Thalidomide-induced Teratogenesis : History and Mechanisms

Peer reviewedPublisher PD

The co-evolution of policy mixes and socio-technical systems: towards a conceptual framework of policy mix feedback in sustainability transitions

Understanding how policymaking processes can influence the rate and direction of socio-technical change towards sustainability is an important, yet underexplored research agenda in the field of sustainability transitions. Some studies have sought to explain how individual policy instruments can influence transitions, and the politics surrounding this process. We argue that such individual policy instruments can cause wider feedback mechanisms that influence not only their own future development, but also other instruments in the same area. Consequently, by extending the scope of analysis to that of a policy mix allows us to account for multiple policy effects on socio-technical change and resultant feedback mechanisms influencing the policy processes that underpin further policy mix change. This paper takes a first step in this regard by combining policy studies and innovation studies literatures to conceptualise the co-evolutionary dynamics of policy mixes and socio-technical systems. We focus on policy processes to help explain how policy mixes influence socio-technical change, and how changes in the socio-technical system also shape the evolution of the policy mix. To do so we draw on insights from the policy feedback literature, and propose a novel conceptual framework. The framework highlights that policy mixes aiming to foster sustainability transitions need to be designed to create incentives for beneficiaries to mobilise further support, while overcoming a number of prevailing challenges which may undermine political support over time. In the paper, we illustrate the framework using the example of the zero carbon homes policy mix in the UK. We conclude with deriving research and policy implications for analysing and designing dynamic policy mixes for sustainability transitions

Screening for glucose intolerance and development of a lifestyle education programme for prevention of Type 2 diabetes in a population with intellectual disabilities

Background: The prevalence of type 2 diabetes mellitus (T2DM) and of cardiovascular disease (CVD) is believed to be higher among people with intellectual disability (ID) than in the general population. However, research on prevalence and prevention in this population is limited. Objectives: The objectives of this programme of work were to establish a programme of research that would significantly enhance the knowledge and understanding of impaired glucose regulation (IGR) and T2DM in people with ID; to test strategies for the early identification of IGR and T2DM in people with ID; and to develop a lifestyle education programme and educator training protocol to promote behaviour change in a population with ID and IGR (or at a high risk of T2DM/CVD). Setting: Leicestershire, UK. Participants: Adults with ID were recruited from community settings, including residential homes and family homes. Adults with mild to moderate ID who had an elevated body mass index (BMI) of ≥ 25 kg/m2 and/or IGR were invited to take part in the education programme. Main outcome measures: The primary outcome of the screening programme was the prevalence of screen-detected T2DM and IGR. The uptake, feasibility and acceptability of the intervention were assessed. Data sources: Participants were recruited from general practices, specialist ID services and clinics, and through direct contact. Results: A total of 930 people with ID were recruited to the screening programme: 58% were male, 80% were white and 68% were overweight or obese. The mean age of participants was 43.3 years (standard deviation 14.2 years). Bloods were obtained for 675 participants (73%). The prevalence of previously undiagnosed T2DM was 1.3% [95% confidence interval (CI) 0.5% to 2%] and of IGR was 5% (95% CI 4% to 7%). Abnormal IGR was more common in those of non-white ethnicity; those with a first-degree family history of diabetes; those with increasing weight, waist circumference, BMI, diastolic blood pressure or triglycerides; and those with lower high-density lipoprotein cholesterol. We developed a lifestyle educational programme for people with ID, informed by findings from qualitative stakeholder interviews (health-care professionals, n = 14; people with ID, n = 7) and evidence reviews. Subsequently, 11 people with ID (and carers) participated in pilot education sessions (two groups) and five people attended education for the feasibility stage (one group). We found that it was feasible to collect primary outcome measures on physical activity and sedentary behaviour using wrist-worn accelerometers. We found that the programme was relatively costly, meaning that large changes in activity or diet (or a reduction in programme costs) would be necessary for the programme to be cost-effective. We also developed a quality development process for assessing intervention fidelity. Limitations: We were able to screen only around 30% of the population and involved only a small number in the piloting and feasibility work. Conclusions: The results from this programme of work have significantly enhanced the existing knowledge and understanding of T2DM and IGR in people with ID. We have developed a lifestyle education programme and educator training protocol to promote behaviour change in this population. Future work: Further work is needed to evaluate the STOP Diabetes intervention to identify cost-effective strategies for its implementation

System-level change in mental health services in North Wales: An observational study using systems thinking

Purpose: To describe changes to mental health services using systems thinking. Method: Structured standardized quality of life assessment (Manchester Short Quality of Life Assessment: MANSA) was used to establish service user priorities for changes to service provision (part of a process known as check in systems thinking). Current service performance in these priority areas was identified, and changes to service arrangements were planned, implemented and monitored by task and finish (T&F) groups (making use of a process known as flow in systems thinking). Results: 81 MANSA assessments were completed at the check stage (by NM). Work finances and leisure activities emerged as service user priority areas for change, and T&F groups were established with representation of all sectors and service users. Ways to make improvements were observed, planned and implemented by T&F groups (the flow stage). Conclusion: The systems approach reveals how services and quality of life have been changed for patients in Wrexham. Further generalizable research is needed into the potential benefits of using systems thinking in mental health service evaluation

Role of Public Auditors in Fraud Detection – A Critical Review'

The need for independent audit goes back to the agency theory, the theory of delegation of power and the issue of trust. Stakeholders delegate power to management to manage the business on their behalf, yet they face the risk of information asymmetry and management motivations to commit fraud. The main aim of having an independent auditor was therefore to reduce the risk of information asymmetry and fraudulent behaviour by management. Auditors are required by the International Auditing Standards to detect material fraud and error, and they are expected to have a duty of care for stakeholders. However, recently independent auditors, whether conducting private or public audit, have been scrutinised for failing to detect material fraud. There have been a lot of discussions in the literature about the role of private auditors in detecting fraud, but very little discussions about the role of public auditors in detecting fraud. This chapter will outline the difference between private audit and public audit; explain the legal liability of public auditors in relation to fraud detection; the role of public auditors in detecting fraud; and will critically review the root causes for auditors’ failure to detect fraud

The role of law in the control of obesity in England : looking at the contribution of law to a healthy food culture

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article is available from: http://www.anzhealthpolicy.com/content/5/1/21 DOI: 10.1186/1743-8462-5-21Obesity levels in England are significantly higher than in much of the rest of Europe. This article examines aspects of the physical and cultural context of food consumption in England, and the evolution of government policy on obesity, as a background to an analysis of how law might play a role in obesity prevention. Research suggests that individual food choices are associated with cultural and socio-economic circumstances and that they can be manipulated by advertising, food packaging and presentation. This suggests that there might be ways of using law to manage the influences on food choices, and of using law in support of strategies to redirect food choices towards healthy food products. Law is a particularly useful tool in the protection of the individual against the economic power of the food industry, and there is much that law can do to change the physical, economic and social environment of food consumption.Peer reviewe

Zero carbon homes in the UK? Analysing the co-evolution of policy mix and socio-technical system

Understanding how policy and policy-making processes can influence the speed and direction of socio-technical change is an important, yet underexplored research agenda in the field of sustainability transitions. This paper is the first application of a novel analytical framework which conceptualises the co-evolutionary dynamics of policy mixes and socio-technical systems, by complementing the sustainability transitions and policy mix literatures with insights from policy feedback theory. Our paper is an in-depth empirical case study of the zero carbon homes policy mix in the UK which sought to promote radical change in the UK house building system. Our paper makes three contributions. First, it makes an empirical contribution by analysing an example of an ambitious policy strategy in the housing sector where various policy effects and feedback mechanisms led to a loss of political support for the target, eventually leading to its abandonment, and only limited change within the socio-technical system. Second, our paper produces novel insights about the effects of policy mix credibility on socio-technical change, and the underlying feedback mechanisms which influence its formation and loss. Finally, based on our empirical analysis we propose conceptual refinements to the co-evolutionary framework and suggest avenues for future research explaining the dynamics of feedbacks between policy mixes and socio-technical systems. From the empirical analysis a key finding is that policy mixes need to be effectively designed in order to produce positive feedback from the outset, through the creation of resources, provision of clear information and the creation of credibility, and reforming conflicting institutional supports. In the case, ineffective initial design led to uncertainty and inertia, which did not generate sufficient positive feedback to withstand adverse economic and political conditions later on, which ultimately contributed to the abandonment of the policy mix

Corporate Governance and the Public Interest

Abstract Corporate governance has long been a concern for industrial economists but not typically a centrepiece of policy. One reason is that policy design has been based on a market‐orientated approach to the theory and impact of the firm. In contrast, this paper is rooted in a strategic decision‐making perspective that makes corporate governance a central policy issue. Moreover, whereas responses to corporate scandals have focused on shareholders wronged by managers, we see the significance of corporate governance very differently. Merely to punish managers who fail shareholders is to ignore systemic failures, namely that, by design, managers are not democratically accountable to all interests in corporations’ activities. The impact of modern corporations turns crucially on who governs. In practice preferences over strategy vary across actors but not all interests are currently being represented in decision making, resulting in a failure to govern in the public interest. As solutions, we consider the design of company law and also more immediate ways forward, focusing on regulation and democratically controlled public agencies. Our prime concern is the fundamental significance of active, effective citizens. Throughout, the arguments are illustrated using examples from various countries and industries.Governance, strategic decisions, corporations, public interest, industrial economic policy, L5, G38, H11,