Envisioning the third sector's welfare role: critical discourse analysis of 'post-devolution' public policy in the UK 1998-2012

Welfare state theory has struggled to come to terms with the role of the third sector. It has often categorized welfare states in terms of the pattern of interplay between state social policies and the structure of the labour market. Moreover, it has frequently offered an exclusive focus on state policy – thereby failing to substantially recognize the role of the formally organized third sector. This study offers a corrective view. Against the backdrop of the international shift to multi-level governance, it analyses the policy discourse of third sector involvement in welfare governance following devolution in the UK. It reveals the changing and contrasting ways in which post-devolution territorial politics envisions the sector's role as a welfare provider. The mixed methods analysis compares policy framing and the structural narratives associated with the development of the third sector across the four constituent polities of the UK since 1998. The findings reveal how devolution has introduced a new spatial policy dynamic. Whilst there are elements of continuity between polities – such as the increasing salience of the third sector in welfare provision – policy narratives also provide evidence of the territorialization of third sector policy. From a methodological standpoint, this underlines the distinctive and complementary role discourse-based analysis can play in understanding contemporary patterns and processes shaping welfare governance

Voluntary action, territory and timing: the Council of Social Service for Wales, periodisation and the new historiography of the 'British Welfare State', 1919-1980

This article analyses the development of the Council of Social Service for Wales during what is often called the Golden Age of the Welfare State. Recovering the neglected history of the peak organisation for voluntary social service in Wales adds to our understanding of the histories of social policy and postwar Wales. The article addresses social policy from a doubly peripheral perspective – it attends to a territorial periphery of the UK State while voluntary action can be left at the margins of Welfare State analysis. From this perspective we hope to cast new light on the historiography of the ‘British Welfare State

Exploring the meso-territorialization of third sector administration and welfare delivery in federal and union states: evidence and theory-building from the UK

The international trend of state restructuring and the rise of decentralized welfare systems means a key challenge for social research is to systematically explore the breadth of factors shaping the territorialization of third sector welfare delivery at the meso level in federal and union states. We address this lacuna by synthesizing historical-institutionalism and critical realism with Salamon and Anheier’s classic framework on civic infrastructure development to produce an inductive analytical model for wider empirical testing. Its application here to the longitudinal case study data covering Wales shows it to be effective in providing a holistic understanding of the temporal and spatial processes underpinning decentralization. The wider significance of the case study lies in underlining the iterative, reciprocal relationship between governance reforms and territorialization – and showing how territorialization can originate in response to national crises and welfare demand caused by state and market failure in the delivery of public goods

Watery pasts and the constellation of the canal

Heritage trails are an important route into accessing the histories of waterways. They are a multifaceted tourist product, combining a series of complex environmental, economic and cultural policy objectives, and are increasingly used by communities and public agencies as a tool to encourage recreational use along linear corridors. This paper seeks to open a discussion about the use of heritage trails and the processes of heritigisation by thinking about the archival qualities of the canal. It reflects upon research carried out as part of the AHRC-funded ‘European Waterways Heritage’ project, which (through its UK case study) has produced a new 5km heritage trail for the Ashton Canal in Greater Manchester. The paper considers what happens during a process of historical reconstruction and rehabilitation of cultural heritage when a canal is found to be layered in the unspectacular – lacking any special, historical, technical or aesthetic attributes. Using Walter Benjamin’s (1999) concepts of the ‘flash’ and ‘constellation’, alongside cultural geographic readings of post-industrial atmospheres, we seek to think with the water and the surrounding built environment of the waterway in a way that suspends an “indexical imaginary” (van Wyck, 2010) and which encourages a deeper embodied engagement with our surroundings, its material and non-material properties, its happenings and incidence. The paper thus has implications for how we write and construct heritage trails, facilitate new user experiences, and deepen forms of public engagement about our watery pasts

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

Background: The EMPA KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. Methods: EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. Findings: Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5–2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62–0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16–1·59), representing a 50% (42–58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). Interpretation: In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. Funding: Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council

Seven Key Investments for Health Equity across the Lifecourse: Scotland versus the rest of the UK

AbstractWhile widespread lip service is given in the UK to the social determinants of health (SDoH), there are few published comparisons of how the UK's devolved jurisdictions ‘stack up’, in terms of implementing SDoH-based policies and programmes, to improve health equity over the life-course. Based on recent SDoH publications, seven key societal-level investments are suggested, across the life-course, for increasing health equity by socioeconomic position (SEP). We present hard-to-find comparable analyses of routinely collected data to gauge the relative extent to which these investments have been pursued and achieved expected goals in Scotland, as compared with England and Wales, in recent decades. Despite Scotland's longstanding explicit goal of reducing health inequalities, it has recently been doing slightly better than England and Wales on only one broad indicator of health-equity-related investments: childhood poverty. However, on the following indicators of other ‘best investments for health equity’, Scotland has not achieved demonstrably more equitable outcomes by SEP than the rest of the UK: infant mortality and teenage pregnancy rates; early childhood education implementation; standardised educational attainment after primary/secondary school; health care system access and performance; protection of the population from potentially hazardous patterns of food, drink and gambling use; unemployment. Although Scotland did not choose independence on September 18th, 2014, it could still (under the planned increased devolution of powers from Westminster) choose to increase investments in the underperforming categories of interventions for health equity listed above. However, such discussion is largely absent from the current post-referendum debate. Without further significant investments in such policies and programmes, Scotland is unlikely to achieve the ‘healthier, fairer society’ referred to in the current Scottish Government's official aspirations for the nation

Cleaved natural realgar (AsS) by XPS

Realgar (AsS) is an arsenic ore mineral formed in low temperature hydrothermal veins and hotsprings, and commonly associated with other arsenic minerals such as orpiment (As2S3). It is of significance environmentally in areas affected by acid mine drainage where oxidation causes both the generation of acid and the release of arsenic in surface water and groundwater. The sample studied here is a natural crystal from The Realgar Mine, Shimen, China, which was fractured along the [010] cleavage plane under a dry nitrogen atmosphere before XPS analysis. General survey and high resolution spectra were collected using a Kratos Axis Ultra spectrometer under normal operating conditions. Adventitious carbon was used for energy referencing. Charge corrected binding energies for the photoelectrons emitted from realgar (S 2s, S 2p, As 3p, As 3d, O 1s and C 1s) are reported. These binding energies are of use in experiments characterising the surface chemistry of realgar providing insights into the reactivity of the mineral.</p