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Decision makers in adult social care are increasingly interested in using evidence from research to support or shape their decisions. The scope and nature of the current landscape of adult social care research (ASCR) need to be better understood. This paper provides a bibliometric assessment of ASCR outputs from 1996 to 2011. ASCR papers were retrieved using three strategies: from key journals; using keywords and noun phrases; and from additional papers preferentially citing or being cited by other ASCR papers. Overall, 195,829 ASCR papers were identified in the bibliographic database Scopus, of which 16 per cent involved at least one author from the UK. The UK output increased 2.45-fold between 1996 and 2011. Among selected countries, those with greater research intensity in ASCR generally had higher citation impact, such as the USA, UK, Canada and the Netherlands. The top five UK institutions in terms of volume of papers in the UK accounted for 26 per cent of total output. We conclude by noting the limitations to bibliometric analysis of ASCR and examine how such analysis can support the strategic development of the field. [ABSTRACT FROM AUTHOR]

In this pa per, we argue for the importance of unsettling dominant narratives in the current terrain of harm-reduction policy, practice and research. To accomplish this, we trace the historical developments regarding the Human Immunodeficiency Virus (HIV), the Hepatitis C Virus (HCV) and harm-reduction policies and practice. We argue that multiple historical junctures rather than single causes of social exclusion engender the processes of marginalisation, propelled by social movements, institutional interests, state legislation, community practices, neo-liberalism and governmentality techniques. We analyse interests (activist, lay expert, institutional and state) in the harm-reduction field, and consider conceptualisations of risk, pleasure, stigma, social control and exclusionary moral identities. Based on our review of the literature, this paper provides recommendations for social workers and others delivering health and social care interested in the fields of substance use, HIV prevention and harm reduction. [ABSTRACT FROM AUTHOR]

Despite a sizeable literature on the evolution of health insurance in Britain and Canada, there is virtually no research on the transnational migration of physicians between these countries in the immediate postwar period. This article hopes to address this neglected subject. Three inter-related topics will be examined. First, the paper will summarize the debate over physician emigration from the National Health Service (NHS) in postwar Britain. It will demonstrate how British social scientists and politicians began to come to grips with a major demographic exodus of British-trained doctors in the late 1950s and early 1960s. Second, it will analyze the changing health human resource situation in 1960s Canada, which focused, for practical and cultural reasons, on General Medical Council of Britain licensed practitioners. Third, through oral interviews of British-trained physicians who settled in Canada during the 1960s, it will examine the professional and personal reasons why physicians left Britain for Canada. It reveals that, among a myriad of personal issues that motivated a physician to leave the NHS, the inflexibility and hierarchical nature of British medicine loomed very large. The paper will conclude by reflecting on the contemporary significance of this fascinating historical phenomenon. [ABSTRACT FROM PUBLISHER]

Introduction: Quality of life is included in the economic evaluation of health services by measuring the preference for health states, i.e. health state utilities. However, most intervention studies include a disease-specific, not a utility, instrument. Consequently, there has been increasing use of statistical mapping algorithms which permit utilities to be estimated from a disease-specific instrument. The present paper provides such algorithms between the MacNew Heart Disease Quality of Life Questionnaire (MacNew) instrument and six multi-attribute utility (MAU) instruments, the Euroqol (EQ-5D), the Short Form 6D (SF-6D), the Health Utilities Index (HUI) 3, the Quality of Wellbeing (QWB), the 15D (15 Dimension) and the Assessment of Quality of Life (AQoL-8D). Methods: Heart disease patients and members of the healthy public were recruited from six countries. Non-parametric rank tests were used to compare subgroup utilities and MacNew scores. Mapping algorithms were estimated using three separate statistical techniques. Results: Mapping algorithms achieved a high degree of precision. Based on the mean absolute error and the intra class correlation the preferred mapping is MacNew into SF-6D or 15D. Using the R squared statistic the preferred mapping is MacNew into AQoL-8D. Implications for research: The algorithms reported in this paper enable MacNew data to be mapped into utilities predicted from any of six instruments. This permits studies which have included the MacNew to be used in cost utility analyses which, in turn, allows the comparison of services with interventions across the health system. [ABSTRACT FROM AUTHOR]

The First World War career of R.H. Brand, 1st Baron Brand of Eydon, provides an important insight into a number of issues. An important financier (with Lazard Brothers) and an ardent Imperialist (a founding member of The Round Table), in 1915 Brand helped establish the Imperial Munitions Board (IMB), the Canadian branch of the Ministry of Munitions. After that time, until 1917, Brand served as the Representative of the IMB in London, acting as the key link between that body and the Ministry of Munitions. As such, he was at the centre of intra-Imperial relations and wartime finance and supply. In addition, Brand’s work involved him in Anglo-American relations, as Washington became an important aspect of finance and supply. Brand’s activities illuminate the difficulties involved in the attempt to coordinate the interests of Britain with the embryonic nationalist desires of Canada. They also underline the significance of the Dominion for the British war effort, both financially and in the production of munitions. In addition, Brand’s work makes evident the close ties between the Canadian war economy and the United States, making clear the need to look at both Ottawa and Washington when attempting to understand Britain’s North American economic and financial activities during the First World War. [ABSTRACT FROM PUBLISHER]

Debates surrounding the ostensibly ‘transformative’ potential of personalisation for social work services, and service users, have variously illustrated the risks and opportunities this presents, although the implications for criminal justice social work services have received comparatively limited attention. By extending the concept of ‘service user’ to include not only offenders, but wider stakeholders (victims and communities), this paper considers the practical application of theories of personalisation and co-production by reviewing proposed and extant strategies for maximising stakeholder involvement in criminal justice services. It is argued that, in progressing beyond the more individualistic interpretations of this somewhat controversial reform agenda—in prioritising not only the individual, their rights, strengths and subjective identities, but locating the individual in situ, in the concrete realities and textures of their lives and communities—the strength of the personalisation agenda rests in its potential to develop and strengthen the collective organisation of service users, service providers and communities in a co-productive endeavour. It is argued that both this reading and the principles underpinning it resonate more widely with the empirical and theoretical literature on just and effective penal practices and, in so doing, this paper exposes the complexities that lie behind the apparent simplicity of this argument. [ABSTRACT FROM PUBLISHER]

The article discusses the efforts of author Richard Jebb and political writer John Skirving Ewart to resist the activities of the Round Table, a group of thinkers and publicists, in Great Britain and Canada. It examines the historical significance of Round Table. It also argues that the activities of Lionel Curtis, one of the people who revived the idea of imperial federation, can be better understood when placed in the context of alternative visions of Jebb and Ewart of the future of the British empire.

Substantial changes to mental health law and policy have occurred throughout the Western world during the last decade. The drift towards control, particularly in the form of Community Treatment Orders (CTOs), has profound implications for the role of mental health social workers, yet this issue is rarely discussed in academic literature. This paper seeks to redress this gap in knowledge by examining aspects of law, policy and practice using three case studies: Victoria, Australia; Ontario, Canada; and regions of the UK. The paper begins by critically reviewing selected literature on CTOs, revealing competing claims about efficacy and their impact upon service users and practitioners. A discussion of policy and practice contexts in the three jurisdictions is then presented and supported with a typology, to illustrate contrasts and comparisons. In their conclusions, the authors assert that mental health social workers often have a crucial part to play in the implementation of CTOs but that this is not always acknowledged in law and organizational policy. Social workers' roles and responsibilities need to be more explicitly identified in mental health law. At the same time, there should be a continuing debate about how such coercive powers fit with codes of ethics and practice standards, at national and international levels. [ABSTRACT FROM AUTHOR]

Canada's trade relations with the UK have been governed by the CETA since the signature of that agreement with the EU in October 2016. Subsequent to the decision of the UK electorate to leave the EU, it became necessary to envisage the creation of a new trade agreement directly between the UK and Canada. Initially, the Government of Canada indicated a willingness to negotiate a new trade agreement with the UK as quickly as possible. But, as the future relationship of the UK to the EU became increasingly uncertain, the Government of Canada decided to hold back until greater clarity could be obtained. As of July 2020, Canada was still waiting. The future trade agreement will reflect the desire of both countries to maintain their long-standing and close relationship. Both have strong interests in trade and investment with the other and both will seek to reinforce these interests. The particular concerns of both countries are outlined in this paper and the outlines of a future trade agreement are set out. In conclusion, the author suggests that it would be in the interests of the UK, rather than seeking simply a bilateral agreement, to seek to negotiate an Atlantic Free Trade Agreement, thereby clarifying its relations not simply with Canada but with all of Europe and North America. [ABSTRACT FROM AUTHOR]

Background: OECD countries over the past two decades have implemented a range of labour market integration initiatives to improve the employment chances of disabled and chronically ill individuals. This article presents a systematic review and evidence synthesis on effectiveness of government interventions to influence employers’ employment practices concerning disabled and chronically ill individuals in five OECD countries. A separate paper reports on interventions to influence the behaviour of employees. Methods: Electronic and grey literature searches to identify all empirical studies reporting employment effects and/or process evaluations of government policies aimed at changing the behaviour of employers conducted between 1990 and 2008 from Canada, Denmark, Norway, Sweden and the UK. Results: Few studies provided robust evaluations of the programmes or their differential effects and selection of participants into programmes may distort the findings of even controlled studies. A population-level effect of legislation to combat discrimination by employers could not be detected. Workplace adjustments had positive impacts on employment, but low uptake. Financial incentives such as wage subsidies can work if they are sufficiently generous. Involving employers in return-to-work planning can reduce subsequent sick leave and be appreciated by employees, but this policy has not been taken up with the level of intensity that is likely to make a difference. Some interventions favour the more advantaged disabled people and those closer to the labour market. Conclusions: Future evaluations need to pay more attention to differential impact of interventions, degree of take-up, non-stigmatizing implementation and wider policy context in each country. [ABSTRACT FROM AUTHOR]

Questions of timing, phasing and sequence have been central to recent critiques of science policy-making, which have highlighted sustained disjunctures between the relevance and importance given to different stakeholders at different moments in the policy-making process. In this paper we expand upon this recent 'upstream/downstream' literature through a case study analysis of xenotransplantation (XTP), one of the defining controversies of 1990s UK biotechnology regulation. Drawing on insights from the sociology of expectations we trace the emergence of a UK policy narrative concerning the future of XTP and explore how the policy role became narrowly defined as a process of 'reflex regulation', based upon technologically determinist assumptions and producing extremely short-term decision-making. We draw attention to the concrete costs of this delineation of the policy role and reveal that it is neither inevitable or necessary, by considering contrasts between the policy temporalities of the UK, Canada and the Netherlands. [ABSTRACT FROM AUTHOR]

This paper uses mixed Markov latent class models and data from multiwave national panel surveys to investigate the stability of individual-level party identification in three Anglo-American democracies—the United States, Britain, and Canada. Analyses reveal that partisan attachments exhibit substantial dynamism at the latent variable level in the American, British, and Canadian electorates. Large-scale partisan dynamics are not a recent development; rather, they are present in all of the national panel surveys conducted since the 1950s. In all three countries, a generalized “mover–stayer” model outperforms rival models including a partisan stability model and a “black–white” nonattitudes model that specifies random partisan dynamics. The superiority of generalized mover–stayer models of individual-level party identification comports well with American and British studies that document nonstationary, long memory in macropartisanship. The theoretical perspective provided by party identification updating models is consistent with the mix of durable and flexible partisans found in the United States and elsewhere. [ABSTRACT FROM PUBLISHER]

Background the mySupport advance care planning intervention was originally developed and evaluated in Northern Ireland (UK). Family caregivers of nursing home residents with dementia received an educational booklet and a family care conference with a trained facilitator to discuss their relative's future care. Objectives to investigate whether upscaling the intervention adapted to local context and complemented by a question prompt list impacts family caregivers' uncertainty in decision-making and their satisfaction with care across six countries. Second, to investigate whether mySupport affects residents' hospitalisations and documented advance decisions. Design a pretest–posttest design. Setting in Canada, the Czech Republic, Ireland, Italy, the Netherlands and the UK, two nursing homes participated. Participants in total, 88 family caregivers completed baseline, intervention and follow-up assessments. Methods family caregivers' scores on the Decisional Conflict Scale and Family Perceptions of Care Scale before and after the intervention were compared with linear mixed models. The number of documented advance decisions and residents' hospitalisations was obtained via chart review or reported by nursing home staff and compared between baseline and follow-up with McNemar tests. Results family caregivers reported less decision-making uncertainty (−9.6, 95% confidence interval: −13.3, −6.0, P  < 0.001) and more positive perceptions of care (+11.4, 95% confidence interval: 7.8, 15.0; P  < 0.001) after the intervention. The number of advance decisions to refuse treatment was significantly higher after the intervention (21 vs 16); the number of other advance decisions or hospitalisations was unchanged. Conclusions the mySupport intervention may be impactful in countries beyond the original setting. [ABSTRACT FROM AUTHOR]

This paper focuses on the problems of measurement of progressivity in taxation and public expenditure. The problem has attracted the attention of several writers. Among the important contributions to this field are those of Dalton (1955), Slitor (1948), Musgrave and Thin (1948) and Bracewell-Milnes (1971). The major weakness of the existing literature is that it does not distinguish between the effects of changes in average tax rates and in progressivity on the distribution of income. One of the aims of this paper is to show how the distributional effect of taxation is influenced by changes in the average tax rate while progressivity is held constant and vice versa. Further the method enables one to study the contribution of individual taxes and expenditure items to the overall progressivity of the fiscal system of taxation and public expenditure. Finally, the methods developed are applied to the empirical investigation of fiscal operations in four developed countries -- Australia, Canada, the United Kingdom and the United States. In this paper a new measure of tax progressivity has been introduced. This measure helps to distinguish between different effects of taxation on income distribution. In particular, it has helped to show clearly that the reduction in income distribution resulting from taxation depends not only on the degree of tax progressivity, as is commonly believed, but also on average tax rate. We have also analysed the effects of various taxes and items of public expenditure at different levels of Government. This empirical analysis has been done for four developed countries, namely Australia, Canada, the United Kingdom and the U.S.A. It would be interesting for future research to extend the empirical analysis to other developed and developing countries. [ABSTRACT FROM AUTHOR]

Canadian social work educators, in recognizing the importance of preparing students for anti-oppressive practice, can look to developments in the United Kingdom for direction and guidance. Recent changes to education policy statements in Canada have included the requirement that social work students graduate with the knowledge. values and skills to be ethnically sensitive practitioners. The Canadian equivalent to practice teaching, the field practicum, is an ideal venue to learn about multi-cultural differences, oppression, and how to combat institutional and individual racism, sexism and ethnocentrism. However. such learning must be explicitly and purposely developed. Thus, guidelines have been suggested to promote the establishment of an ethnically sensitive, anti-discriminatory practice teaching process. This paper discusses how concepts and practices derived in Britain can be applied in a Canadian context to help course instructors, tutors, practice teachers and students build effective learning experiences for the multi-cultural realities and struggles of today. These guidelines can be used by both Canadian and British social work courses and include questions to be raised at key points throughout the practice teaching process to ensure the focus and attention to ethnically sensitive, anti-discriminatory practice is maintained. The guidelines were derived from a synthesis of British concepts and practices combined with a review of selected North American and British literature and the experiences of two practice teaching projects in one social work course in Canada. The projects involved practice teaching placements with a community development project that had a multi-cultural and multi-racial focus and the experience of a native studies concentration with a practice teaching component. From a Canadian perspective this combination facilitates a step forward and provides a framework which has a timely practical application. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editor discusses two reports published within the issue such as a paper by Roman Romero-Ortuno and colleagues on a data offering insight into plasma 250HD levels in Irish community-dwelling older people and a paper from V. G. M. Chel and colleagues on the impact of ultraviolet B (UVB) exposure on vitamin D status in eight psycho-geriatric nursing home residents.

This article explores the impact of online Irish traditional singing sessions on health and well-being during the COVID-19 pandemic. Singing sessions are unique facets of Ireland's music tradition that saw dramatic closure, interruption and digital transition in response to COVID-19 social distancing measures. This study highlights a gap in health promotion literature with regard to traditional singing sessions as a group singing activity and examines the potential for online group singing activities to have positive impacts on the health and well-being of participants. While traditional singing sessions foreground solo performances, they are quintessentially group activities, and include community engagement and active participation from singers and listeners alike. Through an online survey (n  = 108), and ethnographic interviews (n  = 3), this study explores potential health and well-being implications of online traditional singing sessions, and reveals four main areas of impact: social connection, enjoyment, cognitive motivation and timekeeping. The study suggests that online traditional singing sessions can promote health and well-being in participants, particularly during times of isolation. [ABSTRACT FROM AUTHOR]

Information and Communication Technologies (ICTs) permeated social work practice before coronavirus disease 2019 (COVID-19). In addition to ICT-based formal services (e.g. e-counselling), social workers used ICTs informally as an adjunct to face-to-face practice. Building on our previous research, our cross-sectional online survey examined social workers' informal use of ICTs in four countries: Canada, the USA, Israel and the UK. The survey was administered through Qualtrics software among social workers across Canada (n  = 2,609), the USA (n  = 1,225), Israel (n  = 386) and the UK (n  = 134), and analysed using IBM SPSS Statistics version 26. The findings substantiate the ubiquitous use of informal ICTs in social work practice, as an adjunct to face-to-face treatment, across the four countries. Given the current, unprecedented context of COVID-19, we discuss the meaning of our findings related to access, ethical considerations (e.g. professional boundaries) and supervision in the context of restricted face-to-face practice. We discuss the implications for social work practice, education and research, and conclude that in the COVID-19 context, there is an even greater need for research, clinical discussion, supervision and policy on informal ICT use in social work practice. [ABSTRACT FROM AUTHOR]

This article situates the subject of the academic–practitioner (AP) exchange within an International Relations-orientated critique of the imperial dynamics of counterterrorism practices and racial subjugation. It uses an analytical framework that upholds the significance of racial hierarchy to knowledge production. A key contribution of this article is to situate the AP nexus within the circumstances of liberal democratic counterterrorism regimes, to demonstrate how race becomes meaningful to the knowledge that is produced about Islamophobia. The main argument of this article is that in present policy debates concerning the existence of systemic racism, one of the mechanisms enabling counterterrorism practitioners to regulate the AP exchange is that of institutionalized whiteness. Exploring two scenarios of AP exchanges in the United Kingdom and Canada, where counterterrorism practitioners were challenged to reconcile with academic explanations of Islamophobia as a systemic issue, this article uses colour-line inspired critiques of white logic to identify instances where anti-racist knowledge was subjugated in the name of imperialism. The article finds that in each scenario discussed, practitioners demonstrate trajectories of white logic by contesting the suitability of anti-racist knowledge put forward by academics, on the basis of racial hierarchy and self-aggrandizement. It concludes by discussing how a lack of practitioner–academic consensus continues to affect the dissemination of knowledge concerning systemic racism, thus prompting considerations of what this means for an anti-racist future. [ABSTRACT FROM AUTHOR]

Under inflation, targeting estimates of the indexation parameter in hybrid New Keynesian Phillips curves are either equal to zero, or very low, in the United Kingdom, Canada, Sweden, and New Zealand. Analogous results hold for the Euro area under the European Monetary Union, and for Switzerland under the new monetary regime: under stable regimes with clearly defined nominal anchors, inflation appears to be purely forward-looking. These results question the notion that the intrinsic inflation persistence found in post-WWII U.S. data is structural in the sense of Lucas (Carnegie-Rochester Conference Series on Public Policy, 1 [1976], 19-46), and suggest that "hardwiring" inflation persistence in macroeconomic models is potentially misleading. [ABSTRACT FROM AUTHOR]

This article re-examines the problem of radical disunity after 1832. The main focus is on radical attitudes towards the second Melbourne ministry (1835–41) and its handling of the Canadian rebellions of 1837. Even when the government's imperial difficulties created a suitable opportunity to rekindle their reform campaign, radical leaders failed to co-operate effectively and made little headway in mobilizing and harnessing popular support. This defeat can be profitably explored through the experiences of Thomas Perronet Thompson (1783–1869), who emerged as one of the most energetic and strident critics of British policy in Canada during and after the rebellions. Despite his best efforts, Thompson was unable to win over other radical leaders or to attract a large following, a failure that highlights the wider constraints faced by radicalism in this era. [ABSTRACT FROM AUTHOR]

The failure of the global community to effectively address many large-scale environmental challenges calls into question the existing regulatory approaches. A large number of these challenges are diffuse issues which have, over the years been targeted by significant and sizable regulatory frameworks and yet the challenges persist—energy efficiency is one such issue and is the focus of this article. Increasing monitoring or enforcement to achieve improvements in regulatory compliance is too expensive in the context of diffuse problems due to the scale and costs such activities would entail. We suggest a focus on the fit between regulatory frameworks and norm creation may identify more fruitful routes to regulatory reform. Drawing on the 'interactional account of law' as a framework, this research uses new empirical data from a survey and a set of interviews to investigate the failure of energy efficiency regulatory frameworks at achieving energy efficient norms of behaviour in industry. We look at Canada and the UK as our case studies and our emphasis is on industry actors as they represent a significant and yet understudied area of society. We find that though existing regulatory structures seem adequate to generate general shared understandings around obligations to engage in energy efficiency actions, more specific shared practice around actually engaging in these actions remains elusive, resulting in a failure to engender norms of behaviour. These failures, we suggest, link directly to an inadequate fit between the regulatory tools and Fuller's criteria for the internal morality of law. [ABSTRACT FROM AUTHOR]

Numerous studies investigate how personality traits and individual characteristics influence vote choice. However, the effect of risk attitudes on the proclivity to cast a strategic vote has not been tested yet. This article tests whether the likelihood of defecting from one's preferred party is influenced by attitudes towards risk. I argue that the utility stemming from expressing a preference by opting for the favored party is a sure thing, whereas the utility stemming from an instrumental choice depends on some probabilities, and consequently that strategic voting is riskier than sincere voting. Using survey data from the United Kingdom and Canada, I find that risk-averse voters are less likely to vote strategically than risk-acceptant ones. [ABSTRACT FROM AUTHOR]

Objective: To assess trends in daily smokers' social norms and opinions of smoking between 2002 and 2015 in Canada, the United States, the United Kingdom, and Australia.Method: Data were from wave 1 (2002) to wave 9 (2013-2015) of the longitudinal International Tobacco Control Four Country Survey (Canada, the United States, the United Kingdom, Australia), involving 23 831 adult daily smokers. Generalized estimating equation logistic regression models, adjusted for demographics and survey design effects, assessed associations of wave and country with outcomes: (A) over half of five closest friends smoke, (B) agreeing that people important to you believe you should not smoke, (C) agreeing that society disapproves of smoking, and (D) negative opinion of smoking.Results: Between 2002 and 2015, adjusting for covariates, (A) over half of five closest friends smoke did not change (56% vs. 55%; adjusted odds ratio [AOR] = 0.95 [95% Confidence Interval = 0.85-1.07]), (B) agreeing that people important to you believe you should not smoke generally decreased (89% vs. 82%; AOR = 0.54 [0.46-0.64]) despite an increase around 2006-2007, (C) agreeing that society disapproves of smoking increased between 2002 and 2006-2007 (83% vs. 87%; AOR = 1.38 [1.24-1.54]) then decreased until 2013-2015 (78%; AOR = 0.74 [0.63-0.88]), and (D) negative opinion of smoking decreased between 2002 and 2010-2011 (54% vs. 49%; AOR = 0.83 [0.75-0.91]) despite an increase around 2005-2006 and at the final wave (2013-2015). Except friend smoking, Canada had the greatest, and the United Kingdom the lowest, antismoking social norms and opinions.Conclusions: Except friend smoking and opinion of smoking, daily smokers' social norms became less antismoking between 2002 and 2015 despite increases around 2006-2007. Several potential explanations are discussed yet remain undetermined.Implications: Increasingly comprehensive tobacco control policies alongside decreasing smoking prevalence in Canada, the United States, the United Kingdom, and Australia have led to the assumption that smoking has become denormalized in these countries. Absent from the literature is any formal assessment of social norms towards smoking over time. Contrary to our hypotheses, this study found that the injunctive social norms of daily smokers became less antismoking between 2002 and 2015, despite increases around 2006-2007. There was no change over time in the proportion of daily smokers who report that over half of their five closest friends smoke. [ABSTRACT FROM AUTHOR]

What do Masterpiece Cakeshop, Ltd v Colorado Civil Rights Commission , other leading cases from the USA, Canada, and the UK, and Teresa Bejan's concept of 'mere civility', teach us about free speech and toleration? This article seeks to answer that question and suggest a path forward that allows people with deep disagreements about fundamental social and moral issues to live peaceably together despite their differences. This article defends two primary claims: First, 'mere civility' is complimentary to a broader legal argument for protecting the freedom of all members of a society to espouse and live out their views within the context of the public square and marketplace; and Second, compelling speech (or agreement) under the guise of civility endangers liberty and genuine equality. When freedom is properly protected, 'mere civility' is the natural result, while attempts to achieve something more than 'mere civility' invariably jeopardize freedom. [ABSTRACT FROM AUTHOR]

Background: Cancer survival in the UK and Denmark are lower when compared with similar countries with late diagnosis a possible cause. We aimed to study the relationship between barriers to attending a primary care physician (GP) and anticipated time to help seeking (ATHS) with four cancer symptoms in six countries. Methods: A population-based survey measuring cancer awareness and beliefs conducted within the International Cancer Benchmarking Partnership in Australia, Canada, Denmark, Norway, Sweden and UK. Data were collected on perceived barriers to GP consultation (including embarrassment, worry about wasting the doctors' time, fear about what the doctor might find and being too busy) and ATHS for persistent cough, abdominal swelling, rectal bleeding and breast changes. Relationships between perceived barriers and ATHS were investigated using multivariable analysis. Results: Among 19079 respondents, higher perceived barrier scores were associated with longer ATHS intervals for all symptoms studied (P<0.01) responders with the highest barrier scores (>10.84) had between two and three times the odds of longer ATHS. ATHS was low in Australia for all symptoms and highest in Denmark for abdominal bloating. Conclusions: Perceived barriers to help-seeking have a role in delaying GP presentation. Early diagnosis campaigns should address emotional and practical barriers that reduce early presentation with potential cancer symptoms. [ABSTRACT FROM AUTHOR]

When investigating the association between brain tumors and use of mobile telephones, accurate data on tumor position are essential, due to the highly localized absorption of energy in the human brain from the radio-frequency fields emitted. We used a point process model to investigate this association using information that included tumor localization data from the INTERPHONE Study (Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and the United Kingdom). Our main analysis included 792 regular mobile phone users diagnosed with a glioma between 2000 and 2004. Similar to earlier results, we found a statistically significant association between the intracranial distribution of gliomas and the self-reported location of the phone. When we accounted for the preferred side of the head not being exclusively used for all mobile phone calls, the results were similar. The association was independent of the cumulative call time and cumulative number of calls. However, our model used reported side of mobile phone use, which is potentially influenced by recall bias. The point process method provides an alternative to previously used epidemiologic research designs when one is including localization in the investigation of brain tumors and mobile phone use. [ABSTRACT FROM AUTHOR]

The first half of the twentieth century was formative for the Canadian social work profession. White settler Canada was at an intersection between the social forces of capitalism, socialism, feminism, nationalism, imperialism and social reform (Cohen, 1996; Gaudet, 2001). A discourse of British imperial ideas was in wide circulation, although there was contestation and diverging ideas. Through the osmotic transmission process of cultural imperialism, many of these imperial ideas became part of the fabric of social work. Using a comparative historical archival approach, I examine two politically different social work organisations--the Imperial Order of the Daughters of the Empire and Toronto University Settlement--in order to show that this discourse crossed the political spectrum. I consider the influence of imperial discourses on the formation of Canadian social work and the legacy this has left us with. [ABSTRACT FROM AUTHOR]

Background: The Seven Countries Study in the 1960s showed very low mortality from coronary heart disease (CHD) in Japan, which was attributed to very low levels of total cholesterol. Studies of migrant Japanese to the USA in the 1970s documented increase in CHD rates, thus CHD mortality in Japan was expected to increase as their lifestyle became Westernized, yet CHD mortality has continued to decline since 1970. This study describes trends in CHD mortality and its risk factors since 1980 in Japan, contrasting those in other selected developed countries.Methods: We selected Australia, Canada, France, Japan, Spain, Sweden, the UK and the USA. CHD mortality between 1980 and 2007 was obtained from WHO Statistical Information System. National data on traditional risk factors during the same period were obtained from literature and national surveys.Results: Age-adjusted CHD mortality continuously declined between 1980 and 2007 in all these countries. The decline was accompanied by a constant fall in total cholesterol except Japan where total cholesterol continuously rose. In the birth cohort of individuals currently aged 50-69 years, levels of total cholesterol have been higher in Japan than in the USA, yet CHD mortality in Japan remained the lowest: >67% lower in men and > 75% lower in women compared with the USA. The direction and magnitude of changes in other risk factors were generally similar between Japan and the other countries.Conclusions: Decline in CHD mortality despite a continuous rise in total cholesterol is unique. The observation may suggest some protective factors unique to Japanese. [ABSTRACT FROM AUTHOR]

Background. Scientific advances have led to the discovery of novel treatments with high prices. The cost to publicly fund high-cost drugs may threaten the sustainability of drug budgets in different health care systems. In oncology, there are concerns that health-benefit gains are diminishing over time and that the economic evidence to support funding decisions is too limited. Methods. To assess the additional costs and benefits gained from oncology drugs over time, we used treatment protocols and efficacy results from U.S. Food and Drug Administration records to calculate cost-effectiveness ratios for drugs approved to treat first- and second-line metastatic or advanced breast, colorectal, and non-small cell lung cancer during the years 1994-2013. We assessed reimbursement recommendations reached by health technology assessment agencies in the U.K., Australia, and Canada. Results. Cost-effectiveness ratios were calculated for 50 drugs approved by the U.S. regulator. The more recent approvals were often based on surrogate efficacy outcomes and had extremely high costs, often triple the costs of drugs approved in previous years. Over time, the effectiveness gains have increased for some cancer indications; however, for other indications (non-small cell lung and second-line colorectal cancer), the magnitude of gains in effectiveness decreased. Reimbursement recommendations for drugs with the highest cost-effectiveness ratios were the most inconsistent. Conclusion. Evaluation of the clinical benefits that oncology drugs offer as a function of their cost has become highly complex, and for some clinical indications, health benefits are diminishing over time. There is an urgent need for better economic evidence from oncology drug trials and systematic processes to inform funding decisions. [ABSTRACT FROM AUTHOR]

This study examines the effects of different cigarette package warnings in Australia, Canada and the United Kingdom up to 5 years post-implementation. The data came from the International Tobacco Control Surveys. Measures included salience of warnings, cognitive responses, forgoing cigarettes and avoiding warnings. Although salience of the UK warnings was higher than the Australian and Canadian pictorial warnings, this did not lead to greater levels of cognitive reactions, forgoing or avoiding. There was no difference in ratings between the Australian and UK warnings for cognitive responses and forgoing, but the Canadian warnings were responded to more strongly. Avoidance of the Australian warnings was greater than to UK ones, but less than to the Canadian warnings. The impact of warnings declined over time in all three countries. Declines were comparable between Australia and the United Kingdom on all measures except avoiding, where Australia had a greater rate of decline; and for salience where the decline was slower in Canada. Having two rotating sets of warnings does not appear to reduce wear-out over a single set of warnings. Warning size may be more important than warning type in preventing wear-out, although both probably contribute interactively. [ABSTRACT FROM PUBLISHER]

Recent theoretical and empirical evidence has been pointing toward a new development with regard to religion in the Western world: one of polarization between secular and religious individuals. Statistical analyses test the existence of such a trend from 1985 until 2009–2010 at a regional level within three separate national contexts: the United States, the UK, and Canada. Repeated cross-sectional survey data are studied by means of a series of multinomial logit and logistic regression models with generated predicted probabilities. The results show the existence of three distinct patterns of trends since the mid-1980s, one of which consists of religious polarization as measured by the present study: the proportional decline of nominal affiliates coupled with no decline or an increase of unaffiliated and religiously committed individuals. This trend can be found in Great Britain as well as in the Canadian provinces of Alberta and British Columbia. [ABSTRACT FROM AUTHOR]

This study examined the impact of point-of-sale (POS) tobacco marketing restrictions in Australia and Canada, in relation to the United Kingdom and the United States where there were no such restrictions during the study period (2006-10). The data came from the International Tobacco Control Four Country Survey, a prospective multi-country cohort survey of adult smokers. In jurisdictions where POS display bans were implemented, smokers' reported exposure to tobacco marketing declined markedly. From 2006 to 2010, in Canada, the percentages noticing POS tobacco displays declined from 74.1 to 6.1% [adjusted odds ratio (OR)=0.26, P < 0.001]; and reported exposure to POS tobacco advertising decreased from 40.3 to 14.1% (adjusted OR=0.61, P<0.001). Similarly, in Australia, noticing of POS displays decreased from 73.9 to 42.9%. In contrast, exposure to POS marketing in the United States and United Kingdom remained high during this period. In parallel, there were declines in reported exposures to other forms of advertising/promotion in Canada and Australia, but again, not in the United States or United Kingdom. Impulse purchasing of cigarettes was lower in places that enacted POS display bans. These findings indicate that implementing POS tobacco display bans does result in lower exposure to tobacco marketing and less frequent impulse purchasing of cigarettes. [ABSTRACT FROM AUTHOR]

Background Global health training is increasingly part of public health training in high-income countries, with placements as key components. We sought preliminary evidence of student placement experiences and learning through masters' programmes at the universities of Oxford and Toronto. Methods In a mixed-methods design, we drew on existing programme records, student feedback surveys (Oxford only) and semi-structured interviews with graduates. Results Students participated in practice, informed policy and conducted research across a wide variety of topics, and with a range of different tasks, mostly overseas. Building on existing collaboration- or partnership-facilitated placement setup. Clear communication and face-to-face time with organizational representatives or on-site supervisors helped clarify placement objectives. Flexibility on students' and supervisors' part enabled students to take advantage of urgent public health activities for learning. Students valued the opportunity to make cross-country comparisons, to see first-hand the role of international organizations and to learn concrete skills in project design, questionnaire formulation, qualitative and quantitative analysis and writing up. Conclusions Placements were valuable to public health professionals in training. We encourage other programmes to share placement experience of their students, field supervisors and host organizations. [ABSTRACT FROM PUBLISHER]

A discussion by historians including Rachel Hope Cleves, Nicole Eustace, and Paul Gilje regarding the bicentennial of the War of 1812 between the U.S., Canada, and Great Britain is presented. Topics considered include differing public approaches to the history of the War in the U.S. and Canada, the historiography and collective memory of the War, and issues associated with teaching the War. Also discussed in the regional impact of the War on areas such as New England, Quebec, and the Southeastern U.S., how the War of 1812 marked a turning point between the American Republican and Antebellum eras, and the impact of the War on Indian relations and slavery.

Background: Depression affects 20% of people with coronary heart disease (CHD) and predicts worse health-related quality of life (HRQoL), but in primary studies the strength of this reported relationship has been inconsistent. Aims and methods: We conducted a systematic review to investigate the extent to which depression independently predicts subsequent physical HRQoL. We searched electronic databases (MEDLINE, PsycINFO, CINAHL and EMBASE) to identify prospective cohort studies that included CHD patients, focused on depression and subsequent physical HRQoL using standardised measures. Included studies were assessed for methodological quality. Results: We identified 11 independent studies, of which nine showed a significant association between depression and subsequent physical HRQoL. There was no systematic methodological difference between those studies that did and did not show a significant association; in particular the results did not appear to be affected by the way depression or physical HRQoL was measured. Five of the 11 studies were of moderate to high methodological quality and controlled for both HRQoL and the severity of CHD at baseline. Four studies showed a significant association between depression and HRQoL. Conclusions: Depression predicts subsequent physical HRQoL and this association was not attributable to confounding effects of baseline HRQoL or the severity of the CHD. Identification of depressed CHD patients may improve targeting of resources at people at increased risk of worse physical HRQoL. Treating depression may improve subsequent physical HRQoL, though this needs to be established in future randomised controlled trials. [ABSTRACT FROM AUTHOR]

While there has been considerable interest in public participation in new and controversial technologies in the last two decades, less attention has been paid to how different 'publics' and 'participation' are constructed and defined in the context of policy development and the contingencies (historical, cultural, and situational) that can contextualize these processes. This study examines the development of xenotransplantation policy in the US, Canada and the UK in order to understand the emergence of different publics and versions of participation in the social appraisal of a controversial biomedical technology. By examining publics in invited arenas and those that operate in public spaces outside of these official rooms (paying special attention to animal rights and welfare groups), we suggest that a broader understanding can be gained of the nuances in policy trajectories. Contrasting experiences in three case countries with close cultural and historical traditions further elucidate the nature of the framing activities of policy-makers around public participation and the boundary work around different practices that emerged. [ABSTRACT FROM AUTHOR]

Increased interest in the potential societal benefit of incorporating health economics as a part of clinical translational science, particularly nutrition interventions, led the Office of Dietary Supplements at the National Institutes of Health to sponsor a conference to address key questions about the economic analysis of nutrition interventions to enhance communication among health economic methodologists, researchers, reimbursement policy makers, and regulators. Issues discussed included the state of the science, such as what health economic methods are currently used to judge the burden of illness, interventions, or healthcare policies, and what new research methodologies are available or needed to address knowledge and methodological gaps or barriers. Research applications included existing evidence-based health economic research activities in nutrition that are ongoing or planned at federal agencies. International and US regulatory, policy, and clinical practice perspectives included a discussion of how research results can help regulators and policy makers within government make nutrition policy decisions, and how economics affects clinical guideline development. [ABSTRACT FROM AUTHOR]

An essay on East Indian emigration, anticolonialism, and radicalism is presented. It focuses on Western U.S. and Canadian borders, exploring antiradicalism and immigration policies in the U.S. and Canada. The author examines cooperation between Great Britain, the U.S., and Canada in surveying and in suppressing Indian nationalists. Other topics include the Indian revolutionary group the Ghadar party and Indian leader Taraknath Das.

The UK has long experienced a shortage of social workers and has recruited internationally to meet demand. There have been few specific data quantifying the scale of social work mobility to the UK through which such experiences can be set in context. The analysis reported in this article uses data from October 2008, relating to registered social workers working in England. As part of a wider study of migrant social care workers in England, the article reports analysis of data records of over 7,000 non-UK social workers registered to work in England and compares their characteristics to UK-qualified social workers. These analyses are supplemented by analysis of more recent application and registration data from the General Social Care Council pertaining to social workers qualified within and outside the European Union during 2008 and 2009. The findings highlight several important observations in terms of non-UK-qualified social workers' profile as well as some possible trends in migration and variations in rates of qualification verification. Over half of all international social workers in England were trained in four countries: Australia, South Africa, India and the USA. Findings are contextualised with qualitative data obtained from the wider study and policy debates. [ABSTRACT FROM PUBLISHER]

The article presents a roundtable of reflections discussing the contributions and potential trajectory of British historical studies from scholars in the United States and Canada. Questions addressed within the section include the status of teaching 20th-century British history and issues at the undergraduate and graduate levels, the methodology and historiography used by North American scholars, and the influence of imperialism and globalization in the examination of 20th-century history. Multiple entries also reflect on the individual accomplishments of the authors as historians within the field.

CONTEXT: Adrenal crisis is a life-threatening event that occurs regularly in Addison's patients receiving standard replacement therapy. Patient reports suggest that it is an underestimated and under-managed event. OBJECTIVE: To assess the frequency of adrenal crisis in diagnosed patients and to understand the factors contributing to the risks of adrenal crisis. DESIGN: We conducted a postal survey of Addison's patients in four countries, UK (n=485), Canada (n=148), Australia (n=123) and New Zealand (n=85) in 2003, asking about patients' experiences of adrenal crisis and their demographic characteristics. In 2006, a shorter follow-up survey was conducted in the UK (n=261). METHOD: The frequency and causes of adrenal crisis were compared across both surveys. Demographic data from the 2003 survey were analysed to establish the main variables associated with an elevated risk of crisis. RESULTS: Around 8% of diagnosed cases can be expected to need hospital treatment for adrenal crisis annually. Exposure to gastric infection is the single most important factor predicting the likelihood of adrenal crisis. Concomitant diabetes and/or asthma increase the frequency of adrenal crises reported by patients. CONCLUSION: The endocrinologist has a responsibility to ensure that Addison's patients have adequate access to life-saving emergency injection materials and repeated, practical training sessions in how to use them, while the general practitioner plays a vital role as in arranging prompt emergency admissions. [ABSTRACT FROM AUTHOR]

Despite widespread agreement over the connection between federalism and social expenditures during times of welfare state expansion, disagreement exists concerning federalism's role in the retrenchment era. Existing approaches fail to recognize institutional variation among federal states. Analysis of Britain, Germany, and Canada suggests that federalism may promote or hinder health care retrenchment depending upon how it structures the relationship between regional and national governments. Power-sharing federalism hinders health care reform by increasing the institutional obstacles to unpopular cutbacks. Power-separating federalism facilitates reform by creating opportunities for blame avoidance without substantially increasing the number of veto players. These findings challenge traditional linear or dichotomous models of federalism, suggesting the need for an approach that captures how particular types of federalism affect retrenchment politics. [ABSTRACT FROM AUTHOR]

This article focuses on the issues surrounding the liability of end users of the Internet who use peer-to-peer (P2P) technology to communicate and transfer digital files to others throughout the world using the Internet. Part III begins by outlining the legal rights, obligations and liabilities of End Users and Owners in each of the U.S., Great Britain and Canada under the relevant legislation. Part III considers various arguments raised by the relevant players regarding End User liability for copyright infringement through the use of online P2P technology. Part IV examines various options to address the problems posed by file-sharing technology and the Internet including new or modified legislation.

This article considers the effect of jurisprudence on human rights on the interpretation of statutes. It examines the interpretative obligation imposed on courts by section 3 of the Human Rights Act 1998, and traces the leading cases on this section in the House of Lords. The article draws certain conclusions, principally that section 3 does not empower the courts to rewrite legislation but that new rules and canons of interpretation apply when this section is invoked. [ABSTRACT FROM PUBLISHER]

Hand–arm vibration syndrome has been reported in the literature to occur following exposure to vibration from the use of many tools, but to date there have been no case reports of its occurrence in workers who have used high‐pressure hoses, alone or with other tools. To remedy this, the case histories of nine subjects (two without mixed exposure) examined in the UK and Canada are presented, together with their severity classified according to the Stockholm scales. Attention is drawn to the need to use multiple diagnostic tests to establish the diagnosis and the need to implement vibration isolation and damping methodologies, as and when feasible, with respect to hose nozzles in order to minimize the hazard. The ultimate goal for tool manufacturers, hygienists and engineers should be to reduce workplace vibration levels to meet national and international guidelines and legislation, including UK Health & Safety Executive guidelines and European Economic Community directives. The respective risk levels are presented, together with vibration measurements on hoses used by some of the cases. [ABSTRACT FROM PUBLISHER]

Although the college-high school wage gap for younger U. S. men has doubled over the past 30 years, the gap for older men has remained nearly constant. In the United Kingdom and Canada the college-high school wage gap also increased for younger relative to older men. Using a model with imperfect substitution between similarly educated workers in different age groups, we argue that these shifts reflect changes in the relative supply of highly educated workers across age groups. The driving force behind these changes is the slowdown in the rate of growth of educational attainment that began with cohorts born in the early 1950s in all three countries. [ABSTRACT FROM AUTHOR]

The article focuses on research works associated with the invasion of the land surface by plants. At the time when vascular plants appeared on land, all the continents were presumed to have been joined. The Caledonian orogeny had produced a mountainous belt along what is now the Appalachians, eastern Canada, Great Britain, Greenland, and Scandinavia. The first vascular plants, Cooksonia, that can be proven to have vascular and cortical tissues and to bear homosporous sporangia containing resistant spores with trilete marks are found throughout Pridolian strata in Wales. Examination of the stratigraphic evidence for the Silurian age of these plants reveals the absence of marine fossils in the plant-bearing beds, which therefore cannot be dated.

The article focuses on the amending enactments of the Parliament of Canada. It explores the two legal effects of statute revision in Great Britain and peculiarity in North America. It mentions the four parts of the Revised Statutes, including public law, property and civil rights, and civil procedure and criminal law. It highlights the doctrine of merger, which is used as term for the rule operated by amending enactments in the same manner as the enactments they amend.

The article discusses the constitutional measures in the 1981-82 and 1982-83 House of Commons sessions in Great Britain. The victory of Pierre Trudeau's Liberal Party in the Canadian general election on February 1980 led to the enactment of the Canada Act in March 1982. The constitutional impact of the Northern Ireland Bill is discussed. Apart from local government, the two major preoccupations of Prime Minister Margaret Thatcher's government are the trade union law and the excessive scale of the public sector.