Where’s WALY? : A proof of concept study of the ‘wellbeing adjusted life year’ using secondary analysis of cross-sectional survey data

Background The Quality-Adjusted Life Year (QALY) is a measure that combines life extension and health improvement in a single score, reflecting preferences around different types of health gain. It can therefore be used to inform decision-making around allocation of health care resources to mutually exclusive options that would produce qualitatively different health benefits. A number of quality-of-life instruments can be used to calculate QALYs. The EQ-5D is one of the most commonly used, and is the preferred option for submissions to NICE (https://www.nice.org.uk/process/pmg9/). However, it has limitations that might make it unsuitable for use in areas such as public and mental health where interventions may aim to improve well-being. One alternative to the QALY is a Wellbeing-Adjusted Life Year. In this study we explore the need for a Wellbeing-Adjusted Life Year measure by examining the extent to which a measure of wellbeing (the Warwick-Edinburgh Mental Well-being Scale) maps onto the EQ-5D-3L. Methods Secondary analyses were conducted on data from the Coventry Household Survey in which 7469 participants completed the EQ-5D-3L, Warwick-Edinburgh Mental Well-being Scale, and a measure of self-rated health. Data were analysed using descriptive statistics, Pearson’s and Spearman’s correlations, linear regression, and receiver operating characteristic curves. Results Approximately 75 % of participants scored the maximum on the EQ-5D-3L. Those with maximum EQ-5D-3L scores reported a wide range of levels of mental wellbeing. Both the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were able to detect differences between those with higher and lower levels of self-reported health. Linear regression indicated that scores on the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were weakly, positively correlated (with R2 being 0.104 for the index and 0.141 for the visual analogue scale). Conclusion The Warwick-Edinburgh Mental Well-being Scale maps onto the EQ-5D-3L to only a limited extent. Levels of mental wellbeing varied greatly amongst participants who had the maximum score on the EQ-5D-3L. To evaluate the relative effectiveness of interventions that impact on mental wellbeing, a new measure – a Wellbeing Adjusted Life Year – is needed

Occupational image, organisational image and identity in dirty work: Intersections of organisational efforts and media accounts

This article proposes that media representations of an occupational category may intersect with organizations’ efforts to construct a positive organizational identity and image. We fuse three streams of literature namely, organizational identity and image, media and the social construction of reality, and dirty work to extend extant literature on organizational identity and image. Attention is drawn to occupational image as the position of an occupational category in society. We contend that occupational image is likely to influence the decisions and actions taken by organizations and its members, in particular when the occupation is central to the organization’s mission. Occupational image is partly informed by the media. We analyse one year of media coverage of a dirty work occupation, specifically exotic dancing, and identify various ways in which the media portrays the exotic dancing occupation and the organizations providing these services. We focus upon two of these categories, namely Public (dis) Order and Art and Entertainment. We also draw upon a variety of data from one organization, For Your Eyes Only, to explore how organizational efforts to construct a positive organizational identity (based upon professionalism and legitimacy) and image (based upon fantasy, exclusivity and high quality service) intersect these media representations

Sectarianism in Scotland: a ‘West of Scotland’ problem, a patchwork or a cobweb?

Drawing on research carried out for the Scottish Government in 2014, this article explores how people experience sectarianism in Scotland today. For some, sectarianism is manifestly part of their everyday experience, but for others it is almost invisible in their social world. The article sets out a metaphor of sectarianism experienced like a cobweb in Scotland; running strongly down the generations and across masculine culture particularly, but experienced quite differently by different people depending on their social relationships. Using the examples of song and marching, the article suggests that sectarian prejudice should be conceived of as much as a cultural phenomenon as in social and legal terms. A multidisciplinary and intergenerational approach to tackling sectarian prejudice would help emphasise its cultural and relational construction. Much can also be learned from examining the broader research on prejudice worldwide, rather than treating Scottish sectarianism as if it is a unique and inexplicable quality of the national character

Purchasing Strategies, Tactics, and Activities in Engineer-to-Order Manufacturing

Part 9: Operations Management in Engineer-to-Order ManufacturingInternational audienceThis paper presents a six-step method for matching strategic purchasing goals with relevant tactics and operationalizing them through specific activities. The paper provides some of the observations from three Norwegian engineer-to-order companies that are currently working on implementing the proposed method. This paper contributes to purchasing and supply chain management research by providing and testing a method that helps companies to develop strategic goals for different segments of their purchasing portfolios and to match them with relevant tactics and specific activities