54 resultados para United-kingdom
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This study aimed to assess the effectiveness of a novel, community-based weight management programme delivered through general practitioner (GP) practices and community pharmacies in one city in the United Kingdom. This study used a non-randomized, retrospective, observational comparison of clinical data collected by participating GP practices and community pharmacies. Subjects were 451 overweight or obese men and women resident in areas of high socioeconomic deprivation (82% from black and minority ethnic groups, 86% women, mean age: 41.1 years, mean body mass index [BMI]: 34.5 kg m−2). Weight, waist circumference and BMI at baseline, after 12 weeks and after 9 months were measured. Costs of delivery were also analysed. Sixty-four per cent of participants lost weight after the first 12 weeks of the My Choice Weight Management Programme. There was considerable dropout. Mean percentage weight loss (last observation carried forward) was 1.9% at 12 weeks and 1.9% at final follow-up (9 months). There was no significant difference in weight loss between participants attending GP practices and those attending pharmacies at both 12 weeks and at final follow-up. Costs per participant were higher via community pharmacy which was attributable to better attendance at sessions among community pharmacy participants than among GP participants. The My Choice Weight Management Programme produced modest reductions in weight at 12 weeks and 9 months. Such programmes may not be sufficient to tackle the obesity epidemic.
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The concept of the United Kingdom acting as a bridge between Europe and the United States has been a key element in British foreign policy for six decades. Under the second Blair Premiership it reached both its apogee and its nadir. This paper analyses these developments focusing both on the transatlantic and European ends. Particular attention is paid to the failure of the Blair government either to establish a secure place for Britain as a co-leader or to make the British people more comfortable in their European skins. This failure occurred at a period when the EU is characterised by leadership transition and confusion. New leaderships will emerge in the EU over the next two years but it seems unlikely that Britain, characterised by a continuing disconnect between a Euro-sceptic public discourse and deep involvement at a governmental level will develop a European policy narrative that is regarded as convincing at either the EU or domestic level. This weakness is compounded by a failure to develop new thinking about the rise of new powers such as China and India.
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Abstract There is considerable evidence that high-growth firms (HGFs) contribute significantly to employment and economic growth. However, the literature so far does not adequately explore the link between HGFs and productivity. This paper investigates the empirical link between total factor productivity (TFP) growth and HGFs, defined in terms of sales growth, in the United Kingdom over the period 2001-2010, by examining two related research questions. Firstly, does higher TFP growth lead to HGF status and secondly, does HGF experience help firms achieve faster TFP growth? Our findings reveal that firms in both the manufacturing and services sectors are more likely to become HGFs when they exhibit higher TFP growth. In addition, firms that have had HGF experience tend to enjoy faster TFP growth following the high-growth episodes. Policy implications are drawn based on the self-reinforcing process of the high-growth phenomenon that is revealed by our results. © 2014 The Author(s).
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This study examined the impact of team-based working, team structure, and job design on employee well-being (in term of job satisfaction and work stress) in staff working in healthcare organizations in Hong Kong. Cross-cultural differences in the impact of job design, team structure, and employee well-being outcomes between United Kingdom and Hong Kong were also investigated. A group of 197 staff from two Hong Kong hospitals were compared to a sample of 270 UK staff working in National Health Service organizations in the UK. Results showed that team structure and job design were significantly associated with greater employee satisfaction and lower stress for Hong Kong healthcare staff. Culture was also found to moderate the impact of team structure and job design on employee well-being. The findings suggest that although team structure and job design contribute to employee well-being, they have differential impacts across cultures. This provides insights to policy planning on building team-based organizations in the healthcare sector involving multinational collaboration.
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Carbon labels inform consumers about the amount of greenhouse gases (GHGs) released during the production and consumption of goods, including food. In the future consumer and legislative responses to carbon labels may favour goods with lower emissions, and thereby change established supply chains. This may have unintended consequences. We present the carbon footprint of three horticultural goods of different origins supplied to the United Kingdom market: lettuce, broccoli and green beans. Analysis of these footprints enables the characterisation of three different classes of vulnerability which are related to: transport, national economy and supply chain specifics. There is no simple relationship between the characteristics of an exporting country and its vulnerability to the introduction of a carbon label. Geographically distant developing countries with a high level of substitutable exports to the UK are most vulnerable. However, many developing countries have low vulnerability as their main exports are tropical crops which would be hard to substitute with local produce. In the short term it is unlikely that consumers will respond to carbon labels in such a way that will have major impacts in the horticultural sector. Labels which require contractual reductions in GHG emissions may have greater impacts in the short term.
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This paper provides evidence from a newly constructed database of UK firms about the extent of their intellectual property acquisition activities over five years. We focus on service sector firms, which have not previously been studied, with comparisons for firms in manufacturing and other sectors, such as agriculture. The measures of IP include both trade marks, which are most important in services, and patents, which are predominantly sought by manufacturing firms. The analysis includes patents and trade marks applied for via both the UK and European routes. While IP assets sought through the UK Patent Office remained strong, more services firms were seeking European Community trade marks and more manufacturing firms were seeking patents via European Patent Office through time. Firm characteristics that are positively correlated with IP activity include larger firm size, stock market listed status and high product market diversification.
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Strategic sourcing plays an important role in organisations' performance. Strategic sourcing has been researched extensively using empirical studies as well as review work, such as strategic sourcing importance, issues and challenges, processes, source selection criteria and framework. However, there is no research on critical success factors for strategic sourcing specific to industry and country. This research aims to qualitatively evaluate and understand the current role of strategic sourcing, the critical success factors for business performance and its relationship with strategic sourcing, and strategic supplier evaluation criteria from multiple stakeholders' perspectives specific to industry and country. This research studies twenty organisations from Germany and the United Kingdom (UK) covering two industry sectors - electronics manufacturing and construction. We consider five organisations from each industry sector and each country. The findings from twenty case studies reveal comparative analysis of strategic sourcing practices of two countries and two industries.
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This article is motivated by a very simple question – ‘what types of firms create the most jobs in the UK economy?’ One popular answer to this question has been High-Growth Firms (HGFs). These firms represent only a small minority – the ‘Vital 6%’ – of the UK business population yet, but have a disproportionate impact on job creation and innovation. We re-visit the discussion launched by the 2009 National Endowment for Science, Technology and the Arts (NESTA) reports, which identified the 6% figure and, using more recent data, confirm the headline conclusion for job creation: a small number of job-creating firms (mostly small firms) are responsible for a significant amount of net job creation in the United Kingdom. Adopting our alternative preferred analytical approach, which involves tracking the growth performance of cohorts of start-ups confirms this conclusion; however, we find an even smaller number of job-creating firms are responsible for a very significant proportion of job creation. We conclude by considering the question – ‘what are the implications for policy choices?’.
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Background and Objective: Clozapine has been available since the early 1990s. Studies continue to demonstrate its superior efficacy in treatment-resistant schizophrenia. Despite this, numerous studies show under-utilisation, delayed access and reluctance by psychiatrists to prescribe clozapine. This retrospective cross-sectional study compared the prescribing of clozapine in two adult cohorts under the care of large public mental health services in Auckland (New Zealand) and Birmingham (United Kingdom) on 31 March 2007. Method: Time from first presentation to clozapine initiation, prior antipsychotics trialled and antipsychotic co-prescribing were compared. Data included demographics, psychiatric diagnosis, co-morbid conditions, year of first presentation, admissions and pharmacological treatment (clozapine dose, start date, prior antipsychotics, co-prescribed antipsychotic). Results: Overall, 664 people were prescribed clozapine (402 Auckland; 262 Birmingham); mean daily dose of 384 mg (Auckland) and 429 mg (Birmingham). 53 % presented after 1990 and the average duration of time before starting clozapine was significantly longer in the Birmingham cohort (6.5 vs. 5.3 years) but this reduced in both cohorts to a 1-year mean in those presenting within the last 3 years. The average number of antipsychotics trialled pre-clozapine for those presenting since 1990 was significantly higher in the Birmingham cohort (4.3 vs. 3.1) but in both cohorts this similarly reduced in those presenting within the last 3 years. Antipsychotic co-prescribing was significantly higher in the Birmingham cohort (22.9 vs. 10.7 %). Conclusions: There is evidence that access to clozapine has improved over time in both cohorts, with a reduction in the duration between presentation and initiation of clozapine and number of different antipsychotics trialled pre-clozapine. These are very positive findings in terms of optimising outcomes with clozapine and are possibly due to the impact of guideline recommendations, increasing clinician, consumer and carer knowledge, and experience with clozapine and funding changes. © 2014 Springer International Publishing.
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The ambitious and comprehensive Transatlantic Trade and Investment Partnership Agreement (TTIP/TAFTA) agreement between the European Union and United States is now being negotiated and may have far-reaching consequences for health services. The agreement extends to government procurement, investment, and further regulatory cooperation. In this article, we focus on the United Kingdom National Health Service and how these negotiations can limit policy space to change policies and to regulate in relation to health services, pharmaceuticals, medical devices, and health industries. The negotiation of TTIP/TAFTA has the potential to "harmonize" more corporate-friendly regulation, resulting in higher costs and loss of policy space, an example of "trade creep" that potentially compromises health equity, public health, and safety concerns across the Atlantic.
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Background - The intimate relationship between dogs and their owners has the potential to increase the risk of human exposure to bacterial pathogens. Over the past 40 years, there have been several reports on transmission of salmonellae from dogs to humans. This study therefore aimed to determine the prevalence of Salmonella in the faeces of dogs from the Midlands region of the United Kingdom to assess exposure risk and potential for zoonotic transmission. Results - A total of 436 apparently healthy dogs without diarrhoea from households (n = 126), rescue centres (n = 96), boarding kennels (n = 43), retired greyhound kennels (n = 39) and a pet nutrition facility (n = 132) were investigated for Salmonella shedding. Faecal samples were processed by an enrichment culture based method. The faeces from one dog (0.23 %; 95 % confidence limit 0.006 %, 1.27 %) was positive for Salmonella. The species was S. enterica subspecies arizonae. Conclusion - This study showed that the prevalence of Salmonella from faeces from apparently healthy dogs from a variety of housing conditions is low; however, Salmonella shedding was still identified.
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This paper presents the development of a modelling study for part of the Birmingham area. Restricted access and model resolutions have limited wide applications of some of the previously developed models. The study area covers approximately 221 km2, and is underlain geologically, by a multi-layer setup with varied hydraulic properties. The basal aquifer unit is the Kidderminster sandstone Formation, overlain by the Wildmoor and Bromsgrove sandstone Formations. The presence of the Birmingham fault which acts as low permeability barrier demarcates the eastern and southern boundaries. The western boundary is defined by the presence of crystallised rocks and coal measures, while a groundwater divide defines the northern boundary. The estimated recharge flux is 112 mm/yr. The ranges of calibrated values obtained for horizontal and vertical hydraulic conductivities are 5.787x10-6 - 2.315x10-5 m/s and 5.787x10-8 - 1.157x10-7 m/s, respectively. Corresponding values obtained for the specific yield and specific storage are 0.10 - 0.12, and 1x10 -4 - 5x10 -4. The calculated numerical error is generally much less than 0.1 %. Hydraulic layering within the Permo-Triassic sandstone aquifer is thought to account for the large vertical anisotropy. Although, uncertainties are associated with the use of a simplistic delay approach to characterise the effects of the unsaturated zone, the modelled values are comparable with those obtained in the literature, and the flow pattern predictions appear to be realistic. © Research India Publications.
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Purpose: The focus of this paper is the evolution of supply chain management (SCM) and logistics, as well as of the relationship between them. Its purpose is to generate deep insights into practice, particularly in relation to the fundamental issue of how practitioners define these key terms and phrases. Research approach: A largely qualitative study which involved in depth interviews with managers from two third party logistics providers (3PLs)/distributors, two retailers and two manufacturers from the United Kingdom. This interview protocol is based on the template used in a previous study published over a decade ago. Findings and originality: The data collected during the focussed interviews in the United Kingdom is contrasted with results from the earlier study. The findings suggest that there is variation between practitioners particularly in relation to what SCM is specifically concerned with. This variation mirrors to a large extent the differing orientations and emphases evident in the many theoretical definitions of SCM that have been proposed in recent decades. Research impact: The authors introduced the concept of refined replication in SCM research. This allows previous research to be built upon in order to test understanding of SCM theory and its practical implementation among SCM professionals in the United Kingdom. Practical impact: A profile of SCM understanding and adoption by firms in the United Kingdom is presented .