Higher education, mature students and employment goals: policies and practices in the UK

This article considers recent policies of Higher Education in the UK, which are aimed at widening participation and meeting the needs of employers. The focus is on the growing population of part-time students, and the implications of policies for this group. The article takes a critical perspective on government policies, using data from a major study of mature part-time students, conducted in two specialist institutions in the UK, a London University college and a distance learning university. Findings from this study throw doubt on the feasibility of determining a priori what kind of study pathway is most conducive for the individual in terms of employment gains and opportunities for upward social mobility. In conclusion, doubts are raised as to whether policies such as those of the present UK government are likely to achieve its aims. Such policies are not unique to the UK, and lessons from this country are relevant to most of the developed world

The HOME Study: study protocol for a randomised controlled trial comparing the addition of Proactive Psychological Medicine to usual care, with usual care alone, on the time spent in hospital by older acute hospital inpatients

Background: Prolonged acute hospital stays are a major problem for older people and for health services. Failure to effectively manage the psychological and social aspects of illness is an important cause of prolonged hospital stays. Proactive Psychological Medicine (PPM) is a new way of providing psychiatry services to medical wards. PPM is proactive, focussed, intensive and integrated with medical care. A major aim of PPM is to reduce the time older people spend in hospital because of unmanaged psychological and social problems. The HOME Study will test the effectiveness and cost-effectiveness of PPM. Methods/design: A two-arm parallel-group randomised controlled superiority trial, with a linked health economic analysis and an embedded process evaluation, will be conducted at three sites. A total of 3588 participants will be recruited and randomised to usual care or usual care plus PPM. The primary outcome is the number of days spent as an inpatient in a general hospital in the month (30 days) post-randomisation. Secondary outcomes for each participant (measured at 1 and 3 months) include quality of life, independent functioning, symptoms of anxiety and depression, cognitive function, and their experience of the hospital stay. Discussion: The trial has been designed to produce findings that are generalisable to all older medical inpatients (including those with cognitive impairment). It will provide information on the effectiveness and cost-effectiveness of PPM, which we hope will be of value to patients, clinicians, managers and service planners

Major depression and survival in people with cancer

OBJECTIVE: The question of whether depression is associated with worse survival in people with cancer remains unanswered because of methodological criticism of the published research on the topic. We aimed to study the association in a large methodologically robust study. METHODS: We analysed data on 20,582 patients with breast, colorectal, gynaecological, lung and prostate cancers who had attended cancer outpatient clinics in Scotland, UK. Patients had completed two-stage screening for major depression as part of their cancer care. These data on depression status were linked to demographic, cancer and subsequent mortality data from national databases. We estimated the association of major depression with survival for each cancer using Cox regression. We adjusted for potential confounders and interactions between potentially time-varying confounders and the interval between cancer diagnosis and depression screening, and used multiple imputation for missing depression and confounder data. We pooled the cancer-specific results using fixed-effects meta-analysis. RESULTS: Major depression was associated with worse survival for all cancers, with similar adjusted hazard ratios: breast cancer (HR 1.42, 95% CI 1.15-1.75), colorectal cancer (HR 1.47, 95% CI 1.11-1.94), gynaecological cancer (HR 1.36, 95% CI 1.08-1.71), lung cancer (HR 1.39, 95% CI 1.24-1.56), prostate cancer (HR 1.76, 95% CI 1.08-2.85). The pooled hazard ratio was 1.41 (95% CI 1.29-1.54, p<0.001, I2=0%). These findings were not materially different when we only considered the deaths (90%) that were attributed to cancer. CONCLUSIONS: Major depression is associated with worse survival in patients with common cancers. The mechanisms of this association and the clinical implications require further study

Gender, foundation degrees and the knowledge economy

This article questions the concept of ‘education for employment’, which constructs a discourse of individual and societal benefit in a knowledge‐driven economy. Recent policy emphasis in the European Union promotes the expansion of higher education and short‐cycle vocational awards such as the intermediate two‐year Foundation Degree recently introduced into England and Wales. Studies of vocational education and training (VET) and the knowledge economy have focused largely on the governance of education and on the development and drift of policy. Many VET programmes have also been considered for their classed, raced and gendered take‐up and subsequent effect on employment. This article builds on both fields of study to engage with the finer cross‐analyses of gender, social class, poverty, race and citizenship. In its analysis of policy texts the article argues that in spite of a discourse of inclusivity, an expanded higher education system has generated new inequalities, deepening social stratification. Drawing on early analyses of national quantitative data sets, it identifies emerging gendered, classed and raced patterns and considers these in relation to occupationally and hierarchically stratified labour markets, both within and without the knowledge economy

To what extent is behaviour a problem in English schools?:Exploring the scale and prevalence of deficits in classroom climate

The working atmosphere in the classroom is an important variable in the process of education in schools, with several studies suggesting that classroom climate is an important influence on pupil attainment. There are wide differences in the extent to which classroom climate is considered to be a problem in English schools. Some ‘official’ reports suggest that behaviour in schools is ‘satisfactory or better’ in the vast majority of schools; other sources have pointed to behaviour being a serious and widespread problem. The paper details four studies conducted over the past decade which aimed to explore these disparities. The aim of the research was to gain a more accurate insight into the extent to which deficits in classroom climate limit educational attainment and equality of educational opportunity in English schools. The findings question the suggestion that behaviour is satisfactory or better in 99.7% of English schools and the concluding section suggests ways in which deficits in classroom climate might be addressed. Although the study is limited to classrooms in England, OECD studies suggest that deficits in the working atmosphere in classrooms occur in many countries. The study therefore has potential relevance for education systems in other countries

Living for the weekend: youth identities in northeast England

Consumption and consumerism are now accepted as key contexts for the construction of youth identities in de-industrialized Britain. This article uses empirical evidence from interviews with young people to suggest that claims of `new community' are overstated, traditional forms of friendship are receding, and increasingly atomized and instrumental youth identities are now being culturally constituted and reproduced by the pressures and anxieties created by enforced adaptation to consumer capitalism. Analysis of the data opens up the possibility of a critical rather than a celebratory exploration of the wider theoretical implications of this process

Data & Agency

This introduction to the special issue on data and agency argues that datafication should not only be understood as the process of collecting and analysing data about Internet users, but also as feeding such data back to users, enabling them to orient themselves in the world. It is important that debates about data power recognise that data is also generated, collected and analysed by alternative actors, enhancing rather than undermining the agency of the public. Developing this argument, we first make clear why and how the question of agency should be central to our engagement with data. Subsequently, we discuss how this question has been operationalized in the five contributions to this special issue, which empirically open up the study of alternative forms of datafication. Building on these contributions, we conclude that as data acquire new power, it is vital to explore the space for citizen agency in relation to data structures and to examine the practices of data work, as well as the people involved in these practices

''With Great Power Comes Great Responsibility'': Democracy, the Secretary of State for Health and Blame Shifting Within the English National Health Service

The English National Health Service (NHS) has suffered from a democratic deficit since its inception. Democratic accountability was to be through ministers to Parliament, but ministerial control over and responsibility for the NHS were regarded as myths. Reorganizations and management and market reforms, in the neoliberal era, have centralized power within the NHS. However, successive governments have sought to reduce their responsibility for health care through institutional depoliticization, to shift blame, facilitated through legal changes. New Labour’s creation of the National Institute for Clinical Excellence (NICE) and Monitor were somewhat successful in reducing ministerial culpability regarding health technology regulation and foundation trusts, respectively. The Conservative-Liberal Democrat coalition created NHS England to reduce ministerial culpability for health care more generally. This is pertinent as the NHS is currently being undermined by inadequate funding and privatization. However, the public has not shifted from blaming the government to blaming NHS England. This indicates limits to the capacity of law to legitimize changes to social relations. While market reforms were justified on the basis of empowering patients, I argue that addressing the democratic deficit is a preferable means of achieving this goal

Distinguishing Financialization from Neoliberalism

This article contends that neoliberalism and financialization, although sharing much in common, are not synonymous developments. Not only do strongly financialized nations display structural, economic differences, they are also directed by alternative economic epistemologies, cultures and practices. The argument is made by examining the financialization of the UK economy since the mid-1970s. This shift was not simply part of a broad transition away from Keynesianism and towards free market fundamentalism. It was also one very much guided by the particular economic paradigm, discursive practices and devices of the City of London as financial elites took up influential positions in the Thatcher government. The discussion and case example highlight five epistemological elements specific to finance: the creation of money in financial markets, the transactional focus of finance, the centrality of financial markets to economic management, the orthodoxy of shareholder value, and the intense microeconomic approach to financial calculation. Such elements, in conjuction with neoliberalism’s reliance upon finance-blind neoclassical economics, lies at the cultural and epistemological distinction between fiancialization and neoliberalism. Identifying such distinctions opens up new possibilities for understanding financialization, elites, and the neoliberal condition that brought about the financial crash of 2007-08, as well as the political and economic crises that have followed