy. Methods This paper describes Transition using five short example projects and, informed by these, identifies mechanisms by which Transition could potentially help reduce pressure on the NHS. Results Transition is characterized by people self-organizing to address local challenges with benefits arising from both the outcomes and the process of the projects. Transition may be able to help the NHS reframe change, prevent disease, improve staff well-being and increase local economic resilience. Discussion The evidence base for the relationship between Transition and health is growing but is not yet well developed. This reflects the complexity of establishing an evidence base for wider determinants of health. There is substantial potential learning for those in the NHS about change outside formal institutional structures. Conclusions Transition provides new ways of thinking and acting to develop greater 'community intelligence', which could help the NHS in the face of increasing pressures. [ABSTRACT FROM AUTHOR]

In this paper we raise a number of issues that are important for the UK to consider in the light of its decision to leave the European Union (EU). The first of these is the nature of the EU Single Market in Electricity and Gas and the UK's role within this. The second is the nature of UK energy policy in the light of Brexit, and the opportunities for changing this. And third, we consider some of the key issues to be addressed in a negotiating position with the EU. [ABSTRACT FROM AUTHOR]

The decision in 1847 to cut Treasury spending on public relief efforts during the Irish famine is generally attributed by economic historians to the pervasive influence of 'laissez-faire' ideas on the Whig government of Lord John Russell. This article draws on the papers of political leaders and contemporary financial information to argue that economic reasons were the trigger for the change in policy. Robert Peel and Charles Wood's macroeconomic policies of the 1840s, including the gold standard, the Bank Charter Act, and corn law repeal, left the Whigs unable to borrow to finance relief efforts in Ireland without panicking markets. The scaling back of public assistance programmes that resulted from this-and which increased mortality at the height of the Irish famine-was the unintended result of Peel and Wood's economic policies, in the context of the Whig government's parliamentary weakness. [ABSTRACT FROM AUTHOR]

Background: Rising cancer incidence, the cost of cancer pharmaceuticals and the introduction of the Cancer Drugs Fund in England, but not other United Kingdom(UK) countries means evidence of 'postcode prescribing' in cancer is important. There have been no systematic reviews considering access to cancer drugs by geographical characteristics in the UK.Methods: Studies describing receipt of cancer drugs, according to healthcare boundaries (e.g. cancer network [UK]) were identified through a systematic search of electronic databases and grey literature. Due to study heterogeneity a meta-analysis was not possible and a narrative synthesis was performed.Results: 8,780 unique studies were identified and twenty-six included following a systematic search last updated in 2015. The majority of papers demonstrated substantial variability in the likelihood of receiving chemotherapy between hospitals, health authorities, cancer networks and UK countries (England and Wales). After case-mix adjustment, there was up to a 4-5 fold difference in chemotherapy utilisation between the highest and lowest prescribing cancer networks. There was no strong evidence that rurality or distance travelled were associated with the likelihood of receiving chemotherapy and conflicting evidence for an effect of travel time.Conclusions: Considerable variation in chemotherapy prescribing between healthcare boundaries has been identified. The absence of associations with natural geographical characteristics (e.g. rurality) and receipt of chemotherapy suggests that local treatment habits, capacity and policy are more influential. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine a case of companies cooperating with the State to prevent a public controversy over nuclear power following the Fukushima disaster and achieve mutually beneficial policy outcomes. It analyses the private and public communication of pro-nuclear corporate, political and regulatory actors. Design/methodology/approach: Drawing on the political economy theory, the study examines how actors mobilised power by accessing an existing social network to agree a joint public communication strategy in order to ensure public support for the continuation of nuclear power generation in the UK. It traces discursive frames from their inception in private communication to their reproduction in public communication and their dissemination via the media. Findings: The study provides evidence of pro-nuclear actors cooperating behind the scenes to achieve consistent public pro-nuclear messaging. It finds evidence of four discursive frames: avoiding knee-jerk reactions, lessons learned, safety and nuclear renaissance. In combination, they guide audiences' evaluation of the consequences of the Fukushima disaster for the UK in favour of continuing the commercial use of nuclear energy. Originality/value: The private e-mail exchange between pro-nuclear actors presents a unique opportunity to examine the mobilisation of less visible forms of power in the form of agenda setting (manipulation) and discursive framing (domination) in order to influence policy outcomes and shape public opinion on nuclear energy. This is problematic because it constitutes a lack of transparency and accountability on part of the State with respect to policy outcomes and restricts the civic space by curtailing the articulation of alternative interests and voices. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is a serious public health challenge and schools have been identified as an ideal place to implement prevention interventions. The aim of this study was to measure the cost-effectiveness of a multi-faceted school-based obesity prevention intervention targeting children aged 6–7 years when compared to ‘usual activities’. Methods: A cluster randomised controlled trial in 54 schools across the West Midlands (UK) was conducted. The 12-month intervention aimed to increase physical activity by 30 minutes per day and encourage healthy eating. Costs were captured from a public sector perspective and utility-based health related outcomes measured using the CHU-9D. Multiple imputation using chained equations was used to address missing data. The cost effectiveness was measured at 30 months from baseline using a hierarchical net-benefit regression framework, that controlled for clustering and prespecified covariates. Any uncertainty in the results was characterised using cost-effectiveness acceptability curves. Results: At 30 months, the total adjusted incremental mean cost of the intervention was £155 (95% confidence interval [CI]: £139, £171), and the incremental mean QALYs gained was 0.006 (95% CI: -0.024, 0.036), per child. The incremental cost-effectiveness at 30 months was £26,815 per QALY and using a standard willingness to pay threshold of £30,000 per QALY, there was a 52% chance that the intervention was cost-effective. Conclusions: The cost-effectiveness of the school-based WAVES intervention was subject to substantial uncertainty. We therefore recommend more research to explore obesity prevention within schools as part of a wider systems approach to obesity prevention. Trial registration: This paper uses data collected by the WAVES trial: Controlled trials (registered May 2010). [ABSTRACT FROM AUTHOR]

Background: Patient and public involvement (PPI) is a requirement for UK health and social care research funding. Evidence for how best to implement PPI in research programmes, such as National Institute for Health Research (NIHR) Collaborations for Applied Health Research and Care (CLAHRCs), remains limited. This paper reports findings from an action research (AR) project called IMPRESS, which aims to strengthen PPI within CLAHRC East of England (EoE). IMPRESS combines AR with Normalisation Process Theory (NPT) to explore PPI within diverse case study projects, identifying actions to implement, test and refine to further embed PPI. Methods: We purposively selected CLAHRC EoE case study projects for in-depth analysis of PPI using NPT. Data were generated from project PPI documentation, semi-structured qualitative interviews with researchers and PPI contributors and focus groups. Transcripts and documents were subjected to abductive thematic analysis and triangulation within case. Systematic across case comparison of themes was undertaken with findings and implications refined through stakeholder consultation. Results: We interviewed 24 researchers and 13 PPI contributors and analysed 28 documents from 10 case studies. Three focus groups were held: two with researchers (n = 4 and n = 6) and one with PPI contributors (n = 5). Findings detail to what extent projects made sense of PPI, bought in to PPI, operationalised PPI and appraised it, thus identifying barriers and enablers to fully embedded PPI. Conclusion: Combining NPT with AR allows us to assess the embeddedness of PPI within projects and programme, to inform specific local action and report broader conceptual lessons for PPI knowledge and practice informing the development of an action framework for embedding PPI in research programmes. To embed PPI within similar programmes teams, professionals, disciplines and institutions should be recognised as variably networked into existing PPI support. Further focus and research is needed on sharing PPI learning and supporting innovation in PPI. [ABSTRACT FROM AUTHOR]

Background In Britain, the tobacco industry segments cigarettes into four price categories—premium, mid-price, economy and ultra-low-price (ULP). Our previous work shows that tobacco companies have kept ULP prices stable in real terms. Roll your own (RYO) tobacco remains cheaper still. Methods Analysis of 2001–08 General Household Survey data to examine trends in use of these cheap products and, using logistic regression, the profile of users of these products. Results Among smokers, the proportion using cheap products (economy, ULP and RYO combined) increased significantly in almost all age groups and geographic areas. Increases were most marked in under 24 year olds, 76% of whom smoked cheap cigarettes by 2008. All cheap products were more commonly used in lower socio-economic groups. Men and younger smokers were more likely to smoke RYO while women smoked economy brands. Smokers outside London and the South East of England were more likely to smoke some form of cheap tobacco even once socio-economic differences were accounted for. Conclusions This paper demonstrates that cheap tobacco use is increasing among young and disadvantaged smokers compromising declines in population smoking prevalence. Thus, tobacco industry pricing appears to play a key role in explaining smoking patterns and inequalities in smoking. [ABSTRACT FROM PUBLISHER]

The window tax provides a dramatic and transparent historical example of the potential distorting effects of taxation. Imposed in England in 1696, the tax-a kind of predecessor of the modern property tax-was levied on dwellings with the tax liability based on the number of windows. The tax led to efforts to reduce tax bills through such measures as the boarding up of windows and the construction of houses with very few windows. In spite of the pernicious health and aesthetic effects and despite widespread protests, the tax persisted for over a century and a half: it was finally repealed in 1851. Our purpose in this paper is threefold. First, we provide a brief history of the tax with a discussion of its rationale, its role in the British fiscal system, and its economic and political ramifications. Second, we have assembled a dataset from microfilms of local tax records during this period that indicate the numbers of windows in individual dwellings. Drawing on these data, we are able to test some basic hypotheses concerning the effect of the tax on the number of windows and to calculate an admittedly rough measure of the excess burden associated with the window tax. Third, we have in mind a pedagogical objective. The concept of excess burden (or 'deadweight loss') is for economists part of the meat and potatoes of tax analysis. But to the laity the notion is actually rather arcane; public-finance economists often have some difficulty, for example, in explaining to taxpayers the welfare costs of tax-induced distortions in resource allocation. The window tax is a textbook example of how a tax can have serious adverse side effects on social welfare. In addition to its objectionable consequences for tax equity, the window tax resulted in obvious and costly misallocations of resources. [ABSTRACT FROM AUTHOR]

Background Children with maltreatment associated psychiatric problems are at increased risk of developing behavioural or mental health disorders. Dyadic Developmental Psychotherapy (DDP) was proposed as treatment for children with maltreatment histories in the USA, however, being new to the UK little is known of its effectiveness or cost-effectiveness. As part of an exploratory study, this paper explores the feasibility of undertaking economic analysis of DDP in the UK. Methods Feasibility for economic analysis was determined by ensuring such analysis could meet key criteria for economic evaluation. Phone interviews were conducted with National Health Service staff and social service therapists trained and accredited or in the process of becoming accredited DDP practitioners. Three models were developed to represent alternative methods of DDP service delivery. Once appropriate comparators were determined, economic scenarios were constructed. Cost analyses were undertaken from a societal perspective. Finally, appropriate outcome measurement was explored through clinical opinion, literature and further discussions with clinical experts. Results Three DDP models were constructed: DDP Full-Basic, DDP Home-Based and DDP Long- Term. Two potential comparator interventions were identified and defined as Consultation with Carers and Individual Psychotherapy. Costs of intervention completion per case were estimated to be: £6,700 (DDP Full-Basic), £7,100 (Consultations with Carers), £7,200 (DDP Home-Based), £11,400 (Individual Psychotherapy) and £14,500 (DDP Long-Term). None of the models of service delivery were found to currently measure effectiveness consistently. The Strengths and Difficulties Questionnaire (SDQ) was deemed an appropriate primary outcome measure, however, it does not cover all disorders DDP intends to treat and the SDQ is not a direct measure of health gain. Inclusion of quality of life measurement is required for comprehensive economic analysis. Conclusions Economic analysis of DDP in the UK is feasible if vital next steps are taken to measure intervention outcomes consistently, ideally with a quality of life measurement. An economic analysis using the models constructed could determine the potential cost-effectiveness of DDP in the UK and identify the most efficient mode of service delivery. [ABSTRACT FROM AUTHOR]

Personhood discourses in dementia care have gained prominence and current care home standards mandate that care should be “person-centred”. However, it is unclear how the personhood of staff is construed within the care relationship. This paper aims to explore how the personhood of paid carers of people with dementia can be understood by focussing on the views and experiences of care home staff. We undertook a secondary qualitative analysis of interviews with 25 paid care staff in England, conducted as part of the MARQUE (Managing Agitation and Raising QUality of lifE) study. The authors inductively developed themes around the topic of personhood for staff, contrasting management and care staff perspectives. We found that many care staff are not identified as persons in their own right by their employing institutions, and that there is a general lack of acknowledgment of the moral work of caring that occurs within formal care work. This oversight can reduce the complex relationships of care work to a series of care tasks, challenges care workers’ self-worth and self-efficacy, and impede their efforts to deliver person-centred care. We conclude that care staff status as persons in their own right should be explicitly considered in quality standards and supported by employers’ policies and practices, not simply for their role in preserving the personhood of people with dementia but for their own sense of valued personhood. Enhancing staff personhood may also result in improved care. [ABSTRACT FROM AUTHOR]

This paper considers two aspects of this question. First, Brexit has already induced a devaluation of sterling of around 14 per cent since June 2016, which has started to work through to consumer prices: between June 2016 and July 2017 consumer prices increased by around 2.5 per cent. Second, while it is not government policy, nor the desire of the UK public, that the outcome of negotiations is a ‘MFN Brexit’, this remains a distinct possibility. Thus we ask how the imposition of tariffs on imports from the EU will work through into consumer prices. Making very conservative assumptions, we conclude that ‘MFN Brexit’ will increase the average cost of living by around 1 per cent and increase it for 8 per cent of households by 2 per cent or more. We present results for different groups of households according to their employment and structural characteristics and show that the impact will generally be largest on unemployed, single parent and pensioner households. [ABSTRACT FROM AUTHOR]

Challenges in the modern National Health Service cannot be underestimated. Workforce pressures alongside increasing demands for healthcare requires creative adaptation to services. This article describes the introduction of interim wound dressing kits into residential homes and the resulting positive improvements to patient care. It details how a clear baseline investigation of a clinical issue, the use of modern technology and adherence to a structured process can achieve project goals. The objective of maintaining patient safety in relation to interim wound care was met, resulting in a reduction of same-day and out-of-hours community nurse visits. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to investigate how organisational learning (OL) can occur through process improvement (PI) activities, leading to sustained improvements over time in the context of small- and medium-sized enterprises (SMEs).Design/methodology/approach The authors study PI practices in six engineering-oriented SMEs via interview-based case studies. The authors draw from a range of literature and use an OL conceptual framework informed by Crossan et al.’s (1999) 4I framework as an analytical lens.Findings The OL perspective provides new insights to conceptualise the nature of PI as a multi-level practice in SMEs. Effective PI practices within SMEs are shown to be consistent with OL concepts, enabling firms to translate individually identified improvement opportunities into organisational-level changes that result in sustained benefits. A new conceptual model is presented that explains how SMEs can learn through improvement activities. The key role of management support, both operational and strategic, is highlighted. It is necessary for management to provide sufficient PI opportunities to enable and sustain beneficial learning.Research limitations/implications The study is based on a sample of engineering-oriented SMEs located in the UK. Further case-based, longitudinal, and survey-based research studies with firms of different types will enhance the generalisability of the findings, allowing the confirmation and extension of the new conceptual model.Practical implications The findings provide a theoretically underpinned framework for achieving OL in engineering-oriented SMEs through PI activities. The new model highlights the key mechanisms that enable learning from improvement activities. The findings highlight the key role played by management in introducing additional learning opportunities in the form of new business that requires exploratory learning. Without this, the reduction in improvement opportunities reduces the benefits that can be realised from PI.Originality/value OL provides a multi-level perspective to understanding how smaller firms are able to undergo systematic improvements and the support required to continually improve. [ABSTRACT FROM AUTHOR]

Financial services constitute an important net export for the UK economy, for which the rest of the EU is the largest market. This paper considers the likely consequences of Brexit for this sector. A 'soft' Brexit, whereby the UK leaves the EU but remains in the single market, would be a lower-risk option for the City than other Brexit options, because it would enable financial services firms to continue to rely on regulatory passporting rights. Under a 'hard' Brexit scenario, where the UK leaves the single market, the UK might in principle be able to benefit from the EU's third country 'equivalence' frameworks for financial services, but these are cumbrous and incomplete alternatives to passporting. UK firms would find it considerably more costly to export to the EU. This would also be a loss to the EU27, because the UK specializes in capital markets services for which the EU, over-reliant on banking, recognizes a need. However, much of this 'UK' activity is provided by subsidiaries of US-headquartered groups. In the event of hard Brexit, these firms may be able to compete just as effectively from New York as from London. If soft Brexit proves politically impossible, it seems highly desirable that the UK push for a transition period of continued EU membership pending at the very least completion of equivalence determinations and, more usefully, the conclusion of a suitable bilateral agreement. [ABSTRACT FROM AUTHOR]

This paper deals with Brexit (the UK's leaving the EU) and its possible impact on the United Kingdom's politics, economy and the future relationship with the European Union. For the majority of businesses in Great Britain the possibility the UK might leave the European Union is a major source of concern. Both the break with the EU and the uncertainty associated with it would be bad for business and damaging to the UK economy as well as the compactness of country due to the independence efforts of its nations. A great deal has now been written on the economic and political consequences for the UK of Brexit. Some of this is impartial; much of it is partisan. Very little has been written on the consequences for the rest of the UK's nations. While the biggest impact of Brexit would be on the United Kingdom, there can be little doubt that there will also be a significant impact on the rest of the European Union. [ABSTRACT FROM AUTHOR]

The aim of this paper is to throw light on the neglected London and Cambridge Economic Service, a collaboration starting in the early 1920s between the London School of Economics and Cambridge University. We find various results. First, the Service was pioneering in its collection and interpretation of British economic data. It was aided in this by the involvement of a host of noted economists from London and Cambridge. That this collaboration took place at all goes against the traditional view that these two institutions were always at loggerheads during the 1920s and 1930s. Second, the Service carried out important theoretical work in many areas, the focus here being on the construction of indices of industrial production. Finally, an examination of the Service's forecasting record in the period leading up to the US stock market crash in October 1929 finds that it did not match up to the promises made at its launch. [ABSTRACT FROM AUTHOR]

Copyright of Journal for Labour Market Research is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

I present a comparative historical study of the economic growth in the four mandate territories of Lebanon, Palestine, Syria, and Trans-Jordan. In all four areas, the ruling western powers, Britain and France, attempted to introduce inclusive economic institutions with a strong emphasis on private property. These institutions advanced economic growth in all four regions, but there were differences in their growth rates. For example, Palestine had the best growth, even though the British were more successful in instituting inclusive institutions in Trans-Jordan. In Palestine, there was also a huge increase in the proximate causes of growth that did not happen in Trans-Jordan. The paper suggests a refined formulation of the relationship between inclusive institutions, proximate causes of growth, and economic growth. Inclusive institutions will generate economic growth, but at a slower pace. If a country is able to enhance its proximate causes of growth, then the joint effect of the proximate causes of growth and inclusive institutions will lead to much quicker growth. [ABSTRACT FROM AUTHOR]

The remit of the National Institute for Health Research Public Health Research (PHR) Programme is to evaluate public health interventions, providing new knowledge on the benefits, costs, acceptability and wider impacts of interventions, set outside of the National Health Service, intended to improve the health of the public and reduce inequalities. This paper illustrates how the PHR Programme is providing new knowledge for public health decision makers, based on the nine key areas for local authority public health action, described by the King's Fund. Many funded PHR projects are evaluating interventions, applied in a range of settings, across the identified key areas for local authority influence. For example, research has been funded on children and young people, and for some of the wider determinants of health, such as housing and travel. Other factors, such as spatial planning, or open and green spaces and leisure, are less represented in the PHR Programme. Further opportunities in research include interventions to improve the health of adolescents, adults in workplaces, and communities. Building evidence for public health interventions at local authority level is important to prioritise and implement effective changes to improve population health. [ABSTRACT FROM AUTHOR]

Background: The UK National Health Service Health Checks programme aims to reduce avoidable cardiovascular deaths, disability and health inequalities in England. However, due to the reported lower uptake of screening in specific black and minority ethnic communities who are recognised as being more at risk of cardiovascular disease, there are concerns that NHS Health Checks may increase inequalities in health. This study aimed to examine the feasibility and acceptability of community outreach NHS Health Checks targeted at the Afro-Caribbean community.Methods: This paper reports findings from an ethnographic study including direct observation of four outreach events in four different community venues in inner-city Bristol, England and follow up semi-structured interviews with attendees (n = 16) and staff (n = 4). Interviews and field notes were transcribed, anonymized and analysed thematically using a process of constant comparison.Results: Analysis revealed the value of community assets (community engagement workers, churches, and community centres) to publicise the event and engage community members. People were motivated to attend for preventative reasons, often prompted by familial experience of cardiovascular disease. Attendees valued outreach NHS Health Checks, reinforcing or prompting some to make healthy lifestyle changes. The NHS Health Check provided an opportunity for attendees to raise other health concerns with health staff and to discuss their test results with peers. For some participants, the communication of test results, risk and lifestyle information was confusing and unwelcome. The findings additionally highlight the need to ensure community venues are fit for purpose in terms of assuring confidentiality.Conclusions: Outreach events provide evidence of how local health partnerships (family practice staff and health trainers) and community assets, including informal networks, can enhance the delivery of outreach NHS Health Checks and in promoting the health of targeted communities. To deliver NHS Health Checks effectively, the location and timing of events needs to be carefully considered and staff need to be provided with the appropriate training to ensure patients are supported and enabled to make lifestyle changes. [ABSTRACT FROM AUTHOR]

The UK economy is facing an unusual level of uncertainty because of Brexit. This uncertainty primarily stems from the yet to be defined relationship between the UK and the EU but also from the economy's response to the new framework once it emerges. The UK government's White Paper, which set out its preferences for that new relationship, has failed to unite the government or Parliament, leaving open an entire spectrum of possible outcomes. Our central forecast under a ‘soft Brexit’ scenario is that the economy will grow at a pace that is consistent with its potential. This translates to annual GDP growth of 1.4 per cent this year and 1.7 per cent next year, which is broadly unchanged from our previous forecast. The risks to our GDP growth forecast are wider than before and tilted to the downside. As before, we condition our forecast on a gentle path of monetary policy normalisation with the next 25 basis point rate increase this month. On the fiscal side, we recommend that the government maintains its current level of spending (as a share of GDP) and raises the quality of public services. [ABSTRACT FROM AUTHOR]

Background: A number of significant recent research studies have used techniques of economic modelling to demonstrate the potential benefits of increasing breastfeeding rates in the UK overall, and specifically in neonatal care. This paper complements this growing body of evidence by presenting an economic analysis of data from an actual intervention, the ‘Getting It Right From the Start' programme, which took place in the north of the UK during 2011-12, with the aim of increasing breastfeeding and kangaroo skin-to-skin care rates in neonatal units. Methods: ‘Getting It Right from the Start' was a pragmatic, multifaceted programme of change delivered under the auspices of the regional Health Innovation and Education Cluster, of which 17 were established in the UK in 2010. It engaged with 18 neonatal units in two Neonatal Networks with the aim of increasing kangaroo skin-to-skin care and breastfeeding rates. As part of the evaluation of the programme, we conducted an economic study comparing the overall costs and benefits of the intervention. Results: Overall, the economic analysis demonstrated that for every £1 invested in the intervention to increase kangaroo skin-to-skin care and breastfeeding rates, between £4.00 and £13.82 of benefit was generated. This was spread across different healthcare settings and the timescale for the realisation of benefits will vary. The increases in kangaroo skin-to-skin care generated the greatest cost savings, with potential cost savings ranging between £668,000 (minimum cost assumptions) to more than £2 m (maximum cost assumptions). Increases in breastfeeding associated with the project generated between £68,486 and £582,432. The majority of the cost savings generated were associated with reductions in cases of gastroenteritis and necrotising enterocolitis. Conclusion: This was one of the first economic evaluations of an actual intervention to increase breastfeeding and kangaroo skin-to-skin care in neonatal units. It complements the existing economic models by demonstrating that a real intervention in clinical practice was both cost effective as well as clinically beneficial. Future interventions with similar methodology should be supported and considered likely to generate significant cost savings compared to outlay. Economic evaluation should be more frequently included in studies of practical interventions in clinical settings to increase breastfeeding. [ABSTRACT FROM AUTHOR]

Background: Migraine is the world's second most common disabling disorder, affecting 15% of UK adults and costing the UK over £1.5 billion per year. Several costly new drugs have been approved by National Institute for Health and Care Excellence. Aim: To assess the cost-effectiveness of drugs used to treat adults with chronic migraine. Methods: We did a systematic review of placebo-controlled trials of preventive drugs for chronic migraine. We then assessed the cost-effectiveness of the currently prescribable drugs included in the review: Onabotulinum toxin A (BTA), Eptinezumab (100mg or 300mg), Fremanezumab (monthly or quarterly dose), Galcanezumab or Topiramate, each compared to placebo, and we evaluated them jointly. We developed a Markov (state-transition) model with a three-month cycle length to estimate the costs and quality-adjusted life years (QALYs) for the different medications from a UK NHS and Personal Social Services perspective. We used a two-year time horizon with a starting age of 30 years for the patient cohort. We estimated transition probabilities based on monthly headache days using a network meta-analysis (NMA) developed by us, and from published literature. We obtained costs from published sources and applied discount rates of 3.5% to both costs and outcomes. Results: Deterministic results suggest Topiramate was the least costly option and generated slightly more QALYs than the placebo, whereas Eptinezumab 300mg was the more costly option and generated the most QALYs. After excluding dominated options, the incremental cost-effectiveness ratio (ICER) between BTA and Topiramate was £68,000 per QALY gained and the ICER between Eptinezumab 300mg and BTA was not within plausible cost-effectiveness thresholds. The cost-effectiveness acceptability frontier showed that Topiramate is the most cost-effective medication for any amount the decision maker is willing-to-pay per QALY. Conclusions: Among the various prophylactic medications for managing chronic migraine, only Topiramate was within typical cost-effectiveness threshold ranges. Further research is needed, ideally an economic evaluation alongside a randomised trial, to compare these newer, expensive CGRP MAbs with the cheaper oral medications. [ABSTRACT FROM AUTHOR]

This article offers a methodological tool that assesses a company's commitment to sustainability by analysing its business model (which is defined here as a description of processes through which organizations implement their competitive strategies and create value). Insofar as they are considered a key driver for long-term profitability, sustainability strategies should involve a company's value creation processes — that is, a company's business model. This paper specifically examines the extent to which mining companies engage in sustainability by performing content analyses of their business model disclosures. Our empirical analysis focuses on the UK mining industry because this sector often struggles with a host of societal, organizational, and environmental issues, and because UK mining companies are obliged to describe their business model in their strategic reports. In order to determine whether (and how) companies implement sustainability strategies in their business model, we perform a content analysis of the business model disclosures of 16 FTSE All-share index UK mining companies, for a total of 1048 text units. Our results suggest that mining companies have opted for a selective and soft approach to sustainability. Although Air, Energy, Water, Local community engagement, Environmental protection, and Labour conditions are often addressed in the business models of UK mining companies, there is very little evidence to suggest that concrete initiatives were actually implemented in other areas. In fact, some topics are completely ignored (Raw materials), almost completely ignored (Waste, Corruption and Lobbying, Local employment), or discussed in a predominantly descriptive manner (Human rights, Opportunity and equality, Recruitment and bargaining, Training). The practical implications of this study are twofold. First, we offer a new means of investigating how companies engage in sustainability by performing content analyses of their business model disclosures. Secondly, we offer a detailed discussion of how sustainability affects value creation processes in the UK mining industry. [ABSTRACT FROM AUTHOR]

This unique evaluation aimed to estimate, the financial impact of non‐attendance on a nation‐wide hospital lymphoedema service. Along with gaining some understanding of patient characteristics of those who Did Not Attend (DNA) and were subsequently discharged. The evaluation design interrogated existing performance data from 2012 to 2022. This information was used to estimate the costs incurred based on national published sources and pay scales. Staffing costs of over £1.1 m in one decade related to the financial impact of over 23 000 unattended lymphoedema appointments. The characteristics of 870 patients from 2019/2020 were also evaluated suggesting that those with a wound alongside complex lymphoedema were less likely to DNA appointments. Two‐thirds of patients were managing two or more comorbidities—obesity, cardiac conditions and diabetes being the most common. It seems likely that some DNAs are avoidable by adapting appointment administrative processes and greater understanding of patients' perception of value. However, the reasons for DNA are likely to be varied and nuanced so potentially a small proportion are unavoidable. Modernising appointment processes and identifying patient value may help minimise DNA costs in the future. [ABSTRACT FROM AUTHOR]

Background: From April 6th 2015, all small shops in the UK were required to cover up tobacco products at point of sale (POS) to protect children from exposure. As part of a larger 5-year study to measure the impact of the legislation in Scotland, an audit was conducted to assess level and nature of compliance with the ban immediately following its introduction. Materials and Methods: A discreet observational audit was conducted 7–14 days post implementation which took measures of physical changes made to cover products, server/assistant practices, tobacco signage and advertising, and communication of price information. The audit was conducted in all small retail outlets (n = 83) selling tobacco in four communities in Scotland selected to represent different levels of urbanisation and social deprivation. Data were analysed descriptively. Results: Compliance with the legislation was high, with 98% of shops removing tobacco from permanent display and non-compliance was restricted almost entirely to minor contraventions. The refurbishment of shops with new or adapted tobacco storage units resulted in the removal of nearly all commercial brand messages and images from POS, dropping from 51% to 4%. The majority of shops stored their tobacco in public-facing storage units (81%). Most shops also displayed at least one generic tobacco message (88%). Conclusions: Compliance with Scottish prohibitions on display of tobacco products in small retail outlets was high immediately after the legislation implementation date. However, although tobacco branding is no longer visible in retail outlets, tobacco storage units with generic tobacco messages are still prominent. This points towards a need to monitor how the space vacated by tobacco products is utilised and to better understand how the continuing presence of tobacco storage units influences people’s awareness and understanding of tobacco and smoking. Countries with existing POS bans and who are considering such bans should pay particular attention to regulations regarding the use of generic signage and where within the retail setting tobacco stocks can be stored. [ABSTRACT FROM AUTHOR]

Background: Government- and charity-funded medical research and private sector research and development (R&D) are widely held to be complements. The only attempts to measure this complementarity so far have used data from the United States of America and are inevitably increasingly out of date. This study estimates the magnitude of the effect of government and charity biomedical and health research expenditure in the United Kingdom (UK), separately and in total, on subsequent private pharmaceutical sector R&D expenditure in the UK.Methods: The results for this study are obtained by fitting an econometric vector error correction model (VECM) to time series for biomedical and health R&D expenditure in the UK for ten disease areas (including 'other') for the government, charity and private sectors. The VECM model describes the relationship between public (i.e. government and charities combined) sector expenditure, private sector expenditure and global pharmaceutical sales as a combination of a long-term equilibrium and short-term movements.Results: There is a statistically significant complementary relationship between public biomedical and health research expenditure and private pharmaceutical R&D expenditure. A 1% increase in public sector expenditure is associated in the best-fit model with a 0.81% increase in private sector expenditure. Sensitivity analysis produces a similar and statistically significant result with a slightly smaller positive elasticity of 0.68. Overall, every additional £1 of public research expenditure is associated with an additional £0.83-£1.07 of private sector R&D spend in the UK; 44% of that additional private sector expenditure occurs within 1 year, with the remainder accumulating over decades. This spillover effect implies a real annual rate of return (in terms of economic impact) to public biomedical and health research in the UK of 15-18%. When combined with previous estimates of the health gain that results from public medical research in cancer and cardiovascular disease, the total rate of return would be around 24-28%.Conclusion: Overall, this suggests that government and charity funded research in the UK crowds in additional private sector R&D in the UK. The implied historical returns from UK government and charity funded investment in medical research in the UK compare favourably with the rates of return achieved on investments in the rest of the UK economy and are greatly in excess of the 3.5% real annual rate of return required by the UK government to public investments generally. [ABSTRACT FROM AUTHOR]

Recently continuous cover forestry (CCF) has become an accepted approach to forest management in Britain, but uncertainty about its economic consequences may be a barrier to its wider use. A study was carried out to examine the costs and revenues of transforming a stand of Sitka spruce (Picea sitchensis (Bong.) Carr.) to CCF. The main conclusion is that transformation to CCF need not be more costly than clearfelling and replanting if natural regeneration is successful and the aim is to produce a simple canopy structure. The long-term value of transformation to a more complex canopy structure, with three or more strata, is lower and the extra costs need to be justified in terms of management objectives. The main output from the study is an analysis spreadsheet that empowers practitioners and policy makers to investigate the effects of costs, revenues and discount rates on estimates of net present value over 20 years, 100 years and in perpetuity, to suit local conditions. This paper summarises the method and results of the study in a British context, sets these in a wider international context, and considers the merits, applications and possible further developments of the approach. [ABSTRACT FROM AUTHOR]

Background: Overconsumption of energy from food is a major contributor to the high rates of overweight and obesity in many populations. There is growing evidence that interventions that target the food environment may be effective at reducing energy intake. The current study aimed to estimate the effect of decreasing the proportion of higher energy (kcal) foods, with and without reducing portion size, on energy purchased in worksite cafeterias.Methods and Findings: This stepped-wedge randomised controlled trial (RCT) evaluated 2 interventions: (i) availability: replacing higher energy products with lower energy products; and (ii) size: reducing the portion size of higher energy products. A total of 19 cafeterias were randomised to the order in which they introduced the 2 interventions. Availability was implemented first and maintained. Size was added to the availability intervention. Intervention categories included main meals, sides, cold drinks, snacks, and desserts. The study setting was worksite cafeterias located in distribution centres for a major United Kingdom supermarket and lasted for 25 weeks (May to November 2019). These cafeterias were used by 20,327 employees, mainly (96%) in manual occupations. The primary outcome was total energy (kcal) purchased from intervention categories per day. The secondary outcomes were energy (kcal) purchased from nonintervention categories per day, total energy purchased per day, and revenue. Regression models showed an overall reduction in energy purchased from intervention categories of -4.8% (95% CI -7.0% to -2.7%), p < 0.001 during the availability intervention period and a reduction of -11.5% (95% CI -13.7% to -9.3%), p < 0.001 during the availability plus size intervention period, relative to the baseline. There was a reduction in energy purchased of -6.6% (95% CI -7.9% to -5.4%), p < 0.001 during the availability plus size period, relative to availability alone. Study limitations include using energy purchased as the primary outcome (and not energy consumed) and the availability only of transaction-level sales data per site (and not individual-level data).Conclusions: Decreasing the proportion of higher energy foods in cafeterias reduced the energy purchased. Decreasing portion sizes reduced this further. These interventions, particularly in combination, may be effective as part of broader strategies to reduce overconsumption of energy from food in out-of-home settings.Trial Registration: ISRCTN registry ISRCTN87225572. [ABSTRACT FROM AUTHOR]

Background In responding to Covid-19, governments have tried to balance protecting health while minimizing gross domestic product (GDP) losses. We compare health-related net benefit (HRNB) and GDP losses associated with government responses of the UK, Ireland, Germany, Spain and Sweden from UK healthcare payer perspective. Methods We compared observed cases, hospitalizations and deaths under 'mitigation' to modelled events under 'no mitigation' to 20 July 2020. We thus calculated healthcare costs, quality adjusted life years (QALYs), and HRNB at £20,000/QALY saved by each country. On per population (i.e. per capita) basis, we compared HRNB with forecast reductions in 2020 GDP growth (overall or compared with Sweden as minimal mitigation country) and qualitatively and quantitatively described government responses. Results The UK saved 3.17 (0.32–3.65) million QALYs, £33 (8–38) billion healthcare costs and £1416 (220–1637) HRNB per capita at £20,000/QALY. Per capita, this is comparable to £1455 GDP loss using Sweden as comparator and offsets 46.1 (7.1–53.2)% of total £3075 GDP loss. Germany, Spain, and Sweden had greater HRNB per capita. These also offset a greater percentage of total GDP losses per capita. Ireland fared worst on both measures. Countries with more mask wearing, testing, and population susceptibility had better outcomes. Highest stringency responses did not appear to have best outcomes. Conclusions Our exploratory analysis indicates the benefit of government Covid-19 responses may outweigh their economic costs. The extent that HRNB offset economic losses appears to relate to population characteristics, testing levels, and mask wearing, rather than response stringency. [ABSTRACT FROM AUTHOR]

There are many structural problems facing the UK at present, from a weakened National Health Service to deeply ingrained inequality. These challenges extend through society to clinical practice and have an impact on current mental health research, which was in a perilous state even before the coronavirus pandemic hit. In this editorial, a group of psychiatric researchers who currently sit on the Academic Faculty of the Royal College of Psychiatrists and represent the breadth of research in mental health from across the UK discuss the challenges faced in academic mental health research. They reflect on the need for additional investment in the specialty and ask whether this is a turning point for the future of mental health research. [ABSTRACT FROM AUTHOR]

It's official: The UK is in a recession. The economy has suffered its biggest slump on record with a drop in gross domestic product (GDP) of 20.4%. 1 This is going to have a significant impact on our health and well-being. It risks creating a spiralling decay as we know good health is not only a consequence, but also a condition for sustained and sustainable economic development. 2 In this way, the health of a nation creates a virtuous circle of improved health and improved economic prosperity. How we measure prosperity is therefore important and needs to be considered. [ABSTRACT FROM AUTHOR]

Policy PointsNudges steer people toward certain options but also allow them to go their own way. "Dark nudges" aim to change consumer behavior against their best interests. "Sludge" uses cognitive biases to make behavior change more difficult.We have identified dark nudges and sludge in alcohol industry corporate social responsibility (CSR) materials. These undermine the information on alcohol harms that they disseminate, and may normalize or encourage alcohol consumption.Policymakers and practitioners should be aware of how dark nudges and sludge are used by the alcohol industry to promote misinformation about alcohol harms to the public. Context: "Nudges" and other behavioral economic approaches exploit common cognitive biases (systematic errors in thought processes) in order to influence behavior and decision‐making. Nudges that encourage the consumption of harmful products (for example, by exploiting gamblers' cognitive biases) have been termed "dark nudges." The term "sludge" has also been used to describe strategies that utilize cognitive biases to make behavior change harder. This study aimed to identify whether dark nudges and sludge are used by alcohol industry (AI)–funded corporate social responsibility (CSR) organizations, and, if so, to determine how they align with existing nudge conceptual frameworks. This information would aid their identification and mitigation by policymakers, researchers, and civil society. Methods: We systematically searched websites and materials of AI CSR organizations (e.g., IARD, Drinkaware, Drinkwise, Éduc'alcool); examples were coded by independent raters and categorized for further analysis. Findings: Dark nudges appear to be used in AI communications about "responsible drinking." The approaches include social norming (telling consumers that "most people" are drinking) and priming drinkers by offering verbal and pictorial cues to drink, while simultaneously appearing to warn about alcohol harms. Sludge, such as the use of particular fonts, colors, and design layouts, appears to use cognitive biases to make health‐related information about the harms of alcohol difficult to access, and enhances exposure to misinformation. Nudge‐type mechanisms also underlie AI mixed messages, in particular alternative causation arguments, which propose nonalcohol causes of alcohol harms. Conclusions: Alcohol industry CSR bodies use dark nudges and sludge, which utilize consumers' cognitive biases to promote mixed messages about alcohol harms and to undermine scientific evidence. Policymakers, practitioners, and the public need to be aware of how such techniques are used to nudge consumers toward industry misinformation. The revised typology presented in this article may help with the identification and further analysis of dark nudges and sludge. [ABSTRACT FROM AUTHOR]

Background Parallels have been drawn between the 'Great Depression' of the 1930s and the more recent 'Great Recession' that followed the 2007/8 financial crisis. Austerity was the common policy response by UK governments in both time periods. This article examines health inequalities at a local level in the 1930s, through a historical case study. Methods Local and national historical archives, Medical Officer for Health reports, and secondary sources were examined from 1930 to 1939 to obtain data on inequalities in health (infant mortality rates, stillbirths and neonatal mortality rates, 1935 and crude overall mortality rates, 1936) and ward-level deprivation (over-crowding rates, 1935) in Stockton-on-Tees, North-East England. Results There were high geographical inequalities in overcrowding and health in Stockton-on-Tees in the 1930s. Rates of overall mortality, in particular, were higher in those wards with higher levels of overcrowding. Conclusions There were geographical inequalities in health in the 1930s and the most deprived areas had the worst overall mortality rates. The areas with the worst housing conditions and health outcomes in the 1930s remain so today - health inequality is extant over time across different periods of austerity. [ABSTRACT FROM AUTHOR]

Public goods and services such as prisons are often underfunded compared with private goods and services. Social impact bonds (SIBs) are a new financial vehicle to increase the use of private funds for public good. SIBs use a paid‐for‐success, performance‐based structure to reallocate risk and reward. In the current case, the SIB changes a critical reinforcing loop from a vicious cycle of decay to a virtuous cycle of improvement that can perpetuate SIB benefits far after the bond has been repaid. A simulation model of recidivism at Her Majesty's Prison (HMP) Peterborough and the related SIB is developed to identify high‐leverage parameters and dominant feedback loops. These are used to explain SIB success or failure for two primary participants (HMP system and SIB investors). Model analysis also reveals a tipping point structure that puts the Peterborough programme at risk. Contributions include a formal SIB model, improved understanding of SIB structure and behaviour, an example of tipping point structures in a social system and recommendations concerning SIB design and management. [ABSTRACT FROM AUTHOR]

Objective: To explore, through face to face interviews with a selection of General Dental Practitioners (GDPs), their views and experiences of having used the International Caries Detection and Assessment System (ICDAS) within primary care research studies for recording caries. Methods: This qualitative study involved one on one interviews with eight GDP’s who had previously used ICDAS on patients in their dental practices as part of a research study. The participants were selected from among those who had taken part in two clinical studies in the UK using convenient, but purposive sampling. The interviews were tape-recorded and transcribed; the data analysis was conducted by thematic analysis. Results: GDP’s indicated their beliefs that ICDAS had an important role in caries prevention but reported four main barriers while using the full (6 caries stages) ICDAS coding system in their practices: lack of simplicity of coding, financial implications and time consumption (in both training and use of ICDAS) and inadequate undergraduate training. An overarching theme identified from the GDPS was the willingness to offer potential solutions to their barriers which might improve the utilisation of the system in primary care. Conclusion: The GDPs experienced common obstacles in using ICDAS in the primary care setting, many of which have relatively straight-forward solutions which they put forward themselves such as: incentivisation, undergraduate-level training in ICDAS for both dentists and nurses and computerized data entry. Further qualitative and quantitative research is needed on how to facilitate the utilisation of the system in dental practice. It is also recommended to explore the influences of wider agencies on influencing primary dental care professionals’ caries management, including appropriate recording of diagnosis and risk assessment. [ABSTRACT FROM AUTHOR]