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There is a contradiction of intensive national policy efforts and the slow pace of change in widening participation in England. This paper focuses on the use of contextual data in STEM subjects, where there has been less progress in widening access and a more rigid entry pathway through A-level study. Interviews with admissions tutors suggest a narrative in which STEM curricula, and the prior knowledge and skills required to succeed within it are fixed, and that attempts to widen participation and broaden the notion of ‘best students’ could undermine academic standards and the student experience. The paper draws on social justice and social reproduction theoretical frameworks to explore policy enactment, identifying support for widening participation and the effects of a conservative ethos amongst academics. The tension of these approaches, alongside the autonomy of decision-makers, are key dynamics explaining the inertia of policy efforts for change.

In this 2021 AFHVS Presidential Address, Kim Niewolny provides a brief foray into the onto-epistemic framing of critical praxis for sustainable food systems transformation. Niewolny proposes we engage in the creative entanglement of critical praxis and the social imaginary to “unthink” the orthodoxies that govern our ideas of the possible. She offers several possibilities as pathways toward a food system that embodies health equity, ecological justice, land sovereignty, and human rights, including: (1) agroecological research and movement building; (2) food, farm, and health policy; (3) food and farm system worker protections as public health and human rights concerns; (4) intersectional food justice scholarship and curriculum; (5) narrative-led, community-based, and action-oriented methodologies as multi-dimensional inquiry; (6) and multi-sector and multi-racial coalitions as dynamic networks that challenge linear, neoliberal, and technical-rational practices. Niewolny concludes with a call for radical hope as a principle for critical food systems praxis. Published version

While rape historically remains underreported all over the globe, and criminal justice factors contribute to this problem, we investigate unique circumstances that might influence reporting inclinations by Hungarian victims of sexual violence. Among other possible factors, victim-blaming, institutional desensitization, and a lack of trust in the criminal justice system and in the community are discussed. The in-depth interviews (n = 22) with law enforcement and criminal justice professionals conducted in 2018 in Hungary reveal roots of underreporting in the complexities of the criminal justice system: there is a failure to prioritize victims’ needs—mental care services, physical and privacy protection—and a focus instead on solely providing legal justice. The further deficits that can be found among professionals’ attitudes and behaviors in the courtroom are products of the following: a lack of standardized protocols in addressing the needs of victims; a dearth of technical and evidence-based knowledge and training; a lack of supervision and trauma-informed services to practitioners; high caseloads; a focus on the goal of high conviction rates; not providing open communication toward victims; and a shortage of standardized protocols in dealing with victims. Published version

This paper examines determinants of ethnic disparities in workplace risks of COVID-19 among health and social care workers (HCWs) in the UK. This was undertaken to inform public health policy in the management of COVID-19 relating to health and social care provision. A cross-sectional survey was administered in July–August 2020 (n = 456) to elicit HCWs’ experiences of COVID-19 management in the workplace and their perceptions of exposure, personal protection against infection, involvement in local clinical management, and other workplace hazards. Findings suggest minority ethnic HCWs were twice as likely as White HCWs to be in a patient-facing role (OR = 2.14, 95% CI:1.21; 3.78, P < 0.01) and twice as likely (63% vs 39%) to be caring for COVID-19 positive patients (OR = 2.68, 95% CI: 1.77; 4.06, P < 0.01). Those in nursing, were three times as likely to be redeployed to a COVID-19 care setting (OR = 3.33, 95%CI: 1.23; 9.02, P= 0.02). Minority ethnic HCWs within lower- and mid-level roles carried a higher burden of frontline clinical management of COVID-19 positive patients than their White counterparts. This study found evidence of ethnic disparities across several workplace hazards, with increased exposure to and less protection against infection, more responsibility for the clinical management of infection, and evidence of systemic racial bias in the disproportionate redeployment of minority ethnic nursing staff to COVID-19 areas. An NHS-wide review is required to assess procedural fairness, ensure safe practices now, and to avert future crises.

This experiment (N = 591) tests whether audiences adjust their standards for what qualifies as fair journalism based the transparency of news editors, the source of the news, and the target of an accusation. In the context of a whistleblower scandal, the results suggest the relationship between the audience member’s ideology and the news story publisher and target influence what details the audience thinks journalists should reveal. Additionally, we find transparency from editors can alter those perceptions. Accepted version

Cambrosio et al. (2018. “Extending Experimentation: Oncology’s Fading Boundary Between Research and Care.” New Genetics and Society 37 (3): 207–226) argue that “experimental care” in contemporary oncology involves the rapid merging of patient research and care, and invite further study into developments across other health conditions. We present a 2018–2019 study of experimental breast cancer care in an urban clinical setting in the light of two other studies in the same hospital group: in the same cancer service (2013–14) and, prompted by these earlier findings, an interview study in HIV services (2014–15). We found that patients and staff anticipated better outcomes by treating sub-types of breast cancer but they also hoped for a better one-size-fits-all approach, akin to the antiretroviral treatments introduced for HIV and explored in our interview study. We conclude that the promise of targeted treatment for sub-types of disease – variously described as experimental care, personalised, precision, stratified and sub-group medicine – is accompanied by hopes for a single, standard, effective approach.

Supporting more equitable participation in science, technology, engineering, and mathematics (STEM) remains a key, persistent educational challenge. This paper employs a sociological Bourdieusian lens to explore how equitable youth outcomes might be supported through informal science learning (ISL). Drawing on multimodal, ethnographic data from four case study youth aged 11–14 from two ISL programs, we identify four areas of practice that were enacted to a greater or lesser extent in the programs in support of equitable youth outcomes. We identify how the equitable potential of these practices was realized through a disruption of dominant power relations. It is argued that ISL should focus on changing the field, rather than young people. Affordances and limitations of the Bourdieusian lens are discussed.

This paper examines cross-national commonalities and differences in online hate speech content, exposure, and emotional reaction. Using online surveys from 18 to 25-year-old respondents in six countries, we find a majority of respondents were exposed to online hate in the preceding 3 months. Commonalities across countries are the platform where the respondents were exposed and how they arrived at such content. Unique national cultures of hate speech also exist, including the common targets and respondents’ emotional reactions. A majority of respondents report feeling angry, sad, or ashamed, but most worrisome may be the substantial numbers who report feelings of hatred or pride after seeing online hate. Given the potential for repeated exposure and the recent increase in hate crimes in the US. and Europe, this finding should serve as a reminder of the dangers of online hate and its potential link to offline violence. Accepted version

Using interview and observational data from a busy and research-intensive breast cancer service in the United Kingdom, we discuss recent developments in Personalised Medicine. Specifically, we show how clinical and research practices meet in clinical pathways that are reconfigured in response to changing approaches of diagnosing, monitoring, treating and understanding cancers. Clinical pathways are increasingly sensitive to changes in evidence deduced through new technologies and therapies as well as decisions based on intensive, iterative analysis of data collected across a range of platforms. We contribute to existing research by showing how the organisation of on clinical pathways both maintains established clinical practices and responds to new research evidence, managing a threshold between evidence-based and experimental medicine. Finally, we invite comparisons with other forms of personalisation to understand how they depend on the ‘real time’ collection, analysis and application of data.

A reduction in the production and consumption of meat and dairy across much of the world is critical for climate change mitigation, the alleviation of ecological stress, and improved health. We update an agent-based model (ABM) of historic UK milk consumption and apply it to scenarios of dairy reduction and adoption of plant-based milk (PBM) out to 2050. The updated model is comprised of a cognitive function, where agents perceive the physical, health and environmental characteristics of milk choice, which is modified by habit and social influence. We use European Social Survey 2018 and British Social Attitudes 2008 survey data to empirically inform the model. Taking a backcasting approach, we calibrate parameters against published UK dairy reduction targets (2030 and 2050), and test how different price relationships, and characterisations of environmental concern, may affect simulated milk consumption from 2020 to 2050. Scenarios for core targets (20% less dairy by 2030 and 35% by 2050) largely produced plausible consumption trajectories. However, at current pricing of dairy and PBM, simulated consumption was mostly unable to deliver on desired core targets, but this improved markedly with dairy prices set to organic levels. The influence of changing environmental concern on milk choice resulted in higher levels of dairy milk reduction. When modelled as transient, intense shocks to public concern, consumption patterns did not fundamentally change. However, small, incremental but permanent changes to concern did produce structural changes to consumption patterns, with dairy falling below plant-based alternatives at around 2030. This study is the first to apply an ABM in the context of scenarios for dairy reduction and PBM adoption in service to UK climate-related consumption targets. It can serve as valuable bottom-up, alternative, evidence on the feasibility of dietary shift targets, and poses policy implications for how to address impediments to behavioural change.

Substitution of food products will be key to realising widespread adoption of sustainable diets. We present an agent-based model of decision-making and influences on food choice, and apply it to historically observed trends of British whole and skimmed (including semi) milk consumption from 1974 to 2005. We aim to give a plausible representation of milk choice substitution, and test different mechanisms of choice consideration. Agents are consumers that perceive information regarding the two milk choices, and hold values that inform their position on the health and environmental impact of those choices. Habit, social influence and post-decision evaluation are modelled. Representative survey data on human values and long-running public concerns empirically inform the model. An experiment was run to compare two model variants by how they perform in reproducing these trends. This was measured by recording mean weekly milk consumption per person. The variants differed in how agents became disposed to consider alternative milk choices. One followed a threshold approach, the other was probability based. All other model aspects remained unchanged. An optimisation exercise via an evolutionary algorithm was used to calibrate the model variants independently to observed data. Following calibration, uncertainty and global variance-based temporal sensitivity analysis were conducted. Both model variants were able to reproduce the general pattern of historical milk consumption, however, the probability-based approach gave a closer fit to the observed data, but over a wider range of uncertainty. This responds to, and further highlights, the need for research that looks at, and compares, different models of human decision-making in agent-based and simulation models. This study is the first to present an agent-based modelling of food choice substitution in the context of British milk consumption. It can serve as a valuable pre-curser to the modelling of dietary shift and sustainable product substitution to plant-based alternatives in Britain.

National systems of official statistics are expected to provide governments, businesses and the public with data about the economic, demographic, social and environmental situation. Digitisation of data collection for official statistics is mooted as having a major potential impact on society. Greater use of administrative data held in government is proceeding slowly. Evidence is limited, but access to big data − from satellites, point-of-sale systems and social media − is being explored and trialled. Initiatives are driven by new requirements for official statistics as well as pressures on traditional data collection from households and businesses. Effective government use of new data sources has the possibility of creating the ultimate evidence base for policies intended to improve lives, and anonymised data are also being made available to other researchers. The article uses the UK as a case study to outline how the big data evidence-to-policy process is intended to work in that context, and to assess the challenges faced in making it work as intended. We conclude that technical developments need to be accompanied throughout with attention to the marketing of official statistics and engagement with all users and potential users. The goal is to produce trusted as well as trustworthy statistics.

The present study is focused on the online debate relating to the Brexit process, three years and half since the historical referendum that has sanctioned the divide of the United Kingdom from the European Union. In our analysis we consider a corpus of approximately 33 million Brexit related tweets, shared on Twitter for 58 weeks, spanning from 31 December 2019 to 9 February 2020. Due to its great accessibility to data, Twitter constitutes a convenient data source to monitor and evaluate a wide variety of topics. In addition, Twitter’s marked orientation towards news and the dissemination of information makes this microblogging network more connected to politics compared to other platforms. Through static and dynamic topic modelling techniques, we were able to identify the topics that have attracted the most attention from Twitters users and to characterise their temporal evolution. The topics retrieved by the static model highlight the major events of the Brexit process while the dynamic analysis recovered the persistent themes of discussion and debate over the entire period.

Millions of freelancers work on digital platforms in the online labour market (OLM). The OLM’s capacity to both undermine and reproduce labour inequalities is a theme in contemporary platform economy debates. What is less well understood is how processes of social (re)production take place in practice for diverse freelancers on global platforms. Drawing on a study of freelance designers, we use Bourdieu’s notions of capital and field to explore the specific ‘rules of the game’ and the symbolic valuing of skills and identities that secure legitimacy and advantage in the OLM. We contribute to contemporary debates by illuminating the power of Global North actors to shape freelancer positions and hierarchies in the online design field. The ‘cost advantages’ of Global South workers are counterbalanced by the symbolic legitimising of specific cultural and social practices (specifically in relation to language) and the devaluing of others.

Despite continued development of effective HIV treatment, expanded access to care and advances in prevention modalities, HIV‐related stigma persists. We examine how, in the context of a universal HIV‐testing and treatment trial in South Africa and Zambia, increased availability of HIV services influenced conceptualisations of HIV. Using qualitative data, we explore people’s stigma‐related experiences of living in ‘intervention’ and ‘control’ study communities. We conducted exploratory data analysis from a qualitative cohort of 150 households in 13 study communities, collected between 2016 and 2018. We found that increased availability of HIV‐testing services influenced conceptualisations of HIV as normative (non‐exceptional) and the visibility of people living with HIV (PLHIV) in household and community spaces impacted opportunities for stigma. There was a shift in community narratives towards individual responsibility to take up (assumingly) widely available service – for PLHIV to take care of their own health and to prevent onward transmission. Based on empirical data, we show that, despite a growing acceptance of HIV‐related testing services, anticipated stigma persists through the mechanism of shifting responsibilisation. To mitigate the responsibilisation of PLHIV, heath implementers need to adapt anti‐stigma messaging and especially focus on anticipated stigma.

There is a paucity of research in the UK which examines problem gambling and that which does exist is mainly quantitative, focuses on male samples and fails to look at treatment seeking populations or obstacles preventing problem gamblers from seeking treatment. This paper presents findings from part of a larger qualitative study that explored the experience of treatment for female problem gamblers. Data were collected using semi-structured interviews with eight women who had received individual cognitive-behavioural therapy in the National Health Service for their gambling problem. An interpretative phenomenological analysis approach was applied in the research process, identifying three main themes, of which the subtheme ‘Barriers to Treatment’ is examined here. Internal and external barriers to treatment organically emerged in all female participants’ accounts and appear to have an impact on service utilisation. Input directly from gamblers can be combined with findings from other studies to devise better ways of reaching female problem gamblers. A better understanding of barriers to treatment can also provide valuable direction for future research and suggest applications in clinical service provision and treatment planning.

This article assesses whether job insecurity is higher in leveraged buyouts (LBOs) than elsewhere. It draws on matched employer‐employee data from the British 2011 Workplace Employment Relations Study linked to data from the Centre for Management Buyout Research. The analysis finds no consistent evidence of higher job insecurity in LBOs as measured by workforce reduction practices (redundancy rates, job security/no‐compulsory redundancies policies and redundancy consultation), dismissal rates, labour use practices (non‐permanent employment contracts and outsourcing) and employees’ job security perceptions. Job insecurity is no higher in either current or former LBOs than elsewhere. Contrary to what might be expected, it is also no higher in private equity (PE)‐backed LBOs, management buy‐ins or high‐debt LBOs and there is only partial and weak evidence of higher job insecurity in short‐hold LBOs. Job insecurity is also no higher in perfect storm LBOs (PE‐backed management buy‐ins that are short‐holds with high‐debt). Concerns over the negative implications of LBOs for job security thus appear misplaced.

With more graduates, degree outcomes have a renewed significance for high-achieving students to stand out in a graduate crowd. In the United Kingdom, over a quarter of undergraduates now leave university with the highest grade – a ‘first-class’ degree – although students from non-traditional and underprivileged backgrounds are the least likely. This article explores the experiences of high-achieving non-traditional (HANT) university students. Drawing on in-depth interviews with 30 final-year students who are on course to achieve a first-class degree from working-class, minority ethnic and/or mature backgrounds, we examine their pathways to academic success through identity works and negotiations. We argue that early successes are crucial for students to re-evaluate their self-expectations as students who can achieve in higher education, while self-esteem, pride or fear can prevent students from maximising their available resources and opportunities. Implications for practice and policy are discussed, including the reflective advice from HANT students towards academic success.

The socioeconomic gradient in chronic conditions is clear in the poorest and wealthiest of countries, but extant evidence on this relationship in low- and middle-income countries is inconclusive. We use data gathered between 2008 and 2012 from a nationally representative sample of over 10,000 South African adults, and objective health measures to analyse the differential effects of education, income and other factors on the prevalence of hypertension, individuals' awareness and control of hypertensive status. Prevalence of hypertension is high at 38% among women and 34% among men. 59% of hypertensive individuals are unaware of their status. We find prevalence and unawareness of hypertension are a public health concern across all income groups in South Africa. Higher income is however associated with effective control amongst men. Completing secondary education is associated with 7 mmHg lower blood pressure only in a small sub-group of women but is associated with 22 percentage point higher likelihood of effective hypertension control amongst women. We conclude that poorer and less educated individuals are particularly at high risk of cardiovascular disease in South Africa.

Objectives: Dementia interferes with older adults’ functioning in cognitive, daily, psychosocial, and neuroendocrine domains. The present study examined the psychophysiological effects of dance movement therapy (DMT) and physical exercise for older adults with dementia. Methods: This randomized controlled trial recruited 204 older adults diagnosed with mild dementia into the DMT, exercise, or waitlist control group. Both DMT and exercise interventions had similar intensity and comprised 24 hr of intervention that spanned over 12 weeks. All participants completed self-report questionnaires on psychosocial well-being, daily functioning, neurocognitive assessments, and salivary cortisol measures at baseline and 3 follow-up measurements more than 1 year. Results: The DMT group showed significant decreases in depression, loneliness, and negative mood (d = 0.33–0.42, p < .05) and improved daily functioning (d = 0.40, p < .01) and diurnal cortisol slope (d = 0.30, p < .01). The effects on daily functioning and cortisol slope remained at 1-year follow-up. The exercise group of matched intensity showed no significant effects on the outcomes. Discussion: The study findings support the potential utility of DMT as a multifaceted intervention for improving various aspects of functioning in older adults with declining cognitive abilities. The lack of beneficial effects for our exercise intervention and long-term DMT effects highlights the need to maintain persistent levels of exercise with adequate intensity and duration.

In 2006, the Massachusetts healthcare reform was introduced to mandate health insurance, extend eligibility of publicly subsidised health insurance, improve quality and access to care and develop preventive health services. The objective of this study was to determine the impact of expanding publicly subsidised health insurance through the Massachusetts reform on access to primary care, disease management and behavioural risk factors. Using cross-sectional data from the Behavioural Risk Factor Surveillance System (BRFSS) from 2001 to 2010 and exploiting the selective introduction of the healthcare reform, we assessed its impact on primary care access, behavioural risk factors, such as obesity, and receipt of diabetes management tests. We did so using a differences-in-differences methodology by comparing Massachusetts with other New England States for 131,002 adults under 300% of the federal poverty level and by race/ethnicity within this group. Triple difference estimates were also conducted to control for potential within state time varying confounding factors. The results suggest that increasing publicly subsidised health insurance had a positive impact on primary care access for lower income adults, particularly those that are white. However, with the exception of improvements in alcohol consumption for one specific group (lower income whites) the reform had no effect on behaviour risk factors or diabetes disease management. The aims of the reform were to improve access to care and through this, behavioural risk factors and diabetes management. This study suggests that while access to care was increased, reducing risk factors attributed to health risky behaviour and diabetes cannot be sufficiently done simply by extending health insurance coverage and the provision of preventive services. This suggests that more targeted interventions are required.

The DSM-5 includes provisions for episodic forms of gambling disorder, with such changes aligned with earlier accounts of potential binge gambling behaviours. However, there is little research that indicates the utility of these classifications of episodic or binge gambling, and this study considered their characteristics in a clinical sample. It involved administration of a new binge gambling screening tool, along with routine measures, to n = 214 patients entering a specialist treatment clinic for gambling problems. Results indicated that episodic gambling was common in this clinical context, with 28% and 32% of patients reporting gambling episodes that were (a) regular and alternating, and (b) irregular and intermittent, respectively. These patterns were distinguished by factors including associations with covariates that indicated differences from continuous gamblers. For example, the irregular episodic gamblers, but not the regular pattern, demonstrated lower levels of problem gambling severity and comorbidity. Rates of potential binge gambling, which was defined in terms of additional criteria, were around 4% and numbers were insufficient for comparable analyses. The findings support inclusion of episodic forms of gambling disorder in the DSM-5, but highlight the need for improved recognition and research on heterogeneous forms of episodic gambling.

Pneumonia is the leading cause of mortality for children under five years in sub-Saharan Africa. Household air pollution has been found to increase risk of pneumonia, especially due to exposure from dirty burning biomass fuels. It has been suggested that advanced stoves, which burn fuel more efficiently and reduce smoke emissions, may help to reduce household air pollution in poor, rural settings. This qualitative study aims to provide an insight into the household costs and perceived benefits from use of the stove in Malawi. It was conducted alongside The Cooking and Pneumonia Study (CAPS), the largest village cluster-level randomised controlled trial of an advanced combustion cookstove intervention to prevent pneumonia in children under five to date. In 2015, using 100 semi-structured interviews this study assessed household time use and perceptions of the stove from both control and intervention participants taking part in the CAPS trial in Chilumba. Household direct and indirect costs associated with the intervention were calculated. Users overwhelming liked using the stove. The main reported benefits were reduced cooking times and reduced fuel consumption. In most interviews, the health benefits were not initially identified as advantages of the stove, although when prompted, respondents stated that reduced smoke emissions contributed to a reduction in respiratory symptoms. The cost of the stove was much higher than most respondents said they would be willing to pay. The stoves were not primarily seen as health products. Perceptions of limited impact on health was subsequently supported by the CAPS trial data which showed no significant effect on pneumonia. While the findings are encouraging from the perspective of acceptability, without innovative financing mechanisms, general uptake and sustained use of the stove may not be possible in this setting. The findings also raise the question of whether the stoves should be marketed and championed as ‘health interventions’., Highlights • The first evaluation of household perceptions of an advanced cookstove trial in Malawi. • We investigate the intensive margin, i.e. how the technology is used and perceived. • Significant benefits from reduced cooking and fuel collection times were reported. • Unless prompted, respondents rarely associated the stoves with health benefits. • The high cost of the advanced cookstove will need addressing to ensure future uptake.

Over 1.9 billion individuals require preventive chemotherapy through mass drug administration (MDA). Community-directed MDA relies on volunteer community medicine distributors (CMDs) and their achievement of high coverage and compliance. Yet, it is unknown if village social networks influence effective MDA implementation by CMDs. In Mayuge District, Uganda, census-style surveys were conducted for 16,357 individuals from 3,491 households in 17 villages. Praziquantel, albendazole, and ivermectin were administered for one month in community-directed MDA to treat Schistosoma mansoni, hookworm, and lymphatic filariasis. Self-reported treatment outcomes, socioeconomic characteristics, friendship networks, and health advice networks were collected. We investigated systematically missed coverage and noncompliance. Coverage was defined as an eligible person being offered at least one drug by CMDs; compliance included ingesting at least one of the offered drugs. These outcomes were analyzed as a two-stage process using a Heckman selection model. To further assess if MDA through CMDs was working as intended, we examined the probability of accurate drug administration of 1) praziquantel, 2) both albendazole and ivermectin, and 3) all drugs. This analysis was conducted using bivariate Probit regression. Four indicators from each social network were examined: degree, betweenness centrality, closeness centrality, and the presence of a direct connection to CMDs. All models accounted for nested household and village standard errors. CMDs were more likely to offer medicines, and to accurately administer the drugs as trained by the national control programme, to individuals with high friendship degree (many connections) and high friendship closeness centrality (households that were only a short number of steps away from all other households in the network). Though high (88.59%), additional compliance was associated with directly trusting CMDs for health advice. Effective treatment provision requires addressing CMD biases towards influential, well-embedded individuals in friendship networks and utilizing health advice networks to increase village trust in CMDs., Highlights • Evaluation of mass drug administration implementation using social networks. • Evidence of social biases and status-seeking from community medicine distributors. • Coverage and compliance with mass drug administration for 16,357 individuals. • Impact of friendship and health advice networks on treatment probability. • Overlap of network status and formal social status in rural villages.

Socioeconomic differences in health have been consistently observed worldwide. Physical health deteriorates more rapidly with age among men and women with lower socioeconomic status (SES) than among those with higher SES. The biological processes underlying these differences are best understood by adopting a life course approach. In this paper we introduce the pan- European LIFEPATH project which uses multiple cohorts - including biomarker data - to investigate ageing as a phenomenon with two broad stages across life: build-up and decline. The ‘build-up’ stage, from conception and early intra-uterine life to late adolescence or early twenties, is characterised by rapid successions of developmentally and socially sensitive periods. The second stage, starting in early adulthood, is a period of ‘decline’ from maximum attained health to loss of function, overt disease and death. LIFEPATH adopts a study design that integrates social science and public health approaches with biology (including molecular epidemiology), using well-characterised population cohorts and omics measurements (particularly epigenomics). LIFEPATH includes information and biological samples from 17 cohorts, including several with extensive phenotyping and repeat biological samples, and a very large cohort (1 million individuals) without biological samples (WHIP, from Italy). The countries that are covered by the cohorts are France, Italy, Portugal, Ireland, UK, Finland, Switzerland and Australia. These cohorts are only a small proportion of all cohorts available in Europe, but we have chosen them for the combination of good measures of socioeconomic status, risk factors for non-communicable diseases (NCDs) and biomarkers already measured (or availability of blood samples for further testing). The majority of cohorts include ‘hard’ outcomes (diabetes, cancer, Cardiovascular Disease (CVD), total mortality), and the extensively phenotyped cohorts also include several measurements of the functional components of healthy ageing, including frailty, impaired vision, cognitive function, renal and brain function, osteoporosis, sleep disturbances and mental health. All age groups are represented with two birth cohorts, one cohort of adolescents and several cohorts encompassing young adults (age 18 and above). Furthermore, there is a strong representation of elderly subjects in seven cohorts. The specific objectives of the project are: (a) to show that healthy ageing is an achievable goal for society; (b) to improve the understanding of the mechanisms through which healthy ageing pathways diverge by SES, by investigating life course biological pathways using omic technologies; (c) to examine the consequences of the current economic recession on health and the biology of ageing (and the consequent increase in social inequalities); (d) to provide updated, relevant and innovative evidence for healthy ageing policies (particularly ‘health in all policies’) using both observational studies and an experimental approach based on a reanalysis of data from a ‘conditional cash transfer’ randomised experiment in New York and new data collected as part of an earned income tax credit randomised experiment in Atlanta and New York. To achieve these objectives, data are used from three categories of studies: 1. national census-based followup data to obtain mortality by socioeconomic status; 2. cohorts with intense phenotyping and repeat biological samples; 3. large cohorts with biological samples. With these objectives and methodologies, LIFEPATH seeks to provide updated, relevant and innovative evidence to underpin future policies and strategies for the promotion of healthy ageing, targeted disease prevention and clinical interventions that address the issue of social disparities in ageing and the social determinants of health. The present paper describes the design and some initial results of LIFEPATH as an example of the integration of social and biological sciences to provide evidence for public health policies.

We conducted ethnographic research in collaboration with a large, research‐intensive London breast cancer service in 2013–2014 so as to understand the practices and potential effects of stratified medicine. Stratified medicine is often seen as a synonym for both personalised and precision medicine but these three terms, we found, also related to distinct facets of treatment and care. Personalised medicine is the term adopted for the developing 2016 NHS England Strategy, in which breast cancer care is considered a prime example of improved biological precision and better patient outcomes. We asked how this biologically stratified medicine affected wider relations of care and treatment. We interviewed formally 33 patients and 23 of their carers, including healthcare workers; attended meetings associated with service improvements, medical decision‐making, public engagement, and scientific developments as well as following patients through waiting rooms, clinical consultations and other settings. We found that the translation of new protocols based on biological research introduced further complications into an already‐complex patient pathway. Combinations of new and historic forms of stratification had an impact on almost all patients, carers and staff, resulting in care that often felt less rather than more personal.

This article engages in the debate on the effects of early childhood health and children’s cognition at preschool and school ages in low- and middle-income countries. On the basis of three rounds of the ‘Young Lives’ panel, it endorses a multidimensional approach to health. A ‘suite of indicators’ of malnutrition and morbidity, and a composite Multidimensional Health Poverty Index (MHPI) are used to measure health. Expanding the informational basis for measuring health helped to capture variations in children’s medium-term cognitive outcomes more effectively. Beyond stunting, our empirical analysis shows that acute malnutrition is an important predictor of children’s lifecourse learning in India, while it has minor or no effects in the other countries. The composite MHPI is also significantly associated with later cognition; however, it is substantially less informative than the suite of indicators. Finally, the article explores some potential channels through which the relationship between early health and mid-term cognitive abilities operates.

This article introduces the Icehotel, the world’s first and largest hotel to be constructed entirely of ice and snow, as a unique and generative organizational trope. As a trope (and metaphor, in particular), it both supplements and complements Morgan’s seminal book, The Images of Organization, and generates unique insights with regard to surprise, unifinality, purity, eco-coreness and rebirth. The Icehotel also serves as a lens for examining organizations through each master trope, that is, metaphor, metonymy, synecdoche and irony. Evidence of metonymy in language describing the Icehotel is presented. The case for synecdoche is made by arguing that the Icehotel is a species of two genera, that is, temporary organizations and paradoxical organizations. Also, the Icehotel is not only paradoxical (i.e. a form of irony), but also generates four other paradoxes, namely, the ways that organizations are evolutionary yet revolutionary, negative as well as positive, different yet similar and unsustainably sustainable. The Icehotel also exemplifies serious play – a particular approach for managing paradoxes. Finally, the article discusses implications for research and practice.

A book review of Iran and the Muslim World: Resistance and Revolution, by Nikki R. Keddie. New York: New York University Press, 1995. 303 pp. $45.00 cloth. ISBN: 0-8147-4663-2. Published version

Corruption may lead to tax evasion and unbalanced favors and this may lead to extraordinary wealth amongst a few. We study for 13 countries 6 years of Forbes rankings data and we examine whether corruption leads to more inequality amongst the wealthiest. When we correct in our panel model for current and one-year lagged competitiveness and GDP growth rates, we find no such effect. In fact, we find that more competitiveness decreases inequality amongst the wealthiest.