The ambitions and challenges of SROI.

With the growing interest in measuring the social impact of third sector activities, there have been a range of approaches developed. One of these, social return on investment (SROI) has received particular attention and is being promoted by third sector organisations, as well as public and private bodies. This paper examines this approach in detail and identifies a series of issues that require further investigation. These include technical and methodological issues related to this adjusted cost-benefit analysis such as quantifying the value of social benefits, and attribution; the judgement involved in setting indicators; whether projects deemed successful based on an SROI analysis can provide the basis for replicability and scaling up; and the ways in which SROI is being used by stakeholders. Through examining these challenges in detail, the approaches to measuring social impact can be strengthened, standardised and made more rigorous. While the issues raised here are essential to developing SROI further, they are also valid for more general discussions regarding the proving and improving of the value added by the UK third sector

The ambitions and challenges of SROI (social return on investment)

With the growing interest in measuring the social impact of third sector activities, there have been a range of approaches developed. One of these, social return on investment (SROI) has received particular attention and is being promoted by third sector organisations, as well as public and private bodies. This paper examines this approach in detail and identifies a series of issues that require further investigation. These include technical and methodological issues related to this adjusted cost-benefit analysis such as quantifying the value of social benefits, and attribution; the judgement involved in setting indicators; whether projects deemed successful based on an SROI analysis can provide the basis for replicability and scaling up; and the ways in which SROI is being used by stakeholders. Through examining these challenges in detail, the approaches to measuring social impact can be strengthened, standardised and made more rigorous. While the issues raised here are essential to developing SROI further, they are also valid for more general discussions regarding the proving and improving of the value added by the UK third sector

Modelling economic effects of international retirement migration within the European Union

International retirement migration (IRM) is a growing and significant feature of the European Union. It has important economic implications in terms of the redistribution of social costs, factors reward and incomes. Using overlapping generations models and simulation techniques this thesis focuses on the economic effects of International Retirement Migration (IRM) within the European Union (EU). Three main parts make up this thesis. The first part summaries the legal and the social framework within the European Union where IRM takes place. Access to European welfare system is based on the principle of non-discrimination. However, the European Comunity law regulates the possibility of free riding through the resource requirement. In the second part, after a brief literature review in social security, the thesis develops a quantitative model that tries to explain some reasons why IRM may take place. Starting with a difference between "environment" of European countries, some people may opt for a better life in another country when they retire. We also focus on the capital accumulation effect for home and host countries. The presence of large populations of retired foreign residents in European countries raises fundamental questions with respect to the right of access to health and welfare services. In the third part, bearing in mind the principle of free movement of capital and the non-discrimination principle in accessing public service within the EU, we focus on the economic effects of IRM for the host country, for the individual migrants themselves, for the host communities and for public policy

Does volunteering improve employability? Insights from the British Household Panel Survey and beyond

Policy interest in the role of volunteering as a route to employment is enduring, with an assumption that links between volunteering, employability and employment are positive and straightforward. This has largely been supported by existing evidence, although there have been few longitudinal studies testing the theory. Analysing data from the British Household Panel Survey, we used multivariate techniques to explore the effects of volunteering on moves from being out of work into work; and on retention and wage progression for people in employment. We suggest that the relationship is complex: volunteering may have a positive effect on the labour market position of some individuals in some circumstances; for others it may have a negative, or no, effect. We offer some suggestions for the variations we found: the limitations of the dataset and our analysis; a limited concept of employability; and too narrow a view of volunteering and its impact

The marketisation of charities in England and Wales

Much has been written about the reasons for and impact of marketisation on charities, their clients, and wider civil society. A central component of the marketisation thesis is that charities are substituting grants and donations with commercial revenue. However, there is no consensus in the existing literature as to whether the two sources of revenue are substitutes or complementary. This paper shows that between 2003 and 2007 there was a significant increase in the proportion of overall revenue attracted from commercial sources by charities in England and Wales. Using our preferred generalised method of moments estimation model we show that the annual persistence of commercial revenue overtime was 44% . In particular, a +10% change in grants and donations was associated with a -3.1% change in commercial revenue

'A Better Way to Measure Choices' Discrete Choice Experiment and Conjoint Analysis Studies in Nephrology: A Literature Review

Discrete choice experiments (DCE) and conjoint analysis (CA) are increasingly used to address health policy issues. This is because the DCE and CA approaches have theoretical foundations in the characteristics theory of demand, which assumes goods, services, or healthcare provision, can be valued in terms of their characteristics (or attributes). As a result, such analysis is grounded in economic theory, lending theoretical validity to this approach. With DCEs, respondents are also assumed to act in a utility-maximising manner and make choices contingent upon the levels of attributes in DCE scenarios. Therefore, choice data can be analysed using econometric methods compatible with random utility theory (RUT) or random regret minimisation (RRM) theory. This means they have additional foundations in economic theory. In contrast, analyses described as CAs are sometimes compatible with RUT or RRM, but by definition they do not have to be. In this paper we review the CA/DCE evidence relating to nephrology. The CA/DCE approach is then compared with other approaches used to provide either quality of life information or preference information relating to nephrology. We conclude by providing an assessment of the value of undertaking CA or DCE analysis in nephrology, comparing the application of CA/DCEs in nephrology with other methodological approaches.</p

Step-like displacements of a deep seated gravitational slope deformation observed during the 2016–2017 seismic events in Central Italy

Deep Seated Gravitational Slope Deformations are characterized by low deformation rates although they can experience partial-collapse phases or more rapid movements, especially in presence of active tectonic structures. In the Central Italy, considering the high seismicity rate, seismic activity must be considered to be an important trigger of deep slope movements. We aim to contribute to the research in this field by reporting the results of a monitoring program on a Deep Seated Gravitational Slope Deformation in this region that involves marly calcareous rocks. We documented the pre-earthquakes evolution of the phenomenon and measured its displacements during the seismic sequence in 2016 and 2017 in Central Italy, which largest events were Mw 5.0-to-6.5. A multidisciplinary approach that combines a field geomorphological survey, installation of permanent GPS stations, and InSAR elaborations was adopted for this study. The average ground motion rate of the slope deformation before the earthquakes was very low (< 3 mm/y) and not spatially homogenous, as detected by GPS and InSAR. In detail, the uppermost area of the slope instability likely moves faster than the lowest sector. On the other hand, GPS and InSAR recorded significant step-like movements, one to ten times higher than the normal activity rate, triggered by the M-w 5.0-to-6.5 earthquakes. In detail, the movement mainly depended on the magnitude of the earthquake and the distance from the epicenter, and only secondarily on the number of larger magnitude earthquakes on a given day. In conclusion, we furnished monitoring data on the activity rate of a Deep Seated Gravitational Slope Deformation in seismic context, we indicated two sectors of the investigated deformation that resulted more unstable and we proved that the combination of InSAR and GPS data is a useful monitoring system for earthquake activated, slow-moving slope instabilities.Published337-3482T. Deformazione crostale attivaJCR Journa

Adaptive deep brain stimulation (aDBS) for tourette syndrome

Deep brain stimulation (DBS) has emerged as a novel therapy for the treatment of several movement and neuropsychiatric disorders, and may also be suitable for the treatment of Tourette syndrome (TS). The main DBS targets used to date in patients with TS are located within the basal ganglia-thalamo-cortical circuit involved in the pathophysiology of this syndrome. They include the ventralis oralis/centromedian-parafascicular (Vo/CM-Pf) nucleus of the thalamus and the nucleus accumbens. Current DBS treatments deliver continuous electrical stimulation and are not designed to adapt to the patient\u2019s symptoms, thereby contributing to unwanted side effects. Moreover, continuous DBS can lead to rapid battery depletion, which necessitates frequent battery replacement surgeries. Adaptive deep brain stimulation (aDBS), which is controlled based on neurophysiological biomarkers, is considered one of the most promising approaches to optimize clinical benefits and to limit the side effects of DBS. aDBS consists of a closed-loop system designed to measure and analyse a control variable reflecting the patient\u2019s clinical condition and to modify on-line stimulation settings to improve treatment efficacy. Local field potentials (LFPs), which are sums of pre- and post-synaptic activity arising from large neuronal populations, directly recorded from electrodes implanted for DBS can theoretically represent a reliable correlate of clinical status in patients with TS. The well-established LFP-clinical correlations in patients with Parkinson\u2019s disease reported in the last few years provide the rationale for developing and implementing new aDBS devices whose efficacies are under evaluation in humans. Only a few studies have investigated LFP activity recorded from DBS target structures and the relationship of this activity to clinical symptoms in TS. Here, we review the available literature supporting the feasibility of an LFP-based aDBS approach in patients with TS. In addition, to increase such knowledge, we report explorative findings regarding LFP data recently acquired and analysed in patients with TS after DBS electrode implantation at rest, during voluntary and involuntary movements (tics), and during ongoing DBS. Data available up to now suggest that patients with TS have oscillatory patterns specifically associated with the part of the brain they are recorded from, and thereby with clinical manifestations. The Vo/CM-Pf nucleus of the thalamus is involved in movement execution and the pathophysiology of TS. Moreover, the oscillatory patterns in TS are specifically modulated by DBS treatment, as reflected by improvements in TS symptoms. These findings suggest that LFPs recorded from DBS targets may be used to control new aDBS devices capable of adaptive stimulation responsive to the symptoms of TS

Who should be prioritized for renal transplantation?: Analysis of key stakeholder preferences using discrete choice experiments

Background Policies for allocating deceased donor kidneys have recently shifted from allocation based on Human Leucocyte Antigen (HLA) tissue matching in the UK and USA. Newer allocation algorithms incorporate waiting time as a primary factor, and in the UK, young adults are also favoured. However, there is little contemporary UK research on the views of stakeholders in the transplant process to inform future allocation policy. This research project aimed to address this issue. Methods Discrete Choice Experiment (DCE) questionnaires were used to establish priorities for kidney transplantation among different stakeholder groups in the UK. Questionnaires were targeted at patients, carers, donors / relatives of deceased donors, and healthcare professionals. Attributes considered included: waiting time; donor-recipient HLA match; whether a recipient had dependents; diseases affecting life expectancy; and diseases affecting quality of life. Results Responses were obtained from 908 patients (including 98 ethnic minorities); 41 carers; 48 donors / relatives of deceased donors; and 113 healthcare professionals. The patient group demonstrated statistically different preferences for every attribute (i.e. significantly different from zero) so implying that changes in given attributes affected preferences, except when prioritizing those with no rather than moderate diseases affecting quality of life. The attributes valued highly related to waiting time, tissue match, prioritizing those with dependents, and prioritizing those with moderate rather than severe diseases affecting life expectancy. Some preferences differed between healthcare professionals and patients, and ethnic minority and non-ethnic minority patients. Only non-ethnic minority patients and healthcare professionals clearly prioritized those with better tissue matches. Conclusions Our econometric results are broadly supportive of the 2006 shift in UK transplant policy which emphasized prioritizing the young and long waiters. However, our findings suggest the need for a further review in the light of observed differences in preferences amongst ethnic minorities, and also because those with dependents may be a further priority.</p