The burden of alcohol-related ill health in the United Kingdom

Background Although moderate alcohol consumption has been shown to confer a protective effect for specific diseases, current societal patterns of alcohol use impose a huge health and economic burden on modern society. This study presents a method for estimating the health and economic burden of alcohol consumption to the UK National Health Service (NHS).

Methods Previous estimates of NHS costs attributable to alcohol consumption were identified by systematic literature review. The mortality and morbidity due to alcohol consumption was calculated using information from the World Health Organization Global Burden of Disease Project and routinely collected mortality data. Direct health-care costs were derived using information on population attributable fractions for conditions related to alcohol consumption and NHS cost data.

Results We estimate that alcohol consumption was responsible for 31 000 deaths in the UK in 2005 and that alcohol consumption cost the UK NHS £3.0 billion in 2005–06. Alcohol consumption was responsible for 10% of all disability adjusted life years in 2002 (male: 15%; female: 4%) in the UK.

Conclusions Alcohol consumption is a considerable public health burden in the UK. The comparison of the health and economic burden of various lifestyle factors is essential in prioritizing and resourcing public health action.

Investigation into the interactive multimedia production processes of novice multimedia designer /producers in a constructivist environment

The main purpose of this study was to investigate the instructional interactive multimedia (IMI) production processes of adult novice multimedia production course. The study aimed at discovering whether a constructivistic teacher-learning environment facilitated these multimedia novice designer / producers to further develop metacognitivestates of higher-order thinking like schema formation, problem-solving and cognitive construction when producing their interactive multimedia project. To achieve this study examined the facilitative and limiting activities in planning, design and development that have assisted or hindered the NMDPs during their multimedia production work This research utilises a qualitative paradigm and makes extensive use of multiple data sources such as the participants’ proposals, planning aids, logs and final projects for single as well as cross-case analyses and discussion. Three cases were selected for in-depth analysis in the study because they provided interviews and more complete documentation and "thick descriptions" of their multimedia production activities. Findings about the NMDPs multimedia production endeavours showed that they learnt best about multimedia technology for teacing and learning by producing an interactive multimedia project themselves. Factors that enabled some of the NMDPs to flourish in a constructivistic environment included their ability to utilise their new and extended schemata to problem solve, their self regulation and a creative and positive attitude to demanding multimedia work NMDPs who utilised facilitative planning aids and design strategies produced impressive work. The study further indicates that the NMDPs’ holistic multimedia production experience made them aware of the levels of complexity involved and boosted their confidence about multimedia production for educational purposes. Suggestions for further research include examining the production styles of adult multimedia novices and young novices and investigating the implications of designing multimedia for large audience presentation rather than for single or small group learner usage.

Review of prevalence data in, and evaluation of methods for cross cultural adaptation of, UK surveys on tobacco and alcohol in ethnic minority groups

Objective To assess the adequacy of cross cultural adaptations of survey questions on self reported tobacco and alcohol consumption in the United Kingdom.

Design Assessment of consistency of data between studies identified through literature review. Studies evaluated with 12 guidelines developed from the research literature on achieving cross cultural comparability.

Results The literature review identified 18 key studies, five of them on national samples. Survey instruments were obtained for 15 of these. The comparison of prevalence data in national surveys showed some important discrepancies, greater for tobacco than for alcohol. For example, prevalence of cigarette smoking in Bangladeshi women was 6% in a national survey in 1994 and 1% in a national survey in 1999; in Chinese men it was 31% in a survey in 1993-4 and 17% in one in 1999; in African-Caribbean men it was 29% in a 1992 survey and 42% in one in 1993-4. The most guidelines met by any study was three, although one study partly met a fourth. Two studies met no guidelines. Only four studies consulted with ethnic minority communities in developing the questionnaire, none checked each language version with all others, and two stated the questionnaire had not been validated.

Conclusions Surveys have not followed best practice in relation to measurement of risk factors in cross cultural settings. There is inconsistency in the prevalence data on smoking provided by different major national UK studies. Users of such data should be aware of their limitations. Research is needed to help achieve linguistic equivalence of survey questions in cross cultural research.

Global text project : new horizons in textbook marketing

Purpose: The purpose of this paper is to introduce the global text project (GTP) case. The unique developments of the case provide insight of the many challenges and opportunities created within the open source movement.

Design/methodology/approach: A case study was used to illustrate some of the most pertinent and interesting developments in the field of marketing, alluding to the open source environment. A Wikibook was created in collaboration with all the participants of a graduate course and the development of this offering initiated a project called the GTP.

Findings: The open source movement has created new ways of thinking and acting. The contributions, modifications and improvements by all users to the original product provide a platform of continuous improvement and development.

Originality/value: The value of the paper lies in the lessons and challenges learnt from the case especially by those managing the GTP.

Futures for teachers? Unravelling global agencies development agendas in education and training and lifelong learning

This 20-page paper was presented in June 2001 at an invitational conference hosted by the Education Policy Research Group at Keele University. The theme of the conference was “travelling policy/local spaces: globalisation, identities and education policy in Europe“. Linked from the events page at http://www.keele.ac.uk/depts/ed/events/conf papers.htm, this document is one of 22 papers from the conference that are presented in full text. The paper is organised in three sections, firstly examining the local impact of the application of a global development agenda on educational practices in Victoria, Australia, then analysing policy texts issued by the OECD, Unesco, and the Word Bank, and finally interpreting the data in the light of interagency politics and the authors‘ reading of the global-local dynamics of the educational restructuring in Victoria.

Media pressures and corporate disclosure of social responsibility performance information : a study of two global clothing and sports retail companies

This paper investigates the social and environmental disclosure practices of two large multinational companies, specifically Nike and Hennés & Mauritz. Utilising a joint consideration of legitimacy theory and media agenda setting theory, we investigate the linkage between negative media attention, and positive corporate social and environmental disclosures. Our results generally support a view that for those industry-related social and environmental issues attracting the greatest amount of negative media attention, these corporations react by providing positive social and environmental disclosures. The results were particularly significant in relation to labour practices in developing countries - the issue attracting the greatest amount of negative media attention for the companies in question.

The prevalence of work-related deaths associated with alcohol and drugs in Victoria, Australia, 2001 - 6

To describe the presence of alcohol, cannabis and amphetamines in work-related injury deaths in Victoria, 2001–6, an observational study of work-related deaths reported to the State Coroner's Office, Victoria, Australia was conducted. Case and postmortem forensic toxicology data were obtained from the National Coroner's Information System for work-related injury deaths with positive toxicology screens. Over 6 years there were 43 worker deaths in a total of 355 unintentional work-related injury deaths. The coroner mentioned the presence of alcohol/drugs in 22 of the 43 worker deaths with positive toxicology screens. Toxicology screens were positive for alcohol and/or drugs in 79 work-related deaths overall. Overall, alcohol was present in 26 (7%) work-related deaths and cannabis or amphetamines in 20 (6%). Incidents were mainly transport related. Alcohol and/or drugs were present in a significant portion of work-related deaths. Research is needed to determine the relative contribution of alcohol and drugs compared with other contributing factors to work-related deaths.

A celebrity chef goes global : the business of eating

Purpose – This paper examines the internationalization strategy of Gordon Ramsay Holdings Ltd (GRH) from its base in London. While a substantial body of research on the strategic prerequisites for successful internationalization already exists, little attention has been given within this literature to the international growth of small, informally organized and entrepreneurially-driven firms. The discussion also identifies the challenges facing GRH as it strives to continue its international expansion.

Design/methodology/approach – The paper utilizes various published sources from the general press, business press and trade journals to examine the international expansion of GRH on the back of the personal brand the charismatic Gordon Ramsay has achieved in culinary and media circles. The growth of the GRH organization is interpreted through a theoretical framework of strategic capabilities and relationships.

Findings – The analysis illustrates how critical resources and capabilities, branded reputation, and strategic relationships established in GRH's home market have been leveraged effectively overseas. The most fundamental challenge facing GRH going forward is balancing the opportunities and pressures for growth against the need to maintain the highest levels of quality in existing establishments. This “balancing act” has to unfold within an empire in which the entrepreneur-emperor (Ramsay) has less and less time to devote to any particular activity or establishment.

Originality/value – The case illustrates the importance of developing and leveraging strategic capabilities and relationships in support of successful international expansion. Some of the unique challenges associated with the internationalization of small, informally organized and entrepreneurially-driven (and branded) firms are addressed in terms of both problems and solutions.

Indigenous communities and new media : questions on the global digital age

Purpose – The purpose of this paper is to look at some of the issues surrounding access to and the use of new media technologies, and questions why this is an area of study that receives a marginal focus in academic work.
Design/methodology/approach – Drawing on previous literature in the area of information and communications technology (ICT) adoption and social exclusion, this paper combines the methodological frameworks adopted by hegemony research and more general studies of new media.
Findings – The paper discusses the impacts of new media use by Indigenous communities, within the framework of discussions about a “global Digital Age”. The paper also briefly looks at the social
implications of new media adoption.
Originality/Value - It questions the assumption that adoption and use of new media is for the "good" or "benefit" of all. It will be of value to researchers of ICT adoption by Indigenous communities.

Family relationship quality and early alcohol use : evidence for gender-specific risk processes

Objective: Family characteristics (relationship quality, parental behaviors, and attitudes relating to alcohol use) are known to influence alcohol use in the mid-teen years, and there is evidence that family characteristics have different influences on mid-teen girls versus boys. This study examined child gender differences in the association of family relationship quality, parental disapproval of children's alcohol use, and parental alcohol use with early adolescent alcohol use.

Method: Grade 6 and 8 students (modal age 11 and 13, respectively; N = 6,837; 52.6% female) were recruited from 231 schools across three Australian states. Hypotheses were tested using two-level ordinal logistic regression (individuals nested within schools). The main dependent measure was lifetime frequency of early adolescent alcohol consumption. Independent variables included mother's/father's alcohol use, closeness, conflict, and disapproval of adolescent alcohol use. Control variables included sensation seeking, peer alcohol use, and socioeconomic disadvantage.

Results: The key findings were that for the young age group (Grade 6), emotional closeness to the parent of the opposite sex was protective. Family conflict was associated with females' drinking in both age groups but not males' drinking.

Conclusions: There was evidence of gender differences in the epidemiology of family relationship quality and early alcohol use. Social developmental models may need revision to account for these child gender differences. Gender-specific family dynamics may be an important consideration for family-oriented prevention strategy.

Are shocks to national income persistent? New global evidence

Purpose – This paper aims to investigate the integrational properties of real GDP for 125 countries
.
Design/methodology/approach – The paper applies the Kwiatkowski et al. univariate test and a KPSS-type univariate test that accounts for multiple structural breaks – a test procedure proposed by Carrion-i-Silvestre et al. The panel versions of the KPSS-type test, proposed by Carrion-i-Silvestre et al. with and without structural breaks, are also applied.

Findings – The paper finds that, while univariate tests with and without structural breaks provide mixed results on persistence, the panel test suggests that shocks to national output are persistent.

Originality/value – This is a multi-country study that focuses on both developed and developing countries and uses more recent data to provide new and comparable evidence on the persistence of output.

The global obesity pandemic : shaped by global drivers and local environments

The simultaneous increases in obesity in almost all countries seem to be driven mainly by changes in the global food system, which is producing more processed, affordable, and effectively marketed food than ever before. This passive overconsumption of energy leading to obesity is a predictable outcome of market economies predicated on consumption-based growth. The global food system drivers interact with local environmental factors to create a wide variation in obesity prevalence between populations. Within populations, the interactions between environmental and individual factors, including genetic makeup, explain variability in body size between individuals. However, even with this individual variation, the epidemic has predictable patterns in subpopulations. In low-income countries, obesity mostly affects middle-aged adults (especially women) from wealthy, urban environments; whereas in high-income countries it affects both sexes and all ages, but is disproportionately greater in disadvantaged groups. Unlike other major causes of preventable death and disability, such as tobacco use, injuries, and infectious diseases, there are no exemplar populations in which the obesity epidemic has been reversed by public health measures. This absence increases the urgency for evidence-creating policy action, with a priority on reduction of the supply-side drivers.

Association between 5-HTTLPR genotypes and persisting patterns of anxiety and alcohol use : results from a 10-year longitudinal study of adolescent mental health

The serotonin transporter gene (5-HTT) encodes a transmembrane protein that plays an important role in regulating serotonergic neurotransmission and related aspects of mood and behaviour. The short allele of a 44 bp insertion/deletion polymorphism (S-allele) within the promoter region of the 5-HTT gene (5-HTTLPR) confers lower transcriptional activity relative to the long allele (L-allele) and may act to modify the risk of serotonin-mediated outcomes such as anxiety and substance use behaviours. The purpose of this study was to determine whether (or not) 5-HTTLPR genotypes moderate known associations between attachment style and adolescent anxiety and alcohol use outcomes. Participants were drawn from an eight-wave study of the mental and behavioural health of a cohort of young Australians followed from 14 to 24 years of age (Victorian Adolescent Health Cohort Study, 1992 - present). No association was observed within low-risk attachment settings. However, within risk settings for heightened anxiety (ie, insecurely attached young people), the odds of persisting ruminative anxiety (worry) decreased with each additional copy of the S-allele (B30% per allele: OR 0.77, 95% CI 0.62–0.97, P¼0.029). Within risk settings for binge drinking (ie, securely attached young people), the odds of reporting persisting high-dose alcohol consumption (bingeing) decreased with each additional copy of the S-allele (B35% per allele: OR 0.74, 95% CI 0.64–0.86, Po0.001). Our data suggest that the S-allele is likely to be important in psychosocial development, particularly in those settings that increase risk of anxiety and alcohol use problems.

Early age alcohol use and later alcohol problems in adolescents : individual and peer mediators in a bi-national study

This paper examines whether there is cross-national similarity in the longitudinal relationship between early age alcohol use and adolescent alcohol problems. Potential mechanisms underlying this relationship also are examined, testing adolescent alcohol use, low self-regulation, and peer deviance as possible mediators. Students (N = 1,945) participating in the International Youth Development Study, a longitudinal panel survey study, responded to questions on alcohol use and influencing factors, and were followed annually over a 3-year period from 2002 to 2004 (98% retention rate). State-representative, community student samples were recruited in grade 7 in Washington State, United States (US, n = 961, 78% of those eligible; Mage = 13.09, SD = .44) and Victoria, Australia (n = 984, 76% of those eligible; Mage = 12.93, SD = .41). Analyses were conducted using multiple-group structural equation modeling. In both states, early age alcohol use (age 13) had a small but statistically significant association with subsequent alcohol problems (age 15). Overall, there was little evidence for mediation of early alcohol effects. Low self-regulation prospectively predicted peer deviance, alcohol use, and alcohol problems in both states. Peer deviance was more positively related to alcohol use and low self-regulation among students in Victoria compared to students in Washington State. The small but persistent association of early age alcohol use with alcohol problems across both samples is consistent with efforts to delay alcohol initiation to help prevent problematic alcohol use. Self-regulation was an important influence, supporting the need to further investigate the developmental contribution of neurobehavioral disinhibition.