Who is responsible for responsible business education? Insights into the dialectical inter-relations of dimensions of responsibility

One criticism of the globalisation of Business Schools is the propagation of an instrumentalist, functionalist and market-based approach to education. While programmes such as the United Nations Principles of Responsible Management Education initiative have attempted to promote more socially responsible practice and pedagogy within Business Schools, there is little evidence of significant change. Although the extant literature explores the response of educators to such initiatives, little is known about how management educators interpret and make sense of their and others’ responsibilities, particularly in the Global South. In this article, we critically explore the ways in which lecturers in a private Malaysian Business School locate social responsibility within their understanding of responsible business education. We identify dynamics of responsibilisation and elaborate the dialectical inter-relations of four dimensions of responsibility – individual, interactional, group and collective. Our findings reveal the limited impact of the disruptive potential of responsible business education in this instance. However, we argue that alternative theories of responsibility and responsibilisation, indicated in the dynamic inter-relations between the dimensions of responsibility, remain a potent source of inspiration for changes within business education. We offer suggestions to inform efforts towards transformatively oriented and socially responsible business education

Which best predicts suicides in Northern Ireland - self-rated mental health or medication record? (Abstract)

Background Over 800,000 suicides occur annually worldwide, and approximately 300 suicides in Northern Ireland (NI) each year. Studies from elsewhere have highlighted the role of mental health in the risk of death by suicide, but such studies are scarce in NI. Objectives This project seeks to: (1) examine the association between mental health and death by suicide during 2011–2015, and (2) assess if self-rated mental health, medication record, or both better predict risk of death by suicide. Methods De-identified information will be drawn from 2011 Census on NI’s 1.8 million residents, linked to the Business Service Organisation’s Health Card Registration data, the Enhanced Prescribing Database (EPD) and death registrations. Subjects’ mental health will be ascertained through single-item self-rated mental health question from the Census and/or record of psychotropic medication in the EPD. Data captures over 1,100 suicides over 5 years (main causes of death defined as ICD- 10 codes X60–X84, Y10–Y34, Y87). Cox proportional hazard models will be used to examine the association between mental health and death by suicide (adjusting for age, gender, comorbid physical disorders, socio-economic status). The performance of prediction models of death by suicide, including self-rated mental health or prescribed medication record or both, will be compared. Data are with the Administrative Data Research Centre – NI, with data analysis underway. Findings This study will yield information beneficial for policy-making regarding suicide prevention and identifying “at risk” groups. Understanding which measures of mental health (self-rated versus medication record) best predict risk of death by suicide could be used to inform future studies on suicide risk and to identify groups for targeted interventions

Do differences in religious affiliation explain high levels of excess mortality in the UK?

Background: High levels of mortality not explained by differences in socioeconomic status (SES) have been observed for Scotland and its largest city, Glasgow, compared with elsewhere in the UK. Previous cross-sectional research highlighted potentially relevant differences in social capital, including religious social capital (the benefits of social participation in organised religion). The aim of this study was to use longitudinal data to assess whether religious affiliation (as measured in UK censuses) attenuated the high levels of Scottish excess mortality. Methods: The study used the Scottish Longitudinal Study (SLS) and the ONS Longitudinal Study of England and Wales. Risk of all-cause mortality (2001–2010) was compared between residents aged 35 and 74 years of Scotland and England and Wales, and between Glasgow and Liverpool/Manchester, using Poisson regression. Models adjusted for age, gender, SES and religious affiliation. Similar country-based analyses were undertaken for suicide. Results: After adjustment for age, gender and SES, all-cause mortality was 9% higher in Scotland than in England and Wales, and 27% higher in Glasgow than in Liverpool or Manchester. Religious affiliation was notably lower across Scotland; but, its inclusion in the models did not attenuate the level of Scottish excess all-cause mortality, and only marginally lowered the differences in risk of suicide. Conclusions: Differences in religious affiliation do not explain the higher mortality rates in Scotland compared with the rest of the UK. However, it is possible that other aspects of religion such as religiosity or religious participation which were not assessed here may still be important

The association between self-reported mental health, medication record and suicide risk: a population wide study

Suicide mortality and mental ill health are increasing globally. Mental ill health can be measured in multiple ways. It is unclear which measure is most associated with suicide risk. This study explored the association between self-rated mental health and medication record and death by suicide. The 2011 Northern Ireland Census records of adults aged 18-74 years (n=1,098,967) were linked to a centralised database of dispensed prescription medication and death registrations until the end of 2015. Mental health status was ascertained through both a single-item self-reported question in the Census and receipt of psychotropic medication. Logistic regression models examined the association between indicators of mental ill health and likelihood of suicide mortality. Of the 1,098,967 cohort members, 857 died by suicide during the study period. Just over half of these deaths (n=429, 50.1%) occurred in individuals with neither indicator of mental ill health. Cohort members with both self-reported mental ill health and receipt of psychotropic medication had the highest risk of suicide (OR=6.13, 95%CI: 4.94–7.61), followed by those with psychotropic medication record only (OR=4.00, 95%CI: 3.28–4.88) and self-report only (OR=2.88, 95%CI: 2.16–3.84). Individuals who report mental ill health and have a history of psychotropic medication use are at a high risk of suicide mortality. However, neither measure is particularly sensitive, as both failed to signal over half of subsequent suicides. Some individuals who report poor mental health but are not in receipt of psychotropic medication are at increased risk of suicide, indicating possible unmet treatment need. The combination of the two indicators offers more precision for identifying those most at risk for targeted interventions

Linking prison health care data to other health data: A novel data linkage study in Northern Ireland

Objectives We describe the progress made in the development of a novel linked database designed to improve understanding about the health, mental health, health service use and mortality risk of people following their release from prison in Northern Ireland (NI). Methods This is a collaborative project between the ADRC-NI and the NI Healthcare in Prisons service (HIPS) - South Eastern Health and Social Care Trust (SEHSCT). Data about the health of all adult prisoners between 2012 and 2021 (HIPS) will be linked to a healthcare population spine (National Health Application and Infrastructure Services - NHAIS) via a Health and Care Number (HCN), a unique health identifier for each patient in the NHS in Northern Ireland. Data will subsequently be linked to prescribing data (Enhanced Prescribing Database - EPD), in-patient services data (mental health) and mortality data (General Register Office - GRO). Results Ethical and governance approvals have been obtained. A stepwise approach to the development of this novel health database will be presented. Data cleaning has been undertaken by the HIPS team and records with missing HCNs have been identified and updated. Extraction of prison health data is underway for N=14,898 individuals and N=34,213 custodial episodes. Individuals may have more than one prison episode during the study period. Electronic and manual modes were used to extract 25 health-related variables from prison records. Data will be transferred to the Honest Broker Service (HBS), the trusted research environment for health and social care in NI, for data de-identification and linkage, and data access for analysis. Preliminary results and lessons for other related data-linkage projects will be presented and discussed. Conclusion We will describe our progress regarding the development of a novel health dataset comprising routinely collected administrative data and our work about prisoner health. We will report about our experience of assessing data access, cleaning, extracting, and analysing data and the linkage possibilities with respect to the prison health dataset

COVID-19 mortality and long-term care: a UK comparison

The impact of the COVID-19 pandemic on the oldest old, especially those within care home settings, has been devastating in many countries. The UK was no exception. This article reviews the path of the COVID-19 pandemic across the UK long-term care (LTC) sector, indicating how it evolved in each of the four home nations. It prefaces this with a description of LTC across the UK, its history and the difficulties encountered in establishing a satisfactory policy for the care of frail older people across the home nations. The paper makes several contributions. First, it provides an up to date estimate of the size of the adult care home sector across the UK – previous work has been bedevilled by inaccurate estimates of the number of care home places available. It also assembles the limited information that is available on delayed transfers of care and testing of care home residents, both of which played a role in the evolution and consequences of the pandemic. Its most important contributions are estimates of the number and share (the P-Score) of "excess deaths" in care homes in each of the home nations. The P-Scores provide measures that allow comparisons across care home populations of different size. Not only do we discuss the number of individuals affected, we also compare the proportions of care homes in each of the home nations that experienced a COVID-19 infection. The paper also discusses deaths of care home residents outside care homes, largely in hospitals. It reviews the sparse information on deaths at home of people who were receiving social care. Throughout our narrative, it will become clear that there have been major deficiencies in both the amount and the consistency of data available to clinicians, care sector staff and researchers trying to understand and to alleviate what has happened in care homes. Thus, the final section makes some recommendations about the scope and timeliness of relevant data. Collection of such data would seem to be a necessary condition to inform best practice and thus avoid a repeat of the troubling effects of the pandemic on people who use formal care between March and June 2020

Maternal multimorbidity and preterm birth in Scotland : an observational record-linkage study

This work was funded by Northwood Charitable Trust and by the Strategic Priority Fund “Tackling multimorbidity at scale” programme (grant number MR/W014432/1) delivered by the Medical Research Council and the National Institute for Health Research in partnership with the Economic and Social Research Council and in collaboration with the Engineering and Physical Sciences Research Council.Background Multimorbidity is common in women across the life course. Preterm birth is the single biggest cause of neonatal mortality and morbidity. We aim to estimate the prevalence of multimorbidity in pregnant women and to examine the association between maternal multimorbidity and PTB. Methods This is a retrospective cohort study using electronic health records from the Scottish Morbidity Records. All pregnancies among women aged 15 to 49 with a conception date between 1 January 2014 and 31 December 2018 were included. Multimorbidity was defined as the presence of two or more pre-existing long-term physical or mental health conditions, and complex multimorbidity as the presence of four or more. It was calculated at the time of conception using a predefined list of 79 conditions published by the MuM-PreDiCT consortium. PTB was defined as babies born alive between 24 and less than 37 completed weeks of gestation. We used Generalised Estimating Equations adjusted for maternal age, socioeconomic status, number of previous pregnancies, BMI, and smoking history to estimate the effect of maternal pre-existing multimorbidity. Absolut rates are reported in the results and tables, whilst Odds Ratios (ORs) are adjusted (aOR). Results Thirty thousand five hundred fifty-seven singleton births from 27,711 pregnant women were included in the analysis. The prevalence of pre-existing multimorbidity and complex multimorbidity was 16.8% (95% CI: 16.4–17.2) and 3.6% (95% CI: 3.3–3.8), respectively. The prevalence of multimorbidity in the youngest age group was 10.2%(95% CI: 8.8–11.6), while in those 40 to 44, it was 21.4% (95% CI: 18.4–24.4), and in the 45 to 49 age group, it was 20% (95% CI: 8.9–31.1). In women without multimorbidity, the prevalence of PTB was 6.7%; it was 11.6% in women with multimorbidity and 15.6% in women with complex multimorbidity. After adjusting for maternal age, socioeconomic status, number of previous pregnancies, Body Mass Index (BMI), and smoking, multimorbidity was associated with higher odds of PTB (aOR = 1.64, 95% CI: 1.48–1.82). Conclusions Multimorbidity at the time of conception was present in one in six women and was associated with an increased risk of preterm birth. Multimorbidity presents a significant health burden to women and their offspring. Routine and comprehensive evaluation of women with multimorbidity before and during pregnancy is urgently needed.Publisher PDFPeer reviewe