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IntroductionDevelopments in information and communication technologies have enabled electronic health and seen a huge expansion over the last decade. This has increased the possibility of self-management of health issues.PurposeTo assess the effectiveness of the Baby Buddy app on maternal self-efficacy and mental well-being three months post-birth in a sample of mothers recruited antenatally. In addition, to explore when, why and how mothers use the app and consider any benefits the app may offer them in relation to their parenting, health, relationships or communication with their child, friends, family members or health professionals. METHODS: We will use a mixed-methods approach, a cohort study, a qualitative element and analysis of in-app data. Participants will be first-time pregnant women, aged 16 years and over, between 12 and 16 weeks of gestation and recruited from five English study sites.Evaluation planWe will compare maternal self-efficacy and mental health at three months post-delivery in mothers who have downloaded the Baby Buddy app compared with those that have not downloaded the app, controlling for confounding factors. Women will be recruited antenatally between 12 and 16 weeks of gestation. Further follow-ups will take place at 35 weeks of gestation and three months post-birth. Data from the cohort study will be supplemented by in-app data that will include, for example, patterns of usage. Qualitative data will assess the impact of the app on the lives of pregnant women and health professionals using both focus groups and interviews.EthicsApproval from the West Midlands-South Birmingham Research Ethics Committee (NRES) (16/WM/0029) and the University of the West of England, Bristol, Research Ethics Committee (HAS.16.08.001).DisseminationFindings of the study will be published in peer reviewed and professional journals, presented locally, nationally and at international conferences. Participants will receive a summary of the findings and the results will be published on Best Beginnings' website.

Despite the limited exception introduced by statute in 1974, the principle that truth is and ought to be a complete defence to all actions in defamation is typically regarded as self-evident in modern English law. The fact that England stands here against not only the whole of the civilian tradition but also a number of common-law jurisdictions suggests, however, that it is not. This paper, after surveying the history of the principle in English law and the debates that it has spurred in the past, argues that English law is right on this question, but needs to understand more cogently why. This, in turn, requires an examination of the interests protected by the cause of action. It is only if we accept that it is, and is solely, reputation founded in character that the defence of veritas will be secured. [ABSTRACT FROM AUTHOR]

In 1998, a review for the Ministry of Agriculture Fisheries and Food (the predecessor of the Food Standards Agency) was published evaluating the relative merits of different dietary assessment methods against a series of factors likely to affect compliance or accuracy in low-income households. The review informed the design of a method comparison study carried out in London, UK, in 2001, in which the validity and acceptability of 4 d dietary assessment methods based on 24 h recalls, food checklists and a semi-weighed method were compared with 4 d weighed inventories and other reference measures. Results were based on observations in 384 respondents (159 males, 225 females) aged 2-90 years in 240 households. Outcomes of the comparison study included evaluations of each method made by respondents, interviewers and researchers. These findings were used in the present paper to update and extend the 1998 review. Additional factors not included in the 1998 review have been considered. This updated and extended review provides the basis for discussion of the relative merits of approaches to dietary assessment in low-income households in developed economies. The evidence presented here and elsewhere suggests that the 24 h recall is the method best suited for dietary assessment in low-income households, followed by the weighed inventory, food checklist and lastly the semi-weighed method. [ABSTRACT FROM AUTHOR]

Meeting individuals' social care needs is a core element of UK social policy. However, the conceptualisation and operationalisation of 'unmet need' remain a challenge. This paper advances our understanding by incorporating a temporal dimension into the conceptual framework on unmet need to investigate the dynamics of met and unmet need for social care over time. Using data from Waves 8 and 9 of the English Longitudinal Study of Ageing, this paper examines five possible trajectories among individuals with a social care need for bathing or dressing at baseline: (a) no longer having such a need; (b) having continued needs met; (c) delayed needs met; (d) newly arisen unmet needs; and (e) repeated unmet needs. The results indicate that amongst those with need at baseline, unmet need has decreased over time – indicating that some needs for social care may be fulfilled with a delay. However, a significant proportion of older people experienced repeated unmet needs, particularly those who were younger, with no spouse or civil partner, and those whose activities of daily living index scores worsened over time. Understanding the dynamics of unmet need can support policy makers in better ensuring that those facing an elevated risk of repeated unmet need over time do not fall through the social care safety net. [ABSTRACT FROM AUTHOR]

When governments acquire third-party social welfare services (SWS), they create institutions of acquisition. The rules and practices that governments adopt define who is able to participate, on what basis, and how prices are determined. This paper conceptualizes the institutions of SWS acquisition, their variations, and implications, in order to contribute to a deeper understanding of the link between contracting and nonprofit commercialisation. Institutions of SWS acquisition include rules of entry, participation, and assessment. Resulting acquisition regimes can be marketised to a greater or lesser extent, and this is influential through its effect on nonprofit competition. Drawing on interviews with public servants and nonprofit staff, the paper compares acquisition regimes for homelessness services in England, a regime that closely resembles a market, and Canada, a regime which is not marketised. In contrast to their non-marketised counterparts, this paper finds that marketised SWS acquisition regimes create incentives for participants to reduce prices by loss-leading or ratcheting down service quality. [ABSTRACT FROM AUTHOR]

The number of older self-funders in England is growing in the context of tight eligibility criteria and fixed financial thresholds to access statutory adult social care. Older people who self-fund their social care fall largely under the radar of statutory services and of research. Our study aimed to listen closely to the stories that older people tell about finding, managing and paying for their care. We interviewed 65 older people living in the community who were funding all or some of their social care. This paper focuses on narrative analysis of selected transcripts from these interviews. It sheds light on how older people represent their experiences of self-funding and what underpins these constructions. A key finding is that the disjunctions within older people's accounts between the care they want and the care they receive reflect wider political and structural tensions in the funding and delivery of care. Older self-funders temper their expectations in light of their experience of shortfalls in the system. This enables them to adjust to the deficiencies but obscures and perpetuates poor care. The discussion considers the findings in relation to: the fundamental incompatability of body labour and commodified care; the shared precarity of older people and care workers; and the individualisation of risks that makes older people and their carers responsible for making a failing care system 'work'. Our analysis adds to the case for major reform of adult social care, including a revaluing of the status and employment conditions of front-line care workers. [ABSTRACT FROM AUTHOR]

After the publication of the Government's 'Levelling Up' White Paper, this paper reviews the role of institutions and governance structures across English regions in tackling spatial inequality and low productivity. It considers the recent history and changing roles of local and regional organisations and the overarching policy frameworks that oversee them as a key element of tackling spatial inequality and low productivity. Specifically, the paper looks at the frequent changes to institutional arrangements supporting economic development and the process of allocating competitive funds to local and regional bodies. [ABSTRACT FROM AUTHOR]

In the years around 1968 London was home to a sizeable community of writers, musicians, artists, and political activists whose countercultural attitudes are expressed in the publications of the ‘alternative’ or ‘underground’ press – magazines such as International Times, OZ, INK, Friends (later Frendz), Time Out, Gandalf's Garden, The Black Dwarf, and The Hustler. That most of them had at least some pages devoted to music reflected the crucial role of rock in particular in summing up the community's aspirations, focused less on political or social than on cultural transformation. This article seeks to chart in these underground publications the changing attitudes towards music and its revolutionary potential. Initially the alternative press portrayed popular music as sharing with avant-garde tendencies a basic equation between new creative means and their would-be disruptive effects on society as a whole. However, there soon arose contradictions between the radical social potential of music and its growing commercialization, contradictions stemming not only from the co-optation of rock by market forces and record companies but also from the underground's own lack of a coherent ideological agenda. Paradoxically, it was precisely when popular music began to be considered a form of ‘high’ culture – just as the alternative press advocated – that its perceived effectiveness as part of the revolutionary, countercultural project began to diminish. [ABSTRACT FROM AUTHOR]

Social care to assist with the activities of daily living is a necessity for many older people; while informal care provided by family members can be a first step to meeting care needs, formal care provided by professionals is often needed or preferred by older people and their families. In England, the number of older people paying for formal care is set to rise, driven by an ageing population and the limited resources of local authorities. Little is known about how older people and their families experience the potentially disruptive processes of deciding upon, searching for and implementing such care, including the financial implications. This paper explores accounts of seeking self-funded social care in England, told by older people and their families in 39 qualitative interviews. These accounts, which we call 'care chronicles', include stories about the emergence of care needs and informal care-giving, the search for formal care, including interacting with new systems and agencies, and getting formal (paid) care, either as the recipient or an involved family member. Stories are analysed through the lens of biographical disruption, and analysis demonstrates that such disruptions can occur for older people and their families across the entirety of the care chronicle. Needing, seeking and getting care all have the potential to cause practical and symbolic disruptions; moreover, these disruptions can be cumulative and cyclical, as attempts to resolve or minimise one disruption can lead to new ones. While the concept of biographical disruption is a mainstay in medical sociology, it is less frequently applied to issues relating to social care, and most often takes embodiment as a key focus. This study is novel in its application of the concept to experiences of seeking self-funded care, and in its introduction of the concept of 'care chronicles', which invite a longer and broader view of biographical disruptions in the lives of older people with care needs and their families. [ABSTRACT FROM AUTHOR]

The pressure on mental health services has not gone unremarked and is of widespread concern in England and Wales. This can have implications when a bed is being sought for a patient who has undergone a Mental Health Act assessment and is deemed to meet the criteria for being formally admitted to hospital. Once the 24 h period for assessment under section 136 of the Act has lapsed, the ongoing detention of the patient can lead to a legal grey area. Through a fictional example this paper examines the relevant case law and statute that may be used to continue the detention and explores the ethical problems that this may cause. [ABSTRACT FROM AUTHOR]

Secure property rights are usually considered to be essential for sustained economic development. In England, it is debated whether property rights have been secure since the medieval period or if they were only established after the Glorious Revolution. In this context, the paper examines the Court of Wards, which from 1540 to 1646 administered the Crown's right to take custody of children and their lands when these were held by feudal-military tenures. The paper shows that wardship was a common occurrence, its exactions arbitrary but often heavy, and that it reduced the value of lands held by these tenures. [ABSTRACT FROM AUTHOR]

This paper takes, as its starting point, Preston and Haines' observation in Fatal Years that social class was the most important influence on infant and child mortality in England and Wales in the early twentieth century. A subsequent study suggested that this could in part be due to the spatial distribution of the different classes across different types of place, and that some of the mortality differences by social class might actually reflect the contextual effects of healthy and unhealthy places. Although this line of argument has received a considerable amount of attention in health geography literature, it has rarely been examined for a specific historic period, and then only within particular urban areas. In this paper, we apply multi-level models to a complete count individual-level dataset of the 1911 census of England and Wales, comparing influences on infant and child mortality at the level of the individual couple and for two spatial levels. We find that although most variation in infant and child mortality operates at the individual level, there is also important variation at the two spatial levels and part of the mortality differences between social classes is better explained by the areas in which people lived rather than by their social class. A consideration of independent variables at all three levels suggests that different spatial scales capture different sorts of influences on early age mortality. [ABSTRACT FROM AUTHOR]

User participation has become one of the most important concepts in the social care sector in many European countries, but the literature has mostly paid attention to disabled people or those with mental health problems. This article compares the user participation policies directed at social care for older people in Norway and England. Using a discourse analytical approach, a selection primarily of White papers from the 1960s until today are analysed. The analysis draws on the literature's discourse discussion, including a democratic/rights based discourse (full citizenship), a consumer discourse (consumers' rights to choose welfare services), a co-production discourse (users and state/local authorities partnerships), and nuances of these discourses. The analysis shows that, while both countries start with variations of a democratic discourse, Norway develops a temporary and weak consumer discourse in a middle phase, then moves to co-production in current times. England, on the other hand, develops a comprehensive consumer discourse but also a surprisingly strong co-production discourse – the idea of a 'Big Society' – in early and current times. [ABSTRACT FROM AUTHOR]

Information about the topics discussed at the fifteenth biennial International Conference on Baroque Music held at the University of Southampton in England on July 11-15, 2012 is presented. The event featured several papers including "Sources and Performance," "Bach and the Magnificat" and "Approaches to Bach." The Music Department of the University of Southampton hosted the said event.

During Cook's 1772–75 Antarctic circumnavigation on the HMS Resolution , he recorded the positions of hundreds of icebergs. This paper compares Cook's observations and those of Halley in 1700, Bouvet in 1739 and Riou in 1789, with the Brigham Young University/National Ice Center (BYU/NIC) and the Alfred Wegener Institute datasets. Cook's description of the iceberg plume east of the Amery Ice Shelf and the iceberg distributions in the Weddell, Ross and Amundsen Seas agree with modern data. In January 1774, Cook reached his farthest south on the shelf of the Amundsen Sea Embayment, the site of the current International Thwaites Glacier Collaboration field study. Cook's largest iceberg had a 2.5 km diameter, where power-law models show that icebergs of this size or smaller comprise 92% of their total number. In the eastern Weddell, Cook's observation of a sea-ice tongue with a much greater extent than in satellite imagery remains unexplained. Although Riou's icebergs lie 1000 km east of the BYU/NIC trajectories, application of the England and others (2020) fracture and drift model to the trajectories removes the discrepancy and means that all the ship observations are consistent with modern observations and theory. [ABSTRACT FROM AUTHOR]

What's the relevance of 'Linguistic Citizenship' (LC), a concept developed in southern Africa, to language education in England? LC is committed to democratic participation and voice, to linguistic diversity and the value of sociolinguistic understanding (Stroud 2001), and it provides a framework for contesting linguistic conditions in England, where vernacular multilingualism faces monolingual language education policies and an officially 'hostile environment for migrants'. In fact, LC lines up with four sources of opposition to this: civil society and small-scale community organisations cultivating heritage language multilingualism; experience of system-wide 'hospitality to diversity' in education in England in the 1970s & 1980s; c.50 years of linguistics research in Britain; and universities themselves. Drawing on LC's pedigree in sociolinguistics, we then turn to the Hub for Education & Language Diversity, a collaboration between King's and non-profit language organisations which approaches LC as a multi-dimensional programme of language development. This includes BA & MA classes; teacher training (with resonant concepts like 'diasporic local'); and efforts to broaden ideas about university 'impact'. Overall, Linguistic Citizenship invites us to reassess the lie of the land in language education, and suggests an array of practical but principled initiatives at different points of the language teaching/university interface. [ABSTRACT FROM AUTHOR]

This article presents a speech by Barbara Wootton delivered at the Quarterly Meeting of the Royal College of Psychiatrists in London, England on November 18, 1976. She discusses the contributions of Aubrey Lewis to psychiatry and in particular she examines Lewis' research on health as a social concept in the light of recent developments in psychiatry. She praises Lewis for making a sensible and measurable definition of health and its application in understanding mental illness.

Background: Since adenocarcinoma of the ethmoid sinuses was first described as an occupational disease in the woodworkers of High Wycombe, over the 50 subsequent years there has been a gradual decrease in the numbers to none over the last 12 years. Although this mirrored the decline in local industry, it seems the causative factor was first seen and then disappears over a 50-year period. Methods: A total of 146 cases have been traced historically over this time as well as personal experience of 33 cases; these cases are reviewed and success with a new modality of treatment is discussed. Conclusion: This paper outlines how the disease was initially recognised, both its diagnosis and treatment development. It also describes how both the appearance and disappearance were seemingly caused by changes in manufacturing practice. [ABSTRACT FROM AUTHOR]

Health technology assessments (HTAs) are used as a policy tool to appraise the clinical value, or cost effectiveness, of new medicines to inform reimbursement decisions in health care. As HTA organisations have been established in different countries, it has become clear that the outcomes of medicine appraisals can vary from country to country, even though the same scientific evidence in the form of randomised controlled trials is available. The extant literature explains such variations with reference to institutional variables and administrative rules. However, little research has been conducted to advance the theoretical understanding of how variations in HTA outcomes might be explained. This paper compares cases of HTA in England and Germany using insights from Kuhn (1962, The Structure of Scientific Revolutions, 2nd edn. Chicago: The University of Chicago Press) and Hall (1993, Policy paradigms, social learning, and the state: the case of economic policymaking in Britain. Comparative Politics 25, 275-296) to demonstrate how policy paradigms can explain the outcomes of HTA processes. The paper finds that HTA outcomes are influenced by a combination of logical issues that require reasoning within a paradigm, and institutional and political issues that speak to the interaction between ideational and interest-based variables. It sets out an approach that advances the theoretical explanation of divergent HTA outcomes, and offers an analytical basis on which to assess current and future policy changes in HTA. [ABSTRACT FROM AUTHOR]

The historic environment—comprising a palimpsest of landscapes, buildings and objects—carries meaning and plays a crucial role in giving people a sense of place, identity and belonging. It represents a repository of ever-accumulating collective and individually held values—shared perceptions, experiences, life histories, beliefs and traditions. These social or private values are mostly ascribed by people to familiar places within this environment based on the ontological security which this everyday heritage provides. However, these values are notoriously hard to capture and categorize. This makes it difficult to incorporate them into heritage-management strategies, which typically rely on objective, fact-based datasets. In this paper, we present a new methodology to capture those elusive values, by combining Topic Modelling with the principles of Grounded Theory. Results show that our novel approach is viable and replicable and that these important values can be effectively and meaningfully integrated, thus creating more inclusive approaches to heritage management than exist currently. [ABSTRACT FROM AUTHOR]

For the past two decades anti-abortionists in the Global North have been aggressively instrumentalising disability in order to undermine women's social autonomy, asserting, falsely, there is an insuperable conflict between disability rights and reproductive rights. The utilisation of disability in struggles over abortion access is not new, it has a history dating back to the interwar era. Indeed, decades before anti-abortionists' campaign, feminists invoked disability to expand access to safe abortion. This paper examines the feminist eugenics in the first organisation dedicated to liberalising restrictive abortion laws, the Abortion Law Reform Association (ALRA), established in England in 1936. ALRA played a vital role in the passage of the Abortion Act 1967 (or the Act) that greatly expanded the grounds for legal abortion, a hugely important gain for women in Britain and beyond seeking legal, safe abortions. In addition, the Act permitted eugenic abortion, which also had transnational effects: within a decade, jurisdictions in numerous Commonwealth countries passed abortion laws that incorporated the Act's eugenics clause, sometimes verbatim. This essay analyses ALRA's role in codifying eugenics in the Abortion Act 1967 and argues that from the outset, ALRA was simultaneously a feminist and eugenist association. Initially, ALRA prioritized their feminist commitment to 'voluntary motherhood' in their campaign whereas starting in the 1940s, they subordinated feminism to negative eugenics, a shift that was simultaneously strategic and a reflection of genuine concern to prevent the birth of children with disabilities. [ABSTRACT FROM AUTHOR]

Copyright of Proceedings of the Prehistoric Society is the property of Cambridge University Press 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.)

This paper uses a "dates as data" approach to understand how grave good use and cemetery space changed across the early medieval period in England. A series of composite kernel density estimations were created, based on a dataset of nearly 1100 graves with associated radiocarbon dates, from between the fourth and ninth centuries AD. This modeling revealed a previously unrecognized peak in grave furnishing around 600 AD, which coincides with a peak in isolated burials, and a low point for unfurnished graves and for small cemeteries. It argues that this peak is unrecognized as previous models of chronological change have focused only on graves containing chronologically distinctive artifacts and highlights the importance of radiocarbon dating as a way of avoiding this limitation. [ABSTRACT FROM AUTHOR]

Aim: To explore higher education institution (HEI) perspectives on the development and implementation of trainee nursing associates (NAs) in the primary care workforce in England. Background: Current shortages of primary health care staff have led to innovative skill mix approaches in attempts to maintain safe and effective care. In England, a new level of nursing practice, NAs, was introduced and joined the workforce in 2019. This role was envisaged as a way of bridging the skills gap between health care assistants and registered nurses and as an alternative route into registered nursing. However, there is limited evidence on programme development and implementation of trainee NAs within primary care settings and HEI perspectives on this. Methods: This paper draws from a larger qualitative study of HEI perspectives on the trainee NA programme. Twenty-seven staff involved in training NAs, from five HEIs across England, were interviewed from June to September 2021. The interview schedule specifically included questions relating to primary care. Data relating to primary care were extracted and analysed using a combined framework and thematic analysis approach. Findings: Three themes were developed: 'Understanding the trainee role and requirements', 'Trainee support in primary care' and 'Skills and scope of practice'. It is apparent that a more limited understanding of the NA programme requirements can lead to difficulties in accessing the right support for trainees in primary care. This can create challenges for trainees in gaining the required competencies and uncertainty in understanding what constitutes a safe scope of practice within the role for both employers and trainees. It might be anticipated that as this new programme becomes more embedded in primary care, a greater understanding will develop, support will improve and the nature and scope of this new level of practice will become clearer. [ABSTRACT FROM AUTHOR]

The financialization of everyday life has received considerable attention since the 2008 global financial crisis. Financialization is thought to have created active financial subjects through the ability to participate in mainstream financial services. While the lived experience of these mainstream financial subjects has been the subject of close scrutiny, the experiences of financial subjects at the financial fringe have been rarely considered. In the UK, for example, the introduction of High-Cost, Short-Term Credit [HCSTC] or payday loan regulation was designed to protect vulnerable people from accessing unaffordable credit. Exploring the impact of HCSTC regulation is important due to the dramatic decline of the high-cost credit market which helped meet essential needs in an era of austerity. As such, the paper examines the impact of the HCSTC regulation on sixty-four financially marginalized individuals in the UK that are unable to access payday loans. First, we identify the range of socioeconomic strategies that individuals employ to manage their finances to create a typology of financial subjectivity at the financial fringe. Second, we demonstrate how the temporal and precarious nature of financial inclusion at the financial fringe adds nuance to existing debates of the everyday lived experience of financialization. [ABSTRACT FROM AUTHOR]

This paper reports on a study which examined the notions of authenticity and citizenship for people living with cognitive impairment or dementia in a care home in the North-East of England. We demonstrated that both notions were present and were encouraged by engagement with an artist, where this involved audio and visual recordings and the creation of a film. The artist's interactions were observed by a non-participant observer using ethnographic techniques, including interviews with the residents, their families and the staff of the care home. The data were analysed using grounded theory and the constant comparative method of qualitative analysis. Our findings suggest that participatory art might help to maintain and encourage authenticity and citizenship in people living with dementia in a care home. Certainly, authenticity and citizenship are notions worth pursuing in the context of dementia generally, but especially in care homes. [ABSTRACT FROM AUTHOR]

Copyright of Proceedings of the Prehistoric Society is the property of Cambridge University Press 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.)

In north-western varieties of British English the historical process of ng-coalescence that simplified nasal + stop clusters in words like wrong and singer never ran to completion, with surface variation between [ŋ] and [ŋɡ] remaining to this day. This paper presents an empirical study of this synchronic variation, specifically to test predictions made by the life cycle of phonological processes; a diachronic account of /ɡ/-deletion has been proposed under this framework, but crucially the life cycle makes hitherto-untested predictions regarding the synchronic behaviour of (ng) in north-west England. Data from 30 sociolinguistic interviews indicate that these predictions are largely met: internal constraints on the variable are almost entirely accounted for by assuming cyclic application of /ɡ/-deletion across a stratified phonology. There is also evidence of apparent time change in the pre-pausal environment, which is becoming increasingly [ɡ]-favouring contrary to the life cycle's predictions. It is argued that this reflects a separate innovation in the life cycle of (ng), with synchronic variation reflecting two processes: (i) the original deletion, overlaid with (ii) a prosodically-conditioned insertion process. These results have implications for theories of language change and the architecture of grammar and add to a growing body of evidence suggesting that the effect of pause on probabilistic phenomena can be synchronically variable and diachronically unstable. [ABSTRACT FROM AUTHOR]

Informal care plays a crucial role in the social care system in England and is increasingly recognised as a cornerstone of future sustainability of the long-term care (LTC) system. This paper explores the variation in informal care provision over time, and in particular, whether the considerable reduction in publicly-funded formal LTC after 2008 had an impact on the provision of informal care. We used small area data from the 2001 and 2011 English censuses to measure the prevalence and intensity (i.e. the number of hours of informal care provided) of informal care in the population. We controlled for changes in age structure, health, deprivation, income, employment and education. The effects of the change in formal social care provision on informal care were analysed through instrumental variable models to account for the well-known endogeneity. We found that informal care provision had increased over the period, particularly among high-intensity carers (20+ hours per week). We also found that the reduction in publicly-funded formal care provision was associated with significant increases in high-intensity (20+ hours per week) informal care provision, suggesting a substitutive relationship between formal and informal care of that intensity in the English system. [ABSTRACT FROM AUTHOR]

Public reporting of clinical performance is increasingly used in many countries to improve quality and enhance accountability of the health system. The assumption is that greater transparency will stimulate improvements by clinicians in response to peer pressure, patient choice or competition. The international diffusion of public reporting might suggest greater similarity between health systems. Alternatively, national and local contexts (including health system imperatives, professional power and organisational culture) might continue to shape its form and impact, implying continued divergence. The paper considers public reporting in the USA and England through the lens of Scott's 'pillars' institutional framework. The USA was arguably the first country to adopt public reporting systematically in the late 1980s. England is a more recent adopter; it is now being widely adopted through the National Health Service (NHS). Drawing on qualitative data from California and England, this paper compares the behavioural and policy responses to public reporting by health system stakeholders at micro, meso and macro levels and through the intersection of ideas, interests, institutions and individuals through. The interplay between the regulative, normative and cultural-cognitive pillars helps explain the observed patterns of on-going divergence. [ABSTRACT FROM AUTHOR]

Drawing on a 2010 analysis of the reform and costs of adult social care commissioned by Downing Street and the UK Department of Health, this paper sets out projected future costs under different reform scenarios, reviews what happened in practice from 2010-19, explores the impact of the growing gap between need and funding, and explores the relationship between future spending and economic growth. In the process, it identifies a 'lost decade' in which policy makers failed to act on the warnings which they received in 2010, draws attention to the disproportionate impact of cuts on older people (compared to services for people of working age) and calls for urgent action before the current system becomes unsustainable. [ABSTRACT FROM AUTHOR]

The appointment of recent Attorney-Generals for England and Wales has occasioned much comment about their experience. This paper considers whether, following the transmogrification of the Lord Chancellorship over a decade ago, the backgrounds and activities of recent leaders of the Attorney-General's Office suggest the time is now right for similar changes to the Law Officers' roles. In doing so, it presents a range of original data on aspects of the role and on characteristics of Attorney-Generals, which suggests that unless self-restraint is exercised (by the Prime Minister and the post-holders) we may ineluctably be on the path to reform. [ABSTRACT FROM AUTHOR]

The benefits of meaningful activity in later life are well documented. Studies show that being occupied contributes to both physical and mental health as well as quality of life. Research also suggests that activity may be beneficial to people residing in care homes, including people living with dementia. This paper presents findings from a study which used the Adult Social Care Outcomes Toolkit (ASCOT) to measure quality of life in six care homes located in the south-east of England. The study found, like previous ones, that care home residents' days were characterised by a lack of activity. Drawing on observations, interviews and focus groups with residents and staff from these homes, this paper attempts to understand why care home residents do not engage in meaningful activities. We reject the idea that these low levels of activity are a natural part of the ageing process or that they can be explained by notions of resident choice. Instead, the findings point to both insufficient funding and working practices within care homes as more substantive explanations. These explanations inform a discussion of how the low levels of engagement in meaningful activity could be addressed and residents' quality of life improved. [ABSTRACT FROM AUTHOR]

This paper explores telecare manager and other 'stakeholder' perspectives on the nature, extent and impact of family and other unpaid/informal carers' involvement in the provision of telecare equipment and services for older people. Data used in the paper are derived from a larger study on telecare provision by local councils in England. The paper aims to add to the growing evidence about carers' engagement with electronic assistive technology and telecare, and considers this in the context of typologies of professionals' engagement with carers. How carers are involved in telecare provision is examined primarily from the perspectives of senior managers responsible for telecare services who responded to an online survey and/or were interviewed in 2016 as part of a wider study. The perspectives of three unpaid carers were captured in a separate strand of the main study, which comprised more detailed case study interviews within four selected councils. Thematic and comparative analysis of both qualitative and quantitative survey data revealed the varied involvements and responsibilities that carers assumed during the telecare provision process, the barriers that they needed to overcome and their integration in local council strategies. Findings are discussed in the context of Twigg and Atkin's typology of carer support. They suggest that carers are mainly perceived as 'resources' and involvement is largely taken for granted. There are instances in which carers can be seen as 'co-workers': this is mainly around responding to alerts generated by the telecare user or by monitored devices, but only in those councils that fund response services. Though some participants felt that telecare devices could replace or 'supersede' hands-on care that involved routine monitoring of health and wellbeing, it was also acknowledged that its use might also place new responsibilities on carers. Furthermore, the study found that meeting carers' own rights as 'co-clients' was little acknowledged. [ABSTRACT FROM AUTHOR]

The contribution of this paper is to analyse statistical data to assess whether homelessness among people who have recently been granted refugee status in England is concentrated amongst particular groups of these refugees. The methodology was quantitative analysis using logistic regression of the Home Office's Survey of New Refugees (SNR), which they carried out in 2005-7. We tested the relative role played by pre-migration demographic factors, post-migration life experience factors, and government immigration policy in accounting for patterns found, and drew on literature to interpret the meaning of our statistical results. Our analysis clearly suggests that refugee and asylum policy contribute to homelessness among newly-recognised refugees. This interpretation is supported by the qualitative evidence from services providing assistance to refugees, and evidence put to the All Party Parliamentary Group on Refugees (2017). Action to address the housing problems of refugees moving on from accommodation provided for asylum seekers should be considered a high policy priority, albeit that associations between homelessness, household size, and age also present intervention opportunities. [ABSTRACT FROM AUTHOR]

Health systems internationally face demands to deliver care that is better coordinated and integrated. The health system financing and delivery model may go some, but not all the way in explaining health system fragmentation. In this paper, we consider the road to care integration in two countries with Beveridge style health systems, England and Denmark, that are both ranked as highly Integrated systems in Toth's health integration index. We use the SELFIE framework to compare the policies and reforms that have affected care integration over the past 30 years in the two countries. The countries both started their reform path by reforming to introduce choice and competition, but did so in different ways that set them on different pathways. Nevertheless, after two decades, the countries ended the period with largely similar structures that emphasised the creation of a cross-sectoral governance structure. In the relatively centralised England, by introducing decentralised Integrated Care Systems, and in the relatively decentralised Denmark with a centralising element in the form of new Health Clusters. [ABSTRACT FROM AUTHOR]

Several abstracts are presented from the Otology Section Meetings of the Royal Society of Medicine on topics including validity of the Visible Ear Simulator as a tool for temporal bone dissection; and comparison of cervical and ocular vestibular-evoked myogenic potentials in patients with Ménière's disease.

Several abstracts are presented from the Otology Section Meetings of the Royal Society of Medicine on topics including stability of the bone-anchored hearing aid (BAHA) abutment; identification of genetic variants in otosclerosis; and characterization of eosinophilic granulomatosis with polyangiitis.

Research has suggested ecopsychosocial initiatives can promote a sense of wellbeing and inclusion in people with dementia. However, few studies have elucidated the 'active mechanisms' whereby such initiatives can achieve these outcomes, so hindering their generalisability. This is particularly pertinent when seeking to support community-dwelling older men with dementia who are reluctant to engage with traditional health and social care initiatives. This paper reports on a study that drew from the principles of Participatory Action Research to explore the 'active mechanisms' of a technological initiative for older men (65+ years) with dementia in rural England. An individually tailored, male-only initiative, using off-the-shelf computer game technology (e.g. iPad, Nintendo Wii and Microsoft Kinect) was delivered over a nine-week period. Multiple qualitative methods were employed, including: focus groups, open interviews and extensive reflective field notes, to gather data from the perspective of 22 men, 15 care partners and five community volunteers. The data were analysed thematically and interpreted using a masculinity lens. Three mechanisms contributed to the initiative's success: the use of the technology, the male-only environment and the empowering approach adopted. The paper argues that initiatives aimed at community-dwelling older men with dementia would be advised to consider these gendered experiences and ensure participants can maximise their masculine capital when participating in them, by providing enabling activities, non-threatening environments and empowering approaches of delivery. [ABSTRACT FROM AUTHOR]

This paper examines the factors affecting the receipt of informal care among older people in China. It uses the second wave data of the China Health and Retirement Longitudinal Survey, which collected ageing and health-related information on a nationally representative sample of 8,906 older people aged 60 and over in 2013. Apart from the factors that have been examined in the contexts of developed countries, the paper further investigates two factors specific to Chinese society: rural–urban residence and regular financial assistance from children. Based on binary and multinomial logit regression analyses, the research findings are threefold: the determinants of receiving informal care differ remarkably according to the sources of care; disability and living arrangements are the most important determinants; rural–urban residence plays a vital role in the Chinese context, but regular financial assistance from children makes little difference. It is estimated that 53 million older people are receiving informal care each year, a figure equivalent to the entire population of England. With continuous population ageing, Chinese society will face huge pressure to meet the demand for social care among older people in the future. The Chinese government needs to build a well-rounded welfare system that tackles this challenge from multiple dimensions. The formal care services should aim to complement informal care in the short run and reduce inequality in social care in the long run. [ABSTRACT FROM AUTHOR]

Information about the topics discussed at the Manchester International Beethoven Conference held at the Martin Harris Centre for Music and Drama of the University of Manchester in England on June 25-27, 2012 is presented. The event featured papers about string quartet in E flat major op. 127 by Barry Cooper and Ludwig van Beethoven's compositional choices by Lewis Lockwood. Sieghard Brandenburg delivered the keynote address entitled "Problems in the Interpretation of Beethoven's Sketches."

This paper examines how care home managers in England conceptualised the approach to delivering personalised care in the homes they managed. We conducted interviews with care home managers and mapped the approaches they described on two distinct characterisations of personalised care prominent in the research and practitioner literature: the importance of close care relationships and the degree of resident choice and decision-making promoted by the care home. We derived three 'types' of personalised care in care homes. These conceptualise the care home as an 'institution', a 'family' and a 'hotel'. We have added a fourth type, the 'co-operative', to propose a type that merges proximate care relationships with an emphasis on resident choice and decision-making. We conclude that each approach involves trade-offs and that the 'family' model may be more suitable for people with advanced dementia, given its emphasis on relationships. While the presence of a range of diverse approaches to personalising care in a care home market may be desirable as a matter of choice, access to care homes in England is likely to be constrained by availability and cost. [ABSTRACT FROM AUTHOR]

This paper investigates whether high borrowing costs deterred investment in sanitation infrastructure in late nineteenth-century Britain. Town Councils had to borrow to fund investment, with considerable variation in interest rates across towns and over time. Panel regressions, using annual data from more than 800 town councils, indicate that higher interest rates were associated with lower levels of infrastructure investment between 1887 and 1903. Instrumental variable regressions show that falling interest rates after 1887 stimulated investment and led to lower infant mortality. These findings suggest that Parliament could have expedited mortality decline by subsidizing loans or facilitating private borrowing. [ABSTRACT FROM AUTHOR]

While code-switching is quite a common phenomenon, this paper seeks to investigate a common but underreported use of code-switching. In this paper, I focus on the use of code-switching from Korean to English in South Korean TV dramas. The paper first briefly discusses the literature on the connotations of English language in the Korean media and then proceeds to focus on code-switching using data sampled from three Korean TV dramas. The previous literature (e.g. Lee, 2006; Park, 2006, 2009) which discusses the use of the English language in the Korean media, argues that English carries connotations of modernity and power and this subsequently helps to construct a modern identity for Koreans. However, while Korean music, advertisements and comedies have been discussed with regard to their switches to English, there is little, if any research that focuses on switching to English in Korean TV dramas. The argument put forth in this paper is that switching to English in this context is often a means to reflect an identity of power for the characters and this subsequently might be a reflection of the power and dominance that the English language has in Korean society. In turn, this contributes to conclusions that a modern Korean identity of power derives from being proficient in English. [ABSTRACT FROM AUTHOR]

Since the 1990s, human trafficking has become the battleground for competing discourses on human rights and penality. While rights solutions are generally presented as in opposition to crime-control measures, in the context of anti-trafficking interventions, rights-based initiatives and criminal governance are often linked together both discursively and in practice. Drawing on the findings of Discourse Analysis of 120 texts about trafficking, this paper explores how dominant discourses and alternative voices construct the relationship between human rights and penality. It is contended that penality is framed as a crucial tenet of human rights. Dominant discourses (the 'law enforcement' and the 'victims first' discourses) link human rights to state coercive action, seen as a necessary component of their effectiveness. Alternative voices (the 'incompatibility' and the 'transformative justice' discourses) reject the appropriateness of penal intervention, but they end up preserving what they denounce. [ABSTRACT FROM AUTHOR]

Frailty is increasingly used in clinical settings to describe a physiological state resulting from a combination of age-related co-morbidities. Frailty also has a strong 'lay' meaning that conjures a particular way of being. Recent studies have reported how frail older people perceive the term frailty, showing that frailty is often an unwanted and resisted label. While there are many scores and measures that clinicians can use to determine frailty, little has been published regarding how health-care professionals use and make sense of the term. This paper reports the findings of a qualitative study that explored how health professionals perceive frailty. Forty situated interviews were conducted with health-care professionals working in an emergency department in the English Midlands. The interview talk was analysed using discourse analysis. The findings show that the health professionals negotiate an 'ideological dilemma' – a tension between contradictory sets of meanings and consequences for action – based on their 'lay' and clinical experience of the term frailty. It is concluded that this dilemma could have a negative impact on the assessment of frailty depending on the system of assessment used. [ABSTRACT FROM AUTHOR]

Presents an abstract of the paper `Government Debt and Private Capital Markets: England, 1727-1837,' by Gregory Clark, during the fifty-fifth annual meeting of the Economic History Association.