The mother of all sudden stops: capital flows and reversals in Europe, 1919-32

New data documenting European bond issues in major financial centres from 1919 to 1932 show that conditions in international capital markets and not just in borrowing countries are important for explaining the surge and reversal in capital flows. In particular, the sharp increase in stock market volatility in the major financial centres at the end of the 1920s figured importantly in the decline in foreign lending. This article draws parallels with Europe after 200

Measuring and improving the quality of mental health care: a global perspective

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141815/1/wps20482.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141815/2/wps20482_am.pd

An observational study of Donor Ex Vivo Lung Perfusion in UK lung transplantation: DEVELOP-UK

Background: Many patients awaiting lung transplantation die before a donor organ becomes available. Ex vivo lung perfusion (EVLP) allows initially unusable donor lungs to be assessed and reconditioned for clinical use. Objective: The objective of the Donor Ex Vivo Lung Perfusion in UK lung transplantation study was to evaluate the clinical effectiveness and cost-effectiveness of EVLP in increasing UK lung transplant activity. Design: A multicentre, unblinded, non-randomised, non-inferiority observational study to compare transplant outcomes between EVLP-assessed and standard donor lungs. Setting: Multicentre study involving all five UK officially designated NHS adult lung transplant centres. Participants: Patients aged ≥ 18 years with advanced lung disease accepted onto the lung transplant waiting list. Intervention: The study intervention was EVLP assessment of donor lungs before determining suitability for transplantation. Main outcome measures: The primary outcome measure was survival during the first 12 months following lung transplantation. Secondary outcome measures were patient-centred outcomes that are influenced by the effectiveness of lung transplantation and that contribute to the health-care costs. Results: Lungs from 53 donors unsuitable for standard transplant were assessed with EVLP, of which 18 (34%) were subsequently transplanted. A total of 184 participants received standard donor lungs. Owing to the early closure of the study, a non-inferiority analysis was not conducted. The Kaplan–Meier estimate of survival at 12 months was 0.67 [95% confidence interval (CI) 0.40 to 0.83] for the EVLP arm and 0.80 (95% CI 0.74 to 0.85) for the standard arm. The hazard ratio for overall 12-month survival in the EVLP arm relative to the standard arm was 1.96 (95% CI 0.83 to 4.67). Patients in the EVLP arm required ventilation for a longer period and stayed longer in an intensive therapy unit (ITU) than patients in the standard arm, but duration of overall hospital stay was similar in both groups. There was a higher rate of very early grade 3 primary graft dysfunction (PGD) in the EVLP arm, but rates of PGD did not differ between groups after 72 hours. The requirement for extracorporeal membrane oxygenation (ECMO) support was higher in the EVLP arm (7/18, 38.8%) than in the standard arm (6/184, 3.2%). There were no major differences in rates of chest radiograph abnormalities, infection, lung function or rejection by 12 months. The cost of EVLP transplants is approximately £35,000 higher than the cost of standard transplants, as a result of the cost of the EVLP procedure, and the increased ECMO use and ITU stay. Predictors of cost were quality of life on joining the waiting list, type of transplant and number of lungs transplanted. An exploratory model comparing a NHS lung transplant service that includes EVLP and standard lung transplants with one including only standard lung transplants resulted in an incremental cost-effectiveness ratio of £73,000. Interviews showed that patients had a good understanding of the need for, and the processes of, EVLP. If EVLP can increase the number of usable donor lungs and reduce waiting, it is likely to be acceptable to those waiting for lung transplantation. Study limitations include small numbers in the EVLP arm, limiting analysis to descriptive statistics and the EVLP protocol change during the study. Conclusions: Overall, one-third of donor lungs subjected to EVLP were deemed suitable for transplant. Estimated survival over 12 months was lower than in the standard group, but the data were also consistent with no difference in survival between groups. Patients receiving these additional transplants experience a higher rate of early graft injury and need for unplanned ECMO support, at increased cost. The small number of participants in the EVLP arm because of early study termination limits the robustness of these conclusions. The reason for the increased PGD rates, high ECMO requirement and possible differences in lung injury between EVLP protocols needs evaluation

United Nations Sustainable Development Goals: Promoting health and well-being through physical education partnerships

The United Nations recently approved the Sustainable Development Goals (SDGs) which forms a guideline policy for all nations. While the UN have strongly advised that partnerships are essential for the implementation of these global goals, within local communities there is little evidence of how this is best done or what it looks like in practice. This paper shares a health and wellbeing community initiative that achieves goals three and four of the SDGs, and in doing so models how to implement physical education partnerships as advocated by the UN. The highly successful innovative initiative is “Best Start: A community collaborative approach to lifelong health and wellness” (2011–2014).This paper shares a health and wellbeing partnership, modelling implementation of physical education (PE) advocated by the United Nations (UN). The Sustainable Development Goals (SDGs) exemplifies global efforts towards equality, specifically Goal 3 and 4 address health and wellbeing. The purpose of this paper is to provide insights into cross sector “partnerships”, identified as essential for the implementation of the SDGs. This is significant as the UN acknowledge a present gap of information on partnerships in action and a need for reporting from the ground level. The project “Best Start: A community collaborative approach to lifelong health and wellness”, began as a partnership between a university and nearby schools and quickly grew to involve Australian Registered Training Organisations, the local health industry, Education departments and sport governing bodies. The collaborations involved pre-service teachers teaching Health and PE lessons to children in a disadvantaged socio-economic area, creating valuable learning experiences for stakeholders. Local and global communities were involved in research and reform. The project creatively optimised resources available through state, Australian and international connections. International partnerships enabled identification of unique contextual opportunities. Programme planning was strengthened with data gathered from an England and Wales Ofsted awarded Primary Physical Education course. Various methods, including; semi-structured interviews, reflective journal, observations, document analysis, and Student Evaluation of Teaching Units (SETU) were adopted. SETU is valid and reliable data collected by the university for the purposes of research. The findings support that partnerships enable SDG implementation and the research paper offers direction for localisation

Biofuels and the role of space in sustainable innovation journeys

This paper aims to identify the lessons that should be learnt from how biofuels have been envisioned from the aftermath of the oil shocks of the 1970s to the present,and how these visions compare with biofuel production networks emerging in the 2000s. Working at the interface of sustainable innovation journey research and geographical theories on the spatial unevenness of sustainability transition projects,we show how the biofuels controversy is linked to characteristics of globalised industrial agricultural systems. The legitimacy problems of biofuels cannot be addressed by sustainability indicators or new technologies alone since they arise from the spatial ordering of biofuel production. In the 1970-80s, promoters of bioenergy anticipated current concerns about food security implications but envisioned bioenergy production to be territorially embedded at national or local scales where these issues would be managed. Where the territorial and scalar vision was breached, it was to imagine poorer countries exporting higher-value biofuel to the North rather than the raw material as in the controversial global biomass commodity chains of today. However, controversy now extends to the global impacts of national biofuel systems on food security and greenhouse gas emissions, and to their local impacts becoming more widely known. South/South and North/North trade conflicts are also emerging as are questions over biodegradable wastes and agricultural residues as global commodities. As assumptions of a food-versus-fuel conflict have come to be challenged, legitimacy questions over global agri-business and trade are spotlighted even further. In this context, visions of biofuel development that address these broader issues might be promising. These include large-scale biomass-for-fuel models in Europe that would transform global trade rules to allow small farmers in the global South to compete, and smallscale biofuel systems developed to address local energy needs in the South

Carbon dioxide reduction in the building life cycle: a critical review

The construction industry is known to be a major contributor to environmental pressures due to its high energy consumption and carbon dioxide generation. The growing amount of carbon dioxide emissions over buildings’ life cycles has prompted academics and professionals to initiate various studies relating to this problem. Researchers have been exploring carbon dioxide reduction methods for each phase of the building life cycle – from planning and design, materials production, materials distribution and construction process, maintenance and renovation, deconstruction and disposal, to the material reuse and recycle phase. This paper aims to present the state of the art in carbon dioxide reduction studies relating to the construction industry. Studies of carbon dioxide reduction throughout the building life cycle are reviewed and discussed, including those relating to green building design, innovative low carbon dioxide materials, green construction methods, energy efficiency schemes, life cycle energy analysis, construction waste management, reuse and recycling of materials and the cradle-to-cradle concept. The review provides building practitioners and researchers with a better understanding of carbon dioxide reduction potential and approaches worldwide. Opportunities for carbon dioxide reduction can thereby be maximised over the building life cycle by creating environmentally benign designs and using low carbon dioxide materials

Energy model, boundary object and societal lens: 35 years of the MARKAL model in the UK

Abstract Technical energy models operate within social systems and those that perform particular social as well as technical functions are more likely to be used. We illustrate this with the example of the MARKAL energy system model in the UK, a model that is also widely used internationally. In the UK, MARKAL modelling has a long history helping underpin government energy and climate policy. We trace the use of the model from its initial development in the mid-1970s to the present day, highlighting attributes that contribute to its role as a successful ‘boundary object’ for different but interconnecting energy policy communities. We suggest that changing images of the energy policy problem have enabled MARKAL to shift from an initial role in identifying technologies to reduce oil dependency to playing a key role in target-oriented climate policy. Furthermore, we argue that the ability of MARKAL to perform different roles for different groups has served to embed and institutionalise the model in the energy policy community. Moreover, the capacity of the model to represent detailed technology options has accorded with a technological focus that has suited prevailing, shared conceptions of the energy-climate policy problem

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

The British yearbook of international law.

Contains bibliographies.Index to legal periodicalsLegal resource indexVol. 32 covers 1955 and 1956.1955/1956,1965/1966 and 1968/1969 issued combined.Suspended 1940-43.Mode of access: Internet.Vols. for 1921-22-1927 published under the auspices of the British Institute of International Affairs; 1928- of the Royal Institute of International Affairs.Vols. 1 (1920-21)-10 (1929) in v. 10; Vols. 11 (1930)-20 (1939) in v. 20; Vols. 1 (1920-21)-36 (1960). 1 v