Beyond the male breadwinner: Life-cycle living standards of intact and disrupted English working families, 1260–1850

This article provides a novel framework within which to evaluate real household incomes of predominantly rural working families of various sizes and structures in England in the years 1260-1850. We reject ahistorical assumptions about complete reliance on men's wages and male breadwinning, moving closer to reality by including women and children's contributions to family incomes. Our empirical strategy benefits from recent estimates of men's annual earnings, so avoiding the need to gross up day rates using problematic assumptions about days worked, and from new data on women and children's wages and labour inputs. A family life-cycle approach which accommodates consumption smoothing through saving adds further breadth and realism. Moreover, the analysis embraces two historically common but often overlooked family types alternative to the traditional male-breadwinner model: one where the husband is missing having died or deserted, and one where the husband is present but unwilling or unable to find work. Our framework suggests living standards varied widely by family structure and dependency ratio. Incorporating detailed demographic data available for 1560 onward suggests that small and intact families enjoyed high and rising living standards after 1700, while large or disrupted families depended on child labour and poor relief until c. 1830. A broader perspective on family structures informs understanding of the chronology and nature of poverty and coping strategies

Alcohol misuse in patients with alcohol-related liver disease: How can we do better? A narrative review of the literature.

BACKGROUND: Ongoing alcohol use is strongly associated with progressive liver damage and higher mortality in patients with alcohol-related liver disease (ArLD). Reduction in alcohol use is therefore the cornerstone of treatment to improve the long-term outcome of these patients. However, a large proportion of patients continue to use alcohol and do not access or engage with alcohol treatment services after a diagnosis of ArLD. We reviewed the literature on factors associated with ongoing alcohol consumption among patients with ArLD to identify barriers or facilitators to their accessing alcohol treatment. METHODS: A search of MEDLINE and EMBASE was conducted using search strategies relating to ArLD and the psychosocial factors hypothesized to influence alcohol reduction and/or abstinence. RESULTS: There were few relevant studies pertinent to this population group. Several studies reported a high prevalence of mental health diagnoses associated with the severity of alcohol dependence. Social and environmental factors were shown to be important determinants of alcohol use. Common themes perceived as barriers to treatment from qualitative interviews with ArLD patients across studies included poor communication between the clinical team and patient, lack of symptoms recognized by patients themselves, and perceived loss of control over their condition. CONCLUSIONS: We recommend that future clinical studies of patient cohorts with ArLD include detailed psychosocial assessments to capture information on mental health and social factors. Qualitative studies are required to explore the patient journey pre and post hospital admission, which should focus on identifying facilitators and barriers to accessing treatment. Well-designed, controlled studies are needed to identify patient, social, and environmental factors associated with relapse to alcohol use after a diagnosis of ArLD. These data will enable us to adapt our support for patients to enhance engagement with services and improve long-term outcomes

Wave function-dependent mobility and suppression of interface roughness scattering in a strained SiGe p-channel field-effect structure

The 4 K Hall mobility has been measured in a top-gated, inverted, modulation-doped Si/Si0.8Ge0.2 structure having a Si:B doping layer beneath the alloy. From comparisons with theoretical calculations, we argue that, unlike an ordinary enhancement-mode SiGe p-channel metal–oxide–semiconductor structure, this configuration leads to a decrease of interface roughness scattering with increasing sheet carrier density. We also speculate on the nature of the interface charge observed in these structures at low temperature

A return to strong radio flaring by Circinus X-1 observed with the Karoo Array Telescope test array KAT-7

Circinus X-1 is a bright and highly variable X-ray binary which displays strong and rapid evolution in all wavebands. Radio flaring, associated with the production of a relativistic jet, occurs periodically on a ~17-day timescale. A longer-term envelope modulates the peak radio fluxes in flares, ranging from peaks in excess of a Jansky in the 1970s to an historic low of milliJanskys during the years 1994 to 2007. Here we report first observations of this source with the MeerKAT test array, KAT-7, part of the pathfinder development for the African dish component of the Square Kilometre Array (SKA), demonstrating successful scientific operation for variable and transient sources with the test array. The KAT-7 observations at 1.9 GHz during the period 13 December 2011 to 16 January 2012 reveal in temporal detail the return to the Jansky-level events observed in the 1970s. We compare these data to contemporaneous single-dish measurements at 4.8 and 8.5 GHz with the HartRAO 26-m telescope and X-ray monitoring from MAXI. We discuss whether the overall modulation and recent dramatic brightening is likely to be due to an increase in the power of the jet due to changes in accretion rate or changing Doppler boosting associated with a varying angle to the line of sight.Comment: 7 pages, 5 figures, accepted for publication in MNRAS 14 May 201

The ‘expat factor’: the influence of working time on women's decisions to undertake international assignments in the oil and gas industry

This article examines the effect of working time on women’s willingness to go on expatriate assignments in the oil and gas exploration and production sector. The research draws upon an analysis of two case study firms’ international assignment and working time policies, semi-structured interviews with 14 Human Resource staff responsible for policy design and implementation, and a survey of the views of 71 women expatriates, supported by in-depth interviews with 26 of the survey respondents. The research identifies an ‘expat factor’: assignees state that long hours are inherent in expatriation and necessary to further their careers. However in practice, working time is not excessive and flexible working practices are utilised. Hours of work have little effect on women’s decisions to undertake long-term assignments but alternatives such as short-term and commuter assignments are unpopular as their working patterns are disruptive to family life. This article contributes to theory development by linking two discrete frameworks that explain women’s career choices when they strive to balance their career goals with their families and by identifying a career compromise threshold when expatriation is rejected in favour of family considerations. A model is proposed to link working time/patterns to women’s international assignment participation

Access to Dental Care for Children and Young People in Care and Care Leavers: A Global Scoping Review

Aims: This scoping review aimed to explore three research questions: 1. What is the dental care access for children and young people (CYP) in care and care leavers? 2. What factors influence CYP in care and care leavers’ access to dental care? 3. What pathways have been developed to improve access to oral health care for CYP in care and care leavers? Methods: Five databases (Ovid MEDLINE, Ovid Embase, CINAHL, SocINDEX and Dentistry and Oral Sciences Source) and grey literature sources were systematically searched. Articles relating to CYP in care or care leavers aged 0–25 years old, published up to January 2023 were included. Abstracts, posters and publications not in the English language were excluded. The data relating to dental care access were analysed using thematic analysis. Results: The search identified 942 articles, of which 247 were excluded as duplicates. A review of the titles and abstracts yielded 149 studies. Thirty-eight were eligible for inclusion in the review: thirty-three peer-reviewed articles, one PhD thesis and four grey literature sources. All papers were published from very high or medium Human Development Index countries. The studies indicate that despite having higher treatment needs, CYP in care and care leavers experience greater difficulty in accessing dental services than those not care-experienced. Organisational, psycho-social and logistical factors influence their access to dental care. Their experience of dental care may be impacted by adverse childhood events. Pathways to dental care have been developed, but little is known of their impact on access. There are very few studies that include care leavers. The voices of care-experienced CYP are missing from dental access research. Conclusions: care-experienced CYP are disadvantaged in their access to dental care, and there are significant barriers to their treatment needs being met

Can practitioners use patient reported measures to enhance person centred coordinated care in practice? A qualitative study

This is the author accepted manuscript. The final version is available from BMC via the DOI in this record.Background: To ascertain whether person centred coordinated care (P3C) is being delivered in healthcare services, components relating to the construct need to be measured. Patient reported measures (PRMs) can be used to provide a measurement of patients’ experiences of P3C. Traditionally, they have been used to assess whether interventions are delivering P3C. Recently there has been an increased interest in using them to directly enhance P3C in clinical practice by, for example, improving practitioner-patient communication. However, there is limited research available on how P3C can be implemented in practice. This study aimed to extend this literature base by exploring how professionals use PRMs to enhance P3C. Methods: Cross sectional thematic analysis of 26 semi-structured interviews with a variety of 33 professionals who have experience of how PRMs can be used to make improvements to P3C. Inductive themes were mapped onto components of P3C care that fell under five established domains of P3C (Information and Communication; My Goals/Outcomes; Decision making; Care Planning and Transitions) to explore whether and how individual components of P3C were being improved through PRMs. Barriers and facilitators that affected the delivery and the results of the PRMs were also identified. Results: Three P3C domains (Information and Communication, My Goals/Outcomes and 40 Care Planning) were mapped frequently onto themes generated by the participants’ interviews about PRM use. However, the domain ‘Decision Making’ was only mapped onto one theme and ‘Transitions’ was not mapped at all. Participant reports suggested that PRM use by practitioners enhanced patients’ ability to self-manage, communicate, engage and reflect during consultations. Barriers to PRM use were related to a lack of a whole service approach to implementation. Conclusions: Practitioners use both PROMs and PREMs in various ways to improve different aspects of patient care. By sharing experiences professionals can benefit from each other’s learning and work together to extend the potential value that PRMs can offer to P3C delivery.This study was part of a project (Person Centred Care Metrics) that was funded by the National Health Service - England (NHSE). This research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula (NIHR CLAHRC South West Peninsula)