The Value of College Graduates to the Scottish Economy

Scotland’s colleges are significant economic institutions in their own right. Their activities help support and sustain employment across the communities that they serve. However, the key contribution that colleges make extends well beyond simply how much they spend or invest in the local economy. Colleges play a crucial role in developing Scotland’s growth potential through enhancing human capital – whether that be providing routes from school to work, further training or university; continuous skills-development (often in conjunction with employers); or re-training people for new opportunities. By developing a more productive workforce and boosting participation, colleges help deliver long-term sustainable and inclusive economic growth. Sustainable growth is more important than ever given the new revenue raising responsibilities of the Scottish Parliament. This study undertakes a detailed assessment of the contribution to Scotland's economy from a cohort of college learners over the eight years 2008/09-2015/16. To do this we assess the costs and benefits to the economy from graduates leaving college with a nationally recognised qualification. We use the Fraser of Allander's macroeconomic model of the Scottish economy to provide a robust estimate of the impact on Gross Domestic Product (GDP), employment and tax revenues. For the period 2008/09-2015/16 graduate cohorts we estimate that: The Scottish economy (as measured by GDP) will be better off by over £20 billion in present value terms (i.e. with future benefits discounted) over the long-term. This corresponds to around an additional £55,000 boost to productivity for the Scottish economy per graduate. The present value of the increase in public sector revenues is estimated to be £6.8 billion. Over the years studied, the total costs to the public sector of investing in these learners through nationally-recognised qualifications was approximately £2.4 billion – just 35% of the cumulative tax revenues generated over the long-term. The investment is estimated to support 13,896 full time equivalent (FTE) jobs in present value terms. The analysis in this report has been conducted by the Fraser of Allander Institute (FAI) at the University of Strathclyde. The report was commissioned by Colleges Scotland. Colleges Scotland asked the FAI to estimate the long-term value to the Scottish economy from graduates of Scotland’s colleges. The technical analysis, methodology and writing of the results was undertaken independently by the FAI, using their detailed macroeconomic model of the Scottish economy to undertake the analysis

Scottish Business Monitor : Q1 2019

The latest Scottish Business Monitor – for Q1 2019 – highlights that growth has eased since Q4 2018 and although many of the key trends remain positive they are subdued compared to last quarter. The latest results for turnover and business activity show that the trends remained - on balance - positive. However, they are down on the previous quarter, and the level of new business now sits at the lowest point since the end of 2016

Older UK sheltered housing tenants’ perceptions of wellbeing and their usage of hospital services

The aim of this study was to examine sheltered housing tenants’ views of health and wellbeing, the strategies they adopted to support their wellbeing and their use of health and social care services through a Health Needs Assessment. Sheltered housing in the UK is a form of service-integrated housing for people, predominantly over 60. The study used a parallel, three-strand mixed method approach to encompass the tenants’ perceptions of health and wellbeing (n=96 participants), analysis of the service’s health and wellbeing database and analysis of emergency and elective hospital admissions (n= 978 tenant data sets for the period January to December 2012). Tenants’ perceptions of wellbeing were seen to reinforce much of the previous work on the subject with strategies required to sustain social, community, physical, economic, environmental, leisure, emotional and spiritual dimensions. Of the tenants’ self-reported chronic conditions, arthritis, heart conditions and breathing problems were identified as their most common health concerns. Hospital admission data indicated that 43% of the tenant population was admitted to hospital (886 admissions) with 53% emergency and 47% elective admissions. The potential cost of emergency as opposed to elective admissions was substantial. The mean length of stay for emergency admissions was 8.2 days (median 3.0 days). While elective hospital admission had a mean length of stay of 1.0 day (median 0.0 days). These results suggest the need for multi-professional health, social care and housing services interventions to facilitate sheltered housing tenants’ aspirations and support their strategies to live well and independently in their own homes. Equally there is a need to increase tenants’ awareness of health conditions and their management; the importance of services which offer facilitation, resources and support and the key role played by prevention and reablement

Within-trial cost and 1-year cost-effectiveness of the DiRECT/Counterweight-Plus weight-management programme to achieve remission of type 2 diabetes

No abstract available

Emergency and urgent care capacity in a resource-limited setting: an assessment of health facilities in western Kenya

Objective: Injuries, trauma and non-communicable diseases are responsible for a rising proportion of death and disability in low-income and middle-income countries. Delivering effective emergency and urgent healthcare for these and other conditions in resource-limited settings is challenging. In this study, we sought to examine and characterise emergency and urgent care capacity in a resource-limited setting. Methods: We conducted an assessment within all 30 primary and secondary hospitals and within a stratified random sampling of 30 dispensaries and health centres in western Kenya. The key informants were the most senior facility healthcare provider and manager available. Emergency physician researchers utilised a semistructured assessment tool, and data were analysed using descriptive statistics and thematic coding. Results: No lower level facilities and 30% of higher level facilities reported having a defined, organised approach to trauma. 43% of higher level facilities had access to an anaesthetist. The majority of lower level facilities had suture and wound care supplies and gloves but typically lacked other basic trauma supplies. For cardiac care, 50% of higher level facilities had morphine, but a minority had functioning ECG, sublingual nitroglycerine or a defibrillator. Only 20% of lower level facilities had glucometers, and only 33% of higher level facilities could care for diabetic emergencies. No facilities had sepsis clinical guidelines. Conclusions: Large gaps in essential emergency care capabilities were identified at all facility levels in western Kenya. There are great opportunities for a universally deployed basic emergency care package, an advanced emergency care package and facility designation scheme, and a reliable prehospital care transportation and communications system in resource-limited settings

Approaches to integrated housing, health and social care services: case studies from North Tyneside Council and Northumbria Healthcare

The Care Act 2014 places a duty on local authorities to integrate services, including housing, where this could improve wellbeing by preventing, reducing and/or delaying care needs (LGA 2015). Despite calls for greater collaborative working between housing and health professionals, there are limited examples of live projects taking an integrated approach to service delivery. This case study report presents three case studies of innovative approaches to integrated working across housing, health and adult social care from North Tyneside Council and Northumbria Healthcare Foundation Trust. The case studies highlight the relevance of understanding access processes within different services, the role of workforce development in aligning referral and access pathways, targeted and more cost-effective health intervention delivery via housing services, and the potential for achieving health outcomes through housing improvement. Understanding of these issues informed the approach that was developed for the co-ordination of services and departments to work together across organization and sector boundaries

Targeting anticorruption interventions at the frontline: developmental governance in health systems

In 2008, Vian reported an increasing interest in understanding how corruption affects healthcare outcomes and asked what could be done to combat corruption in the health sector. Eleven years later, corruption is seen as a heterogeneous mix of activity, extensive and expensive in terms of loss of productivity, increasing inequity and costs, but with few examples of programmes that have successfully tackled corruption in low-income or middle-income countries. The commitment, by multilateral organisations and many governments to the Sustainable Development Goals and Universal Health Coverage has renewed an interest to find ways to tackle corruption within health systems. These efforts must, however, begin with a critical assessment of the existing theoretical models and approaches that have underpinned action in the health sector in the past and an assessment of the potential of innovations from anticorruption work developed in sectors other than health. To that end, this paper maps the key debates and theoretical frameworks that have dominated research on corruption in health. It examines their limitations, the blind spots that they create in terms of the questions asked, and the capacity for research to take account of contextual factors that drive practice. It draws on new work from heterodox economics which seeks to target anticorruption interventions at practices that have high impact and which are politically and economically feasible to address. We consider how such approaches can be adopted into health systems and what new questions need to be addressed by researchers to support the development of sustainable solutions to corruption. We present a short case study from Bangladesh to show how such an approach reveals new perspectives on actors and drivers of corruption practice. We conclude by considering the most important areas for research and policy

Absenteeism among doctors in the Bangladesh health system: What are the structural drivers?

Despite considerable investment by the Bangladesh government in measures to strengthen accountability and transparency, absenteeism among doctors remains a barrier to the achievement of Universal Health Coverage. Recent innovations in anti-corruption theory point to the importance of acting on the structural drivers of absenteeism and argue for approaches that are better able to take local and national level context into account. In this qualitative study, we sought to understand the socio-economic and political structures that drive absenteeism among junior doctors in rural health facilities in Bangladesh. We conducted 30 purposively sampled, in-depth interviews with doctors in three divisions of the Bangladesh Health system, (Sylhet, Barishal and Dhaka) the majority of whom worked in medical college hospitals and sub-district facilities. The data was analysed using both theory and data driven thematic analysis. The results explore the ways in which poor local social relations and working conditions, and threats to career progression drove junior doctors to seek ways to leave rural facilities. Their absence was facilitated by weak regulatory mechanisms, bribery, and socio-political networks. These findings reveal how doctors’ absenteeism can be traced to structural issues in the health system and socio-political networks that shape access to resource more widely in Bangladesh. Providers with power and access to networks can be absent for longer periods, overburdening and de-motivating their colleagues who lack connections and thus remain in post. While little can be done about longstanding features of Bangladeshi society, those in authority in the health system can take measures to address existing problems in the weak infrastructure and work environment, including measures for career progression. These are expected to support collective action by the doctors who are unable to make use of powerful social and political networks

A Complex Regulatory Network Coordinating Cell Cycles During C. elegans Development Is Revealed by a Genome-Wide RNAi Screen

The development and homeostasis of multicellular animals requires precise coordination of cell division and differentiation. We performed a genome-wide RNA interference screen in Caenorhabditis elegans to reveal the components of a regulatory network that promotes developmentally programmed cell-cycle quiescence. The 107 identified genes are predicted to constitute regulatory networks that are conserved among higher animals because almost half of the genes are represented by clear human orthologs. Using a series of mutant backgrounds to assess their genetic activities, the RNA interference clones displaying similar properties were clustered to establish potential regulatory relationships within the network. This approach uncovered four distinct genetic pathways controlling cell-cycle entry during intestinal organogenesis. The enhanced phenotypes observed for animals carrying compound mutations attest to the collaboration between distinct mechanisms to ensure strict developmental regulation of cell cycles. Moreover, we characterized ubc-25, a gene encoding an E2 ubiquitin-conjugating enzyme whose human ortholog, UBE2Q2, is deregulated in several cancers. Our genetic analyses suggested that ubc-25 acts in a linear pathway with cul-1/Cul1, in parallel to pathways employing cki-1/p27 and lin-35/pRb to promote cell-cycle quiescence. Further investigation of the potential regulatory mechanism demonstrated that ubc-25 activity negatively regulates CYE-1/cyclin E protein abundance in vivo. Together, our results show that the ubc-25-mediated pathway acts within a complex network that integrates the actions of multiple molecular mechanisms to control cell cycles during development

Absenteeism in primary health centres in Nigeria: leveraging power, politics and kinship

BACKGROUND: Primary health centres (PHCs) in Nigeria suffer critical shortages of health workers, aggravated by chronic absenteeism that has been attributed to insufficient resources to govern the system and adequately meet their welfare needs. However, the political drivers of this phenomenon are rarely considered. We have asked how political power and networks influence absenteeism in the Nigerian health sector, information that can inform the development of holistic solutions. METHODS: Data were obtained from in-depth interviews with three health administrators, 30 health workers and 6 health facility committee chairmen in 15 PHCs in Enugu State, Nigeria. Our analysis explored how political configurations and the resulting distribution of power influence absenteeism in Nigeria’s health systems. RESULTS: We found that health workers leverage social networks with powerful and politically connected individuals to be absent from duty and escape sanctions. This reflects the dominant political settlement. Thus, the formal governance structures that are meant to regulate the operations of the health system are weak, thereby allowing powerful individuals to exert influence using informal means. As a result, health managers do not confront absentees who have a relationship with political actors for fear of repercussions, including retaliation through informal pressure. In addition, we found that while health system structures cannot effectively handle widespread absenteeism, networks of local actors, when interested and involved, could address absenteeism by enabling health managers to call politically connected staff to order. CONCLUSION: The formal governance mechanisms to reduce absenteeism are insufficient, and building alliances (often informal) with local elites interested in improving service delivery locally may help to reduce interference by other powerful actors