Using wage council data to identify the effect of recessions on the impact of the minimum wage

Up until now the National Minimum Wage (NMW) introduced in April 1999 appears to have been a policy success. So far there has been little evidence of a negative effect on employment. However, to date, the NMW has largely been operating in a period of prolonged economic expansion. Since the spring of 2008 the UK economy has experienced a downturn of significant proportions. In this report we examine the impact of the UK minimum wages in force during the 1980s and 1990s recessions when a system of Wages Councils was in operation. Wages Councils set (different) minimum rates of pay in a range of low-paying industries. However there were still a large number of low-wage industries not covered by the legislation. This project analyses the impact of the two previous recessions on employment and wages in Wages Council sectors relative to other similar but uncovered low-wage industries using data from the New Earnings Survey and Workforce in Employment Survey form the panel. The findings are informative about the likely consequences of the NMW in the current recession. We can find no significant detrimental impact on employment from the Wages Councils. We do find some evidence of negative hours effects from the Wages Councils, although we cannot find any further detrimental impacts through the recessions of the 1980s or 1990s. In addition, our individual level results are consistent with higher turnover in the Wages Councils sectors. We do find some evidence of a slowdown in turnover through the recessions, and some evidence that hiring increased in the 1990s recession in these low wage sectors. None of the results here indicate that the National Minimum Wage will have any more detrimental impacts on employment through the recent Credit Crunch recession. However, one must be mindful of the fact that recessions can be very different. Our individual results suggest this. So the recent recession that the UK has experienced may play out differently across different sectors than have recessions of the past

Facilitating Emergence: Complex, Adaptive Systems Theory and the Shape of Change

This study used Principal Component Analysis to examine factors that facilitate emergent change in an organization. As organizational life becomes more complex, today’s dominant management paradigms no longer suffice. This is particularly true in a health care setting where multiple sources of disease interacting with each other meet with often-competing organizational priorities and accountabilities in a highly complex world. This study identifies new ways of approaching complexity by embracing the capacity of complex systems to find their own form of order and coherence. Based on a review of the literature, interviews with hospital CEOs, and my organization development practice experience in the health care sector, I identified nine constructs of interest: a strategic framework; organizational culture; work structures; CEO and executive team; leadership culture; quality control systems; accountability framework; learning structures; and feedback processes. One hundred and sixty-two senior leaders, managers, and staff at a hospital in Toronto, Canada, who had completed an eight-week leadership program, completed an Emergence Survey© based on the nine constructs of interest. The survey included Likert items representing the nine constructs, as well as opportunities to provide narrative feedback. In the initial analysis of the survey results, the items taken as a whole would not converge on a clear set of components. It was also clear that the mean for most of the items was very high. I theorized that the size of the sample and possibility that they were a favorably biased convenience sample because they had self-selected as leaders may have contributed to the lack of convergence and high mean. I then theorized three clusters of constructs, based on what appeared to be natural affinities. At that point I facilitated two focus groups with people who were among the survey group. Both focus groups affirmed the importance of each of the factors in improving organizational performance indicators such as patient satisfaction, staff engagement, and quality. I then completed a principal component analysis of each of the three clusters of constructs. From this analysis, seven components emerged. Five of these, executive engagement, safe-fail culture, collaborative decision-processes, a collaborative quality, and intentional learning processes had reliability \u3e.70; culture of experimentation and purposeful orientation had reliability \u3c .70. The electronic version of this Dissertation is at OhioLink ETD Center, www.ohiolink.edu/et

Progress in the utilisation of high-fidelity simulation in basic science education

High-fidelity patient simulators are mainly used to teach clinical skills and remain underutilized in teaching basic sciences. This article summarizes our current views on the use of simulation in basic science education and identifies pitfalls and opportunities for progress. </jats:p

Reframing Resolution - Managing Conflict and Resolving Individual Employment Disputes in the Contemporary Workplace

The resolution of individual workplace conflict has assumed an increasingly important place in policy debates over contemporary work and employment. This is in part due to the decline in collective industrial action and the parallel rise in the volume of employment tribunal applications. It reflects a growing concern over the implications of individual employment disputes for those involved but has perhaps been driven by concerns over the cost of litigation and the perceived burden that this places on employers. Against this backdrop, an ESRC-funded seminar series, entitled ‘Reframing Resolution – Managing Conflict and Resolving Individual Employment Disputes in the Contemporary Workplace’, was held between October 2012 and September 2013. This comprised six seminars held at: University of Strathclyde; University of Central Lancashire; Swansea University; Queen’s University Belfast; IRRU, University of Warwick and University of Westminster. The series brought leading academic researchers, practitioners and policy-makers together to explore new empirical and conceptual developments, examine innovative practice and provide insights into key questions of public policy

Depression and anxiety predict health-related quality of life in chronic obstructive pulmonary disease: systematic review and meta-analysis.

Published onlineJournal ArticleMeta-AnalysisResearch Support, Non-U.S. Gov'tReviewBACKGROUND: The causal association between depression, anxiety, and health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD) is unclear. We therefore conducted a systematic review of prospective cohort studies that measured depression, anxiety, and HRQoL in COPD. METHODS: Electronic databases (Medline, Embase, Cumulative Index to Nursing and Allied Health Literature [CINAHL], British Nursing Index and Archive, PsycINFO and Cochrane database) were searched from inception to June 18, 2013. Studies were eligible for inclusion if they: used a nonexperimental prospective cohort design; included patients with a diagnosis of COPD confirmed by spirometry; and used validated measures of depression, anxiety, and HRQoL. Data were extracted and pooled using random effects models. RESULTS: Six studies were included in the systematic review; of these, three were included in the meta-analysis for depression and two were included for the meta-analysis for anxiety. Depression was significantly correlated with HRQoL at 1-year follow-up (pooled r=0.48, 95% confidence interval 0.37-0.57, P<0.001). Anxiety was also significantly correlated with HRQoL at 1-year follow-up (pooled r=0.36, 95% confidence interval 0.23-0.48, P<0.001). CONCLUSION: Anxiety and depression predict HRQoL in COPD. However, this longitudinal analysis does not show cause and effect relationships between depression and anxiety and future HRQoL. Future studies should identify psychological predictors of poor HRQoL in well designed prospective cohorts with a view to isolating the mediating role played by anxiety disorder and depression.NIHRUniversity of ManchesterCLAHR

Is treatment of depression cost-effective in people with diabetes? A systematic review of the economic evidence

PublishedJournal ArticleResearch Support, Non-U.S. Gov'tReviewOBJECTIVES: Depression is common in diabetes and linked to a wide range of adverse outcomes. UK policy indicates that depression should be treated using conventional psychological treatments in a stepped care framework. This review aimed to identify current economic evidence of psychological treatments for depression among people with diabetes. METHOD: Electronic search strategies (conducted in MEDLINE, EMBASE, PsycINFO, CINAHL, NHS EED) combined clinical and economic search terms to identify full economic evaluations of the relevant interventions. Prespecified screening and inclusion criteria were used. Standardized data extraction and critical appraisal were conducted and the results summarized qualitatively. RESULTS: Excluding duplicates, 1,516 studies for co-morbid depression and diabetes were screened. Four economic evaluations were identified. The studies found that the interventions improved health status, reduced depression and were cost-effective compared with usual care. The studies were all U.S.-based and evaluated collaborative care programs that included psychological therapies. Critical appraisal indicated limitations with the study designs, analysis and results for all studies. CONCLUSIONS: The review highlighted the paucity of evidence in this area. The four studies indicated the potential of interventions to reduce depression and be cost-effective compared with usual care. Two studies reported costs per QALY gained of USD 267 to USD 4,317, whilst two studies reported the intervention dominated usual care, with net savings of USD 440 to USD 612 and net gains in patient free days or QALYs

A mixed-methods pilot study of the acceptability and effectiveness of a brief meditation and mindfulness intervention for people with diabetes and coronary heart disease.

PublishedClinical TrialJournal ArticleResearch Support, Non-U.S. Gov'tMindfulness-based interventions can successfully target negative perseverative cognitions such as worry and thought suppression, but their acceptability and effectiveness in people with long-term conditions is uncertain. We therefore pilot tested a six-week meditation and mindfulness intervention in people (n = 40) with diabetes mellitus and coronary heart disease. We used a sequential mixed-methods approach that measured change in worry and thought suppression and qualitatively explored acceptability, feasibility, and user experience with a focus group (n = 11) and in-depth interviews (n = 16). The intervention was highly acceptable, with 90% completing ≥5 sessions. Meditation and mindfulness skills led to improved sleep, greater relaxation, and more-accepting approaches to illness and illness experience. At the end of the six-week meditation course, worry, and thought suppression were significantly reduced. Positive impacts of mindfulness-based interventions on psychological health may relate to acquisition and development of meta-cognitive skills but this needs experimental confirmation.NIHR Collaboration for Leadership in Applied Health Research and Care forGreater Manchester

INtegration of DEPression Treatment into HIV Care in Uganda (INDEPTH-Uganda): study protocol for a randomized controlled trial

BACKGROUND: Despite 10 to% of persons living with HIV in sub-Saharan Africa having clinical depression, and the consequences of depression for key public health outcomes (HIV treatment adherence and condom use), depression treatment is rarely integrated into HIV care programs. Task-shifting, protocolized approaches to depression care have been used to overcome severe shortages of mental health specialists in developing countries, but not in sub-Saharan Africa and not with HIV clients. The aims of this trial are to evaluate the implementation outcomes and cost-effectiveness of a task-shifting, protocolized model of antidepressant care for HIV clinics in Uganda. METHODS/DESIGN: INDEPTH-Uganda is a cluster randomized controlled trial that compares two task-shifting models of depression care - a protocolized model versus a model that relies on the clinical acumen of trained providers to provide depression care in ten public health HIV clinics in Uganda. In addition to data abstracted from routine data collection mechanisms and supervision logs, survey data will be collected from patient and provider longitudinal cohorts; at each site, a random sample of 150 medically stable patients who are depressed according to the PHQ-2 screening will be followed for 12 months, and providers involved in depression care implementation will be followed over 24 months. These data will be used to assess whether the two models differ on implementation outcomes (proportion screened, diagnosed, treated; provider fidelity to model of care), provider adoption of treatment care knowledge and practices, and depression alleviation. A cost-effectiveness analysis will be conducted to compare the relative use of resources by each model. DISCUSSION: If effective and resource-efficient, the task-shifting, protocolized model will provide an approach to building the capacity for sustainable integration of depression treatment in HIV care settings across sub-Saharan Africa and improving key public health outcomes. TRIAL REGISTRATION: INDEPTH-Uganda has been registered with the National Institutes of Health sponsored clinical trials registry (3 February 2013) and has been assigned the identifier NCT02056106