Local Voices in an Internal Market: The Case of Community Health Services*

This paper presents findings from a study of contract specification and implementation in community health services (CHS). In this paper, we focus on one aspect of that study: the role of local people in informing the assessment of health needs and in determining the provision of community health services in the context of the NHS “internal market”. The paper is based on fieldwork undertaken in three districts within one region. Analysis of data obtained from these localities suggests that while there appears to be a genuine commitment to the principle of local involvement, ideas about how that involvement can be built into the activities of either purchasers or providers are less transparent.     

Estimating the costs of preventive interventions

The goal of this article is to improve the practice and reporting of cost estimates of prevention programs. It reviews the steps in estimating the costs of an intervention and the principles that should guide estimation. The authors then review prior efforts to estimate intervention costs using a sample of well-known but diverse studies. Finally, the authors illustrate the principles with an example, the Family Bereavement Program. They conclude that example by discussing whether and how the costs of the intervention might differ when implemented in a real-world setting.     

Predicting falls in older women

Falls among older people are common and their occurrence is associated with detrimental effects on physical and psychosocial functioning. However, falls are not an inevitable consequence of ageing and there is growing evidence of effective interventions to prevent them. Accurate screening methods to identify high-risk populations are important if such strategies are to be cost-efficient. Epidemiological studies have identified a diverse group of risk factors for falls of different types in a variety of settings and patient groups. These have proved useful in delineating high-risk groups and have propagated a range of risk assessment tools for falls. Without an accepted taxonomy for the reporting of trials testing these instruments, direct comparison of results has been difficult. In frail older people, 'multi factorial assessment tools' have achieved some utility in the discrimination of fallers from non-fallers, whereas performance-based 'functional mobility assessments' appear to be more suited to predicting falls in groups of more active elders. The predictive value of these measures has been hampered by the complex and dynamic interaction between attendant risk factors and their variable influence in populations of different frailty profiles. Furthermore, current indices used in the prediction of falls are built upon statistical methodologies employing logistic regression, which fail to account for the breadth and depth of these associations in populations at risk of falling. Statistical representations more consistent with the complex modelling required in the design of falls risk assessment trials, such as tree classification techniques, may provide better results in future studies that aim to generate accurate predictors of falls.     

Shot at Dawn: Late photography and the anti-war memorial

The military executions of World War One are the subject of Chloe Dewe Mathews’s 2014 photographic series Shot at Dawn. These events—in which hundreds of soldiers were court-martialled and executed for cowardice and desertion—remain controversial, without consensus or established collective narrative. This article charts historic negotiations with the subject but also considers more recent efforts to integrate these proceedings within memorial practice. World War One remembrance activities, whilst diverse, have often emphasised sacrifice, heroism and community. Correspondingly, participation and engagement were core values in the major British World War One centenary arts project, titled 14-18 NOW, from which Shot at Dawn was commissioned. Chloe Dewe Mathews’s contribution to the programme, however, presents a photographic aesthetic of resistance to the principles of inclusivity and remembrance elsewhere embraced by the project. As such, the work challenges the consensual politics of commemoration and—through the practices of late photography, land art and performance pilgrimage—substitutes trauma and forgetfulness for reconciliation and memory.     

Performing the limits of finance

Recent financial turmoil has put emphasis once again on the very meaning and reach of ‘finance’. In doing so, recent financial crises have also provoked questions about the very ‘ends’ of finance: Where are the borders of finance? Given the expansive reach of financial innovation over the past two decades, are there any serious limits to the kinds of practices that can be converted into financial objects? Does the culture of finance (expansive and all encompassing) encounter meaningful interruptions? This paper explores these questions by reviewing a cluster of public-art responses to the 2008 financial crisis mounted by artists critical of the expansive logic of financial abstraction. This paper pays particular attention to the work of Fergal McCarthy and Fred Forest, two public artists who have confronted finance and its rational culture with practices of gameplay, whimsy, and carnival. In doing so, these artists invoke a strategy designed to lay the all-encompassing claims of financial abstraction alongside its own impossibility; alongside performances which undermine the expansive claims of financial abstraction. These are strategies, I conclude, which can interrupt the technocratic discourses which dominate the contemporary cultures of finance; strategies which, in the words of one artist, evoke ‘plausible states of uncertainty’ about our faith in financial abstraction.     

Coherent Mortality Forecasting: The Product-Ratio Method With Functional Time Series Models

When independence is assumed, forecasts of mortality for subpopulations are almost always divergent in the long term. We propose a method for coherent forecasting of mortality rates for two or more subpopulations, based on functional principal components models of simple and interpretable functions of rates. The product-ratio functional forecasting method models and forecasts the geometric mean of subpopulation rates and the ratio of subpopulation rates to product rates. Coherence is imposed by constraining the forecast ratio function through stationary time series models. The method is applied to sex-specific data for Sweden and state-specific data for Australia. Based on out-of-sample forecasts, the coherent forecasts are at least as accurate in overall terms as comparable independent forecasts, and forecast accuracy is homogenized across subpopulations.     

Outsourcing: decision-making methods and criteria during design and engineering

Research to date for decision-making on outsourcing has almost exclusively focussed on strategic and operational levels. Consequently, we know relatively little about decision-making on outsourcing during design and engineering, i.e. the tactical level; that also means that the characteristics of design and engineering – incomplete and inaccurate information and progressive availability of data – are not incorporated in existing frameworks and methods at that level. To fill this gap, a first-of-its-kind framework, based on an extensive appraisal of the literature, is validated; to that purpose, a Delphi survey was undertaken gauging the opinions of two homogeneous groups of academic and industry experts. The analysis of the survey affirms the assumptions made about the role of the progressive availability of data during decision-making on outsourcing. The results from this study should not only inform further research into decision-making during design and engineering but potentially the framework might also have validity for purchasing at the tactical level and strategic decision-making on outsourcing.     

The Future of HRD Research: A SWOT analysis by five leading scholars in the field

This article presents a review of the 11th International Conference on Human Resource Development Research and Practice across Europe through the lens of global mobility. The conference was held in Pécs, Hungary in June, 2010 and the four authors who participated in the conference present their own narratives as agents of global mobility, examine the theme of global mobility in the various aspects of the conference, and conclude with reflections on the factors that supported the learning environment at the conference.     

The Muleteers of Miravet and their Social and Material Spacetime

In this paper I analyze the recollections of the former muleteers of Miravet (Catalonia, Spain) on what they marketed, how they marketed, to whom they marketed, and where and when they did so. The muleteers peddled their merchandise during roughly the first half of this century, a period in which Spain transformed from an agricultural society into an industrial one, and thus these recollections offer their perspective on this transformation. This perspective is brought out by a phenomenological focus on how these muleteers, by their practice of peddling, created and structured a spacetime consisting of dialectically related social relationships through which muleteers purchased and marketed their merchandise, and material characteristics of this merchandise.