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Background Current child measurements of weight status in Wales are determined at early childhood only. A further measurement at late childhood could identify adiposity levels prior to adolescence and young adulthood. The aim of this study therefore was to determine current adiposity levels in a cohort of children at late childhood and present a prediction of future levels upon entering young adulthood. Methods In total, 288 boys (M age = 10.94 years, SD = 0.58) and 257 girls (M age = 10.78 years, SD = 0.63) from South East Wales were measured for anthropometry and their body mass index (BMI) (kg/m2) determined. International Obesity Task Force data predicted their BMI at age 18 years. Results Approximately one quarter of boys and girls in late childhood were classified at an unhealthy weight. Predictive data showed that by age 18 years, this percentage had increased to approximately one-third in both genders. Conclusion The overweight and obesity levels in our cohort were high and predicted that many could become obese adults. This study therefore supports the call for the current Wales child measurement programme to be extended to report weight status in late childhood.

Background Children with life-limiting conditions receive specialist paediatric care in childhood, but the transition to adult care during adolescence. There are concerns about transition, including a lack of continuity in care and that it may lead to increases in emergency hospital visits. Methods A retrospective cohort was constructed from routinely collected primary and hospital care records for young people aged 12–23 years in England with (i) life-limiting conditions, (ii) diabetes or (iii) no long-term conditions. Transition point was estimated from the data and emergency inpatient admissions and Emergency Department visits per person-year compared for paediatric and adult care using random intercept Poisson regressions. Results Young people with life-limiting conditions had 29% (95% CI: 14–46%) more emergency inpatient admissions and 24% (95% CI: 12–38%) more Emergency Department visits in adult care than in paediatric care. There were no significant differences associated with the transition for young people in the diabetes or no long-term conditions groups. Conclusions The transition from paediatric to adult healthcare is associated with an increase in emergency hospital visits for young people with life-limiting conditions, but not for young people with diabetes or no long-term conditions. There may be scope to improve the transition for young people with life-limiting conditions. Impact There is evidence for increases in emergency hospital visits when young people with life-limiting conditions transition to adult healthcare. These changes are not observed for comparator groups - young people with diabetes and young people with no known long-term conditions, suggesting they are not due to other transitions happening at similar ages. Greater sensitivity to changes at transition is achieved through estimation of the transition point from the data, reducing misclassification bias.

China’s pursuit of global superpower status compels the country to make coordinated efforts across numerous sectors. Global leadership in higher education is one example and provides a case study i...

Primary and Secondary schools have been identified as key environments for the promotion of lifelong physical activity, through the provision of Physical Education (PE) classes, although concerns h...

The objective of this collection of essays is to gain insights into the different national-level state responses to COVID-19 around the world and the conditions that shaped them. The pandemic offers a natural experiment wherein the policy problem governments faced was the same but the responses they made were different, creating opportunities for comparison of both the kinds of policy tools being used and the factors that accounted for their choice. Accordingly, after surveying on-line databases of policy tools used in the pandemic and subjecting these to topic modelling to reveal the characteristics of a ‘standard’ national pandemic response, we discuss the similarities and differences found in specific responses. This is done with reference to the nature and level of policy capacity of respective governments, highlighting the critical roles played by (in)adequate preparation and lesson-drawing from past experiences with similar outbreaks or crises. Taken together the articles show how the national responses to the COVID-19 pandemic were shaped by the opportunity and capacity each government had to learn from previous pandemics and their capacity to operationalize and build political support for the standard portfolio of policy measures deployed to deal with the crisis. However, they also show how other factors such as the nature of national leadership, the organization of government and civil society, and blindspots towards the vulnerabilities of certain population segments also helped to shape policy responses to the pandemic.

Polypharmacy is often appropriate for children with life-limiting conditions but is associated with an increase in hospitalizations and inappropriate prescribing, and can affect the quality of life of children and their families as they manage complex medication schedules. Despite this, little is known about polypharmacy in this population.To describe the prevalence and patterns of polypharmacy in children with a life-limiting condition in a nationally representative cohort in England.Observational study of children (age 0-19 years) with a life-limiting condition in a national database from 2000 to 2015. Common definitions of polypharmacy were used to determine polypharmacy prevalence in each year based on unique medications and regular medications. Hierarchical regression analyses were used to explore factors associated with polypharmacy.Data on 15,829 individuals were included. Each year 27%-39% of children were prescribed ≥5 unique medications and 8%-12% were prescribed ≥10. Children with a respiratory (OR 7.6, 95%CI 6.4-9.0), neurological (OR 2.8, 95%CI 2.4-3.2), or metabolic (OR 2.2, 95%CI 1.7-2.8) condition were more likely than those with a congenital condition to experience polypharmacy. Increasing age, being diagnosed with a LLC under one year of age, having1 life-limiting or chronic condition or living in areas of higher deprivation were also associated with higher prevalence of polypharmacy.Children with life-limiting conditions have a high prevalence of polypharmacy and some children are at greater risk than others. More research is needed to understand and address the factors that lead to problematic polypharmacy in this population.

The aims of this study were to investigate levels of fundamental movement skills (FMS) proficiency and their relationship with measures of health-related physical fitness of primary school children...

Market-led development practice has metamorphosed over the last few decades, moving through various iterations of market-oriented reforms targeting state and society. Three phases are discernible: ...

Background: The number of children with life-limiting conditions in England is known to be increasing, which has been attributed in part to increased survival times. Consequently, more of these young people will reach ages at which they start transitioning to adult healthcare (14-19 years). However, no research exists that quantifies the number of young people with life-limiting conditions in England reaching transition ages or their medical complexity, both essential data for good service planning. Methods: National hospital data in England (Hospital Episode Statistics) from NHS Digital were used to identify the number of young people aged 14-19 years from 2012/13 to 2018/19 with life-limiting conditions diagnosed in childhood. The data were assessed for indicators of medical complexity: number of conditions, number of main specialties of consultants involved, number of hospital admissions and Accident & Emergency Department visits, length of stay, bed days and technology dependence (gastrostomies, tracheostomies). Overlap between measures of complexity was assessed. Results: The number of young people with life-limiting conditions has increased rapidly over the study period, from 20363 in 2012/13 to 34307 in 2018/19. There was evidence for increased complexity regarding the number of conditions and number of distinct main specialties of consultants involved in care, but limited evidence of increases in average healthcare use per person or increased technology dependence. The increasing size of the group meant that healthcare use increased overall. There was limited overlap between measures of medical complexity. Conclusions: The number of young people with life-limiting conditions reaching ages at which transition to adult healthcare should take place is increasing rapidly. Healthcare providers will need to allocate resources to deal with increasing healthcare demands and greater complexity. The transition to adult healthcare must be managed well to limit impacts on healthcare resource use and improve experiences for young people and their families.

With indiscriminate geographic and socio-economic reach, COVID-19 has visited destruction of life and livelihoods on a largely unprepared world and can arguably be declared the new millennium’s most trying test of state capacity. Governments are facing an urgent mandate to mobilize quickly and comprehensively in response, drawing not only on public resources and coordination capabilities but also on the cooperation and buy-in of civil society. Political and institutional legitimacy are crucial determinants of effective crisis management, and low-trust states lacking such legitimacy suffer a profound disadvantage. Social and economic crises attending the COVID-19 pandemic thus invite scholarly reflection about public attitudes, social leadership, and the role of social and institutional memory in the context of systemic disruption. This article examines Hong Kong as a case where failure to respond effectively could have been expected due to low levels of public trust and political legitimacy, but where, in fact, crisis response was unexpectedly successful. The case exposes underdevelopment in scholarly assumptions about the connections among political legitimacy, societal capacity, and crisis response capabilities. As such, this calls for a more nuanced understanding of how social behaviours and norms are structured and reproduced amidst existential uncertainties and policy ambiguities caused by sudden and convergent crises, and how these can themselves generate resources that bolster societal capacity in the fight against pandemics.

The aim of this study was to investigate the relationship between the fundamental movement skills (FMS) of primary school children and aspects of their home environment. Four-hundred-and-eighty-four primary school children were recruited to the study, consisting of 255 boys and 229 girls, aged between 9 and 11 years. Participants were assessed on eight different FMS and placed into different ability profiles according to the similarity of their FMS proficiencies. Four-hundred-and-eighty-four parent questionnaires were completed and matched to the profile membership of the participants. For boys, positive relationships were found between their FMS ability and the variables of parent–child interaction in video gaming, parental beliefs concerning the importance of social development, motor development and children’s participation in physical activity, parental awareness of their own child’s extracurricular participation in community sports clubs and physical activity preferences. For girls, positive relationships with FMS proficiency were found for parental beliefs concerning the importance of participation in physical activity for social function and the importance of participation in physical activity for learning rules. In the case of girls only, several family characteristics were also significantly related to FMS proficiency. These were the following: the involvement of members of the extended family in their before and after-school care provision; their parents’ employment status; and their mother’s physical activity participation. In conclusion, parental beliefs and behaviours have the potential to influence children’s FMS performance and their impact needs to be considered in any interventions to improve the FMS of children of primary school age.

While there is a considerable literature concerning policy entrepreneurship and institutional isomorphism, significantly less literature has emerged addressing the impact of context on policy and institutional entrepreneurship and of the interactions between various contexts and agency. In this article, we demonstrate that the actions of entrepreneurs in the public sector are most likely to generate policy and institutional changes when they are reinforced by complementarities arising from context-dependent, dynamic interactions among interdependent structures, institutions and agency-level enabling conditions., NA

This paper describes how statistical methods can be tested on computer-generated data from known models. We explore bias and percentile tests in detail, illustrating these with examples based on insurance claims and financial time series.

In this article we argue against influential analyses of neoliberalism that prioritize variegation and the role of ideas as key theoretical foci relevant to understanding neoliberalism’s diffusion ...

Asia’s rapid economic transformation is the defining event of the twenty-first century, popularly held to be restructuring the locus of global economic activity and with it the contours of the international geo-strategic and political order. But beyond Asia’s rise as ‘factory to the world’, there has also been sustained effort to develop higher education in the region and to evolve research and knowledge capacity that will reposition Asia at the forefront of the global knowledge-economy, driving research and scientific innovation. Investment in the region’s higher education systems has thus grown enormously in the last three decades, with governments increasingly motivated to position their economies competitively and develop higher education systems of world-class standing. Despite these ambitions and the provision of enormous resources, however, this chapter argues that there remain substantial barriers to reform and to the emergence of higher education systems able to meet the rising expectations of the region’s policymakers. To demonstrate our argument, we survey several higher education systems across Asia, grouped by region (Southeast and Northeast Asia) and analysed in relation to a series of qualitative institutional, political and social contexts: firstly, what we term higher education governance indicators such as merit-based recruitment, promotion and remuneration, censorship, institutional and academic autonomy (among others); and secondly, quantitative performance-based indicators such as bibliometric and research performance, reputational and esteem rankings. We draw upon the comparative conceptual framework developed by Dobbins, Knill and Vogtle (Higher Education 62:665–683, 2011) that sees governance of higher education (HE) as interrelated processes of control, coordination and the allocation of autonomy between three levels—the state, professoriate and university management—and broadly reflected in three typologies of governance: (a) state centred; (b) market-oriented; and (c) academic self-governance (Dobbins et al. in Higher Education 62:665–683, 2011), and highlight the continuing dominance of state-centred (often political) governance of higher education in Asia.

Under the European Union’s Solvency II regulations, insurance firms are required to use a one-year VaR (Value at Risk) approach. This involves a one-year projection of the balance sheet and requires sufficient capital to be solvent in 99.5% of outcomes. The Solvency II Internal Model risk calibrations require annual changes in market indices/term structure for the estimation of risk distribution for each of the Internal Model risk drivers. This presents a significant challenge for calibrators in terms of: Robustness of the calibration that is relevant to the current market regimes and at the same time able to represent the historically observed worst crisis; Stability of the calibration model year on year with arrival of new information. The above points need careful consideration to avoid credibility issues with the Solvency Capital Requirement (SCR) calculation, in that the results are subject to high levels of uncertainty. For market risks, common industry practice to compensate for the limited number of historic annual data points is to use overlapping annual changes. Overlapping changes are dependent on each other, and this dependence can cause issues in estimation, statistical testing, and communication of uncertainty levels around risk calibrations. This paper discusses the issues with the use of overlapping data when producing risk calibrations for an Internal Model. A comparison of the overlapping data approach with the alternative non-overlapping data approach is presented. A comparison is made of the bias and mean squared error of the first four cumulants under four different statistical models. For some statistical models it is found that overlapping data can be used with bias corrections to obtain similarly unbiased results as non-overlapping data, but with significantly lower mean squared errors. For more complex statistical models (e.g. GARCH) it is found that published bias corrections for non-overlapping and overlapping datasets do not result in unbiased cumulant estimates and/or lead to increased variance of the process. In order to test the goodness of fit of probability distributions to the datasets, it is common to use statistical tests. Most of these tests do not function when using overlapping data, as overlapping data breach the independence assumption underlying most statistical tests. We present and test an adjustment to one of the statistical tests (the Kolmogorov Smirnov goodness-of-fit test) to allow for overlapping data. Finally, we explore the methods of converting “high”-frequency (e.g. monthly data) to “low”-frequency data (e.g. annual data). This is an alternative methodology to using overlapping data, and the approach of fitting a statistical model to monthly data and then using the monthly model aggregated over 12 time steps to model annual returns is explored. There are a number of methods available for this approach. We explore two of the widely used approaches for aggregating the time series.

This volume emerged from a general call for papers for a panel on institutional entrepreneurship and institutional change at the International Conference on Public Policy (ICPP) held in Milan, Italy, in the summer of 2015. We were overwhelmed by submissions to the panel and a level of interest in the topic which far exceeded our expectations. In retrospect, we should not have been surprised. Issues of institutional change continue to be of central concern to political scientists, economists, sociologists, and policy scholars alike—indeed, why and how institutions emerge, change, or are transcended over time is a core theoretical question at the centre of most social science inquiry.

In this article, we explore the evolution of neoliberal development theory and practice, its manifestations and impact on the political economy of the state, domestic classes, and the material conditions of populations in emerging economies. Specifically, the article focuses on the modes of resistance to the rollout of neoliberal development practice by citizens, civil society, and NGOs, and, in turn, the responses of international financial institutions such as the World Bank—a process that we argue has forced the reinvention and transformation of neoliberal development policy. Furthermore, we attempt to situate the evolution of neoliberal development policy and the changing modes of resistance to it within a theoretical framework that explains emergent class and material interests in the context of the increasing functionality of pro-market agendas to modes of accumulation that benefit discrete elite and class interests but which also generate substantial and ongoing contradictions.

This special issue (SI) of Globalisations brings together six contributions focused on the political relationship between citizens, civil society, and neoliberal development policy. The dramatic in...

Background:In light of recent reports, schools must be realistic in that physical activity recommendations cannot be met through curriculum PE alone. However, extracurricular PE and school sport has the potential to further promote physical activity in adolescents. Consequently, the Welsh Government, UK, proposed through its Climbing Higher strategy (2006) for secondary school children to achieve 60 minutes of physical activity a day. This was implemented through Sport Wales and the 5×60 scheme.Method:This study aimed to examine the experiences of the 5×60 officers responsible for implementing the program, with a view to gain an understanding of the barriers associated with increasing participation in physical activity. Officers from 14 unitary authorities across Wales were interviewed using a socioecological approach that considered the impact of: personal behaviors, physical environment, social environment, and policy.Results:Participants reported a number of challenges affecting the delivery of the program, including: availability of facilities, lack of support from senior management, time, and conflict with PE staff.Conclusion:This study suggests that current methods used by personnel to facilitate extracurricular school sport may not be the most appropriate, and future direction should consider the place and contribution of physical activity to young people’s lives.

The aims of this study were to determine proficiency levels of fundamental movement skills using cluster analysis in a cohort of U.K. primary school children; and to further examine the relationships between fundamental movement skills proficiency and other key aspects of health-related physical activity behavior. Participants were 553 primary children between 9- and 12-years old, 294 boys and 259 girls, who were assessed across eight different fundamental movement skills. Physical activity behaviors included markers of physical fitness, recall of physical activity behavior, and physical self-concept. Hierarchical cluster analysis was used to classify groups based on fundamental movement skills proficiencies and discriminant analysis to predict fundamental movement skills proficiency based upon the physical activity variables. This interpretation of fundamental movement skills performance revealed distinct groups of fundamental movement skills proficiency in both genders with several gender-specific components of physical activity shown to discriminate children with differing levels of fundamental movement skills proficiency (p < .05, r > .40).

Multilateral development agencies have increasingly focused attention on underdeveloped countries in Asia as potential new sites for financial capital. Often referred to as “emerging markets”, these economies are seen as ripe for private sector investment and, at the same time, in need of foreign capital to support rapid industrialisation, modernisation and poverty reduction. For development agencies, this confluence of interests suggests a means for quickly closing the “development gap”, primarily through mobilising techno-managerial modalities designed to reduce barriers to capital entry and other institutional inefficiencies seen as inimical to investment. Thus development agencies now encourage the construction of “enabling environments” to support “market driven development” through processes of “financialisation”. Development, in this sense, is no longer state-led or state-centred, but rather financially driven and privately procured.As we highlight in this special issue, however, financiali...

The spread of quality assurance (QA) regimes in higher education has been an explosive phenomenon over the last 25 years. By one estimate, for example, half of all the countries in the world have adopted QA systems or QA regulatory agencies to oversee their higher education sector. Typically, this phenomenon is explained as a process of policy diffusion, the advent of marketization, the spread of neoliberalism, massification and, concomitantly, the emergence of a ‘global market’ for higher education, prompting governments to respond by validating standards, quality, and introducing certification and compliance regimes. In this paper I question the utility of these explanatory frameworks, specifically looking at the case of Hong Kong in order to explore the role coercive institutional isomorphism plays in policy adoption and the implications of this for regulatory performativity.

Quality assurance (QA) regimes have become an increasingly dominant regulatory tool in the management of higher education sectors around the world. By one estimate, nearly half the countries in the world now have quality assurance systems or QA regulatory bodies for higher education. This paper explores the emergence and spread of QA regimes, the coalescence of regulatory logics around qualifications frameworks, and the broad confluence of such approaches in terms of their impact on the historically contested relationship between the state and university. By focusing on the interlocking regulatory logics provided by QA, the article explores how such approaches impose quasi-market, competitive based rationalities premised on neo-liberal managerialism using a policy discourse that is often informed by conviction rather than evidence.

This paper is a report from the Extreme Events Working Party. The paper considers some of the difficulties in calculating capital buffers to cover potential losses. This paper considers the reasons why a purely mechanical approach to calculating capital buffers may bot be possible or justified. A range of tools and techniques is presented to help address some of the difficulties identified.

The authors outline current best practices in designing and implementing a pension plan’s optimal investment policy toward a clearly defined funding goal given the plans’ liabilities. Two key factors point to a dynamic approach: Changes in the plan’s funding ratio and changes in the investment opportunity set. The authors demonstrate how the range of potential outcomes for the pension plan is improved when its investment policy becomes goal-focused and adaptive to changing circumstances, and refer to this approach as “Journey Management.” The authors propose not a single one-size-fits-all strategy, but a framework that can be tailored to a plan’s unique situation. They speculate that improved governance will likely be required to effectively implement such an approach.

This special issue of the Journal of Asian Public Policy brings together five contributions that arose from a series of workshops held at the National University of Singapore in 2012. The workshops...

This paper describes how statistical methods can be tested on computer generated data. We explore bias and percentile tests in detail, illustrating these with examples based on insurance claims and financial time series.

Background: Despite considerable investment in UK government initiatives (e.g., the Physical Education School Sport [PESS] plan) aimed at improving the delivery and quality of physical education (PE) in primary schools, many remaining problems have been highlighted (e.g., facilities; staff training). It is suggested that the head teacher (school principal) plays a fundamental role in the experience of PE delivery within their schools as well as the effective implementation of government initiatives (e.g., PESS) that aim to enhance the quality of PE within primary schools. However, this role has been previously overlooked in the literature. Purpose: This study offers an in-depth examination of the challenges faced by primary school head teachers in effectively creating and managing an environment that supports high quality PE and school sport. The study also explores the head teachers' perceptions of the challenges caused by the implementation of the PESS plan within their school. Participants: 14 head tea...

In the rush for development, the regulatory state has assumed the mantle of a new panacea: the instruments and mechanisms necessary for better government, better governance, and better lives. This paper poses two basic questions in response to the rise of the regulatory state and its increasing diffusion into developing countries. First, can regulatory states exist in developing societies or, more accurately, can effective regulatory states emerge and hope to function in a manner similar to their counterparts in developed countries and deliver the types of benefits and outcomes they promise? And second, do regulatory states offer the most effective modalities for delivering enhanced social well-being? By unpacking the concept of the regulatory state and addressing its underlying assumptions and implicit normative values, it is suggested that the modalities of governance entailed in the regulatory state model may not be well suited to developing countries, hurting rather than enhancing governance ...

This article explores the cooperative endeavours of the Association of Southeast Asian Nations (ASEAN) in the area of investment liberalisation. Investment liberalisation is variously associated with net positive effects on inflows of investment capital, technology transfer, employment, export generation, economic growth and development. As a net historical beneficiary of investment flows, the article hypothesises that ASEAN's stated commitment to investment liberalisation should by now be realising progress in each of four areas: (1) absolute reductions in national autonomy in relation to investment screening and conditionality provisions; (2) increased transparency in respect of member states' national investment regimes; (3) enhanced standardisation and codification of regulatory standards governing investment-related provisions across member states; and (4) enhanced centralised coordination and decision-making in respect of investment governance. Each of these areas is investigated in relation to ASEA...