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Discrimination law primarily relies on individual enforcement for addressing discrimination at work; yet those who are most impacted by discrimination are likely the least able to enforce their rights. The question then becomes: what role should individual enforcement play in discrimination law? Can we effectively abandon individual enforcement as part of the legislative model? Drawing on a mixed method, multi-year comparative study of the enforcement of age discrimination law in the UK, Australia and Sweden, this paper considers the gaps, limits and risks of the individual enforcement model in discrimination law. Integrating doctrinal analysis; statistical analysis of claims and cases, and data from the EU and OECD; qualitative expert interviews; and a survey of legal practitioners, this paper argues that while individual enforcement is inherently limited as a tool for achieving systemic change, it must remain part of any legislative model. Reflecting on the experience in Sweden, where individual enforcement of discrimination law is significantly curtailed, the paper posits that individual rights and individual enforcement remain important complements to other regulatory tools, particularly in jurisdictions with strong enduring age norms. Abandoning or severely restricting individual enforcement is unlikely to support either the macro or micro effectiveness of age discrimination law.
This paper argues that abortion access is an important subject for bioethics scholarship and reflects on the relationship between legal frameworks and access to care. The author uses the example of the United Kingdom to examine the benefits and limitations of abortion-permissive legal frameworks in terms of access. These are legal frameworks that enable the provision of abortion but subject to restrictions. An abortion-permissive regime—first in Great Britain and then in Northern Ireland—has gone some way to improving access to care over time. However, aspects of the regime (that lead to its description as permissive rather than supportive of abortion) have the potential to endanger abortion access in the future and so legal reform is necessary.
To explore higher education institution (HEI) perspectives on the development and implementation of trainee nursing associates (NAs) in the primary care workforce in England.
Background:
Current shortages of primary health care staff have led to innovative skill mix approaches in attempts to maintain safe and effective care. In England, a new level of nursing practice, NAs, was introduced and joined the workforce in 2019. This role was envisaged as a way of bridging the skills gap between health care assistants and registered nurses and as an alternative route into registered nursing. However, there is limited evidence on programme development and implementation of trainee NAs within primary care settings and HEI perspectives on this.
Methods:
This paper draws from a larger qualitative study of HEI perspectives on the trainee NA programme. Twenty-seven staff involved in training NAs, from five HEIs across England, were interviewed from June to September 2021. The interview schedule specifically included questions relating to primary care. Data relating to primary care were extracted and analysed using a combined framework and thematic analysis approach.
Findings:
Three themes were developed: ‘Understanding the trainee role and requirements’, ‘Trainee support in primary care’ and ‘Skills and scope of practice’. It is apparent that a more limited understanding of the NA programme requirements can lead to difficulties in accessing the right support for trainees in primary care. This can create challenges for trainees in gaining the required competencies and uncertainty in understanding what constitutes a safe scope of practice within the role for both employers and trainees. It might be anticipated that as this new programme becomes more embedded in primary care, a greater understanding will develop, support will improve and the nature and scope of this new level of practice will become clearer.
Norway rats (Rattus norvegicus) are considered one of the most significant vertebrate pests globally, because of their impacts on human and animal health. There are legal and moral obligations to minimise the impacts of wildlife management on animal welfare, yet there are few data on the relative welfare impacts of rat trapping and baiting methods used in the UK with which to inform management decisions. Two stakeholder workshops were facilitated to assess the relative welfare impacts of six lethal rat management methods using a welfare assessment model. Fifteen stakeholders including experts in wildlife management, rodent management, rodent biology, animal welfare science, and veterinary science and medicine, participated. The greatest welfare impacts were associated with three baiting methods, anticoagulants, cholecalciferol and non-toxic cellulose baits (severe to extreme impact for days), and with capture on a glue trap (extreme for hours) with concussive killing (mild to moderate for seconds to minutes); these methods should be considered last resorts from a welfare perspective. Lower impacts were associated with cage trapping (moderate to severe for hours) with concussive killing (moderate for minutes). The impact of snap trapping was highly variable (no impact to extreme for seconds to minutes). Snap traps should be regulated and tested to identify those that cause rapid unconsciousness; such traps might represent the most welfare-friendly option assessed for killing rats. Our results can be used to integrate consideration of rat welfare alongside other factors, including cost, efficacy, safety, non-target animal welfare and public acceptability when selecting management methods. We also highlight ways of reducing welfare impacts and areas where more data are needed.
This article critically examines the relation between work and utility and challenges the mainstream economic view of well-being as a hedonic state for which work is a less pleasurable trade-off. It proposes a conception of work as a potential source of eudaimonic well-being, providing meaning and contributing to human flourishing and self-realisation. Based on micro-level data, the article shows the relevance of distinguishing between hedonic and eudaimonic well-being by way of comparing the effects of increased financial difficulties and deteriorated work conditions on these two types of well-being in five European Union countries – Germany, Poland, Portugal, Sweden and the UK – in the post global financial crisis years between 2009 and 2014. The article concludes by underlining the political importance of addressing aspects pertaining to the quality of working life and of creating jobs that serve to improve the eudaimonic well-being of citizens.
The aim of the present study was to assess the seasonal relationship between serum 25(OH)D concentration, lean mass and muscle strength. This was a secondary data analysis of a subgroup of 102 postmenopausal women participating in the 2006–2007 D-FINES (Vitamin D, Food Intake, Nutrition and Exposure to Sunlight in Southern England) study. The cohort was assessed as two age subgroups: <65 years (n=80) and ≥65 years (n=22). Outcome measures included lean mass (DXA), muscle strength (handgrip dynamometry) and serum 25(OH)D concentration (enzymeimmunoassay). Derived outcomes included appendicular skeletal muscle mass (ASM) and relative appendicular skeletal muscle index (RASM). Sarcopenia status was assessed using the European Working Group on Sarcopenia in Older People 2018 criteria. Non-parametric partial correlation using BMI as a covariate was used to evaluate the study aims. There were no statistically significant associations between total lean mass, ASM or RASM and 25(OH)D in any group at any season. There was a trend for handgrip strength to be positively associated with serum 25(OH)D concentration. There was a trend showing a higher prevalence of sarcopenia in women ≥65 years. Sarcopenia status appeared transient for five women. In conclusion, the present study found no significant association between vitamin D status and functional indicators of musculoskeletal health, which were additionally not affected by season.
Mobility research tends to focus on physical movement and experiences in later life; however, changes in older adult mobility over time remains underexplored. Furthermore, older adults typically experience many life events, some of which result from cognitive and physical decline, and many of which impact mobility. This article aims to explore how life events affect the mobility of older adults over time. We conducted in-depth interviews with 22 older adults aged 55 years and over from Lancashire, United Kingdom. Of these participants, eight lived with memory problems. The findings show that both anticipated and unexpected life events play a profound role in the participants' mobility over time. Retirement, long-term illness and age-related illness were examples of anticipated life events, while the death of a loved one and developing memory problems were examples of unexpected life events. In both cases, participants' made external adaptations, such as moving home, or internal adaptations, such as self-awareness. The findings also emphasise the layered nature of life events and adaptations playing a role in the participants' mobility. Additionally, life events such as developing memory problems showed a domino effect, triggering further life events and adaptations which impacted the participants' mobility. This article emphasises how transition periods can occur before or after a life event, showing that adaptations can be pre-emptive to a life event. Our article contributes to calls for internal adaptations to be fully incorporated into age-related policy and also for age-related policy to be more inclusive for older adults who experience memory problems and dementia.
The end of free movement as a consequence of the United Kingdom (UK)’s withdrawal from the European Union (EU) meant that it was necessary for the UK to devise a new migration system when the transition period came to an end. One aim of this article is to determine in what respects the new system, which came into force on 1 January 2021, draws on or differs from the previous immigration system. To the extent that this inquiry reveals some similarities, another aim is to uncover how the policymaking process produced these continuities. Drawing on the concept of path dependency from the ‘new institutionalism’ literature, the analysis reveals that two critical decisions taken by the New Labour government (1997–2010) set in train a path dependent policy process that has shaped immigration law and policy today. Two mechanisms of path dependency are identified. First, there were continuities in the operation of conceptual frameworks, methodologies and conclusions amongst organisations tasked with designing the new immigration system. Second, the position adopted by employing enterprises favoured the retention of key features of the previous system.
One feature of neoliberal market imperialism is the idea that no corner of life should be off limits from market-based competition and profit. Rather predictably, this sort of economic thinking has found its way into the provision of healthcare, even in the context of countries with socialized, nationalized healthcare such as the United Kingdom. Here, Shapiro examines what happens to care for mothers and children in the United Kingdom after the introduction of neoliberal reforms and compares it to Sweden, both ostensibly national systems, but differing in their degree of market creep. Shapiro makes use of a legal, human-rights-based frame of analysis to show that birth in Sweden is far better for human well-being than it is in the UK. In terms of the overarching theme of the book, the chapter is an example of the advantages of increased government planning against neoliberal orthodoxy. Her analysis also points to the alliance between neoliberal austerity policies and the defense of traditional conservative “family values.”
Chapter V turns to the UK, whose withdrawal remedy has served as the model for similar remedies across the Anglo-Commonwealth. While the ‘unfair prejudice’ remedy was initially a great success that spawned a rapidly developing jurisprudence, the perception of an explosion in shareholder litigation in the courts and mushrooming costs against the backdrop of ongoing civil justice system reforms caused serious backlash in the 1990s. On the judicial front, Lord Hoffmann’s seminal speech in O’Neill v Phillips effectively became the last word on unfair prejudice. Contemporaneously, law reform attempts aimed at addressing the perceived problems of unfair prejudice ultimately led nowhere. The meteoric rise and gradual fall of the unfair prejudice remedy in the UK is a cautionary tale of the power of judges to obstruct, of how one decisive voice prevailed over many divided against themselves, and of the limits of legislative reform in close corporation law.
Close corporations, which are legal forms popular with small and medium enterprises, are crucial to every major economy's private sector. However, unlike their 'public' corporation counterparts, close corporation minority shareholders have limited exit options, and are structurally vulnerable in conflicts with majority or controlling shareholders. 'Withdrawal remedies'-legal mechanisms enabling aggrieved shareholders to exit companies with monetary claims-are potent minority shareholder protection mechanisms. This book critically examines the theory and operation of withdrawal remedies in four jurisdictions: the United States, the United Kingdom, Germany, and Japan. Developing and applying a theoretical and comparative framework to the analysis of these jurisdictions' withdrawal remedies, this book proposes a model withdrawal remedy that is potentially applicable to any jurisdiction. With its international, functional, and comparative analysis of withdrawal remedies, it challenges preconceptions about shareholder remedies and offers a methodology for comparative corporate law in both scholarship and practice.
This article contributes to the debates on the role of anthropology in refugee law research by showing the added value of an interdisciplinary approach to the understanding of complex asylum claims related to cultural and religious beliefs that are unfamiliar to the Western perspective. Based on the analysis of asylum claims in UK courts involving witchcraftbased persecution in the country of origin—both applicants who feared becoming victims of witchcraft practices and those who could be accused of having engaged in witchcraft practices—I demonstrate how anthropology can provide the tools for bridging the gaps between the law in the books and its implementation in practice and solving issues that are beyond the scope of the law. In particular, anthropology can feed into a broader legal conceptualization that accounts for the realities of our diverse societies and helps explain how fear of persecution due to witchcraft can indeed be real and connected with serious human rights violations. Moreover, cultural expertise can assist in assessing asylum claims in their cultural, historical, and political contexts, affording the claimant a fairer and better adjudicated outcome. Nevertheless, the use of anthropology inevitably comes with some challenges related to the different fields’ epistemologies, languages, and styles, as well as a lack of appreciation for interdisciplinarity in some areas of academia.
Mental illness is the single largest cause of disability in the UK, with one in four individuals suffering from a mental health problem. Despite this, only 13% of the NHS budget goes towards treatment of mental illness. It is thus unsurprising that addressing the parity of esteem of mental health has been highlighted as a major priority for the healthcare system, with the NHS Five Year Forward plan aiming to achieve this by 2020.
Objectives
To explore the barriers to achieving parity of esteem of mental healthcare in the UK and develop recommendations for implementation.
Methods
Narrative review of literature and synthesis of findings
Results
Three key barriers to achieving parity of esteem of mental health were identified: the current mental health investment standard (MHIS), medical sub-specialisation, and access to acute day units (ADU). The following recommendations were thus synthesised: to increase the time-period to measure MHIS increments, integrating mental health teaching into specialty training programmes, and increasing the availbility of ADUs to crisis referral teams.
Conclusions
Addressing the disparity between mental and physical health is a major priority for the NHS. This research provides an overview of current barriers and suggests recommendations for improvement. By prioritizing improvement in the MHIS, integrating mental health teaching into specialty training, and increasing access to ADUs, the NHS formulates an excellent founding to achieving the ultimate goal, parity of esteem of mental health.
China’s Mao-era science diplomacy involved strategies and structures that underpinned the hosting of foreign visitors such as scientists. Chapter 5 focuses on networks of individual relationships – professional, personal, and political – that ran through Chinese involvement in the organisations and events discussed in this book, focusing on some of those that developed between Chinese and left-wing British scientists from the 1940s through to the 1970s. Considering the experiences of J. D. Bernal, Howard E. Hinton, Dorothy Hodgkin, Kathleen Lonsdale, and Kurt Mendelssohn, it elucidates the range of motivations, responses, and outcomes on either side of scientists’ visits to China as part of everything from ‘friendship’ delegations made up of political sympathisers to lecture tours organised by scientific organisations. These British scientists had much in common with many other sympathetic visitors from the time, at least in broad strokes; nevertheless, this chapter identifies several key characteristics that set such scientists apart as a category of foreign visitor during the Mao era.
Besides Switzerland, the United Kingdom is the only State to have elaborated a national strategy on the protection of civilians. A formal 2010 UK Government Strategy on the Protection of Civilians in Armed Conflict has been supplemented by an August 2020 Policy Paper, UK Approach to Protection of Civilians in Armed Conflict. The Policy Paper was the joint work of the Department for International Development, the Foreign & Commonwealth Office, and the Ministry of Defence.
Chapter 6 traces the global repercussions of the aftosa campaign, particularly its effects on new US efforts to control animal disease across the Americas and Europe for economic and military purposes. As such, the story helps to underline the multilateral character of Latin America's Cold War, and the ecological contexts that shaped it.
The United Kingdom is more properly called the United Kingdom of Great Britain and Northern Ireland, where Great Britain includes the nations of Scotland, England, and Wales. In this chapter we will see that the development of psychological assessment as a science in the United Kingdom and more widely proceeded in parallel with and in interaction with the development of psychometrics as a set of measurement tools, which in turn was used to support a world view at that time which saw psychological differences as relatively fixed attributes that were only primarily changeable through genetic changes. We also track the development of assessment methods which were influenced strongly by the two World Wars. The greatest changes and developments in testing and assessment in the United Kingdom took place in occupational job selection and training settings before they had an impact on practice in clinical and educational assessment. As a consequence, this chapter focuses on the history of occupational assessment rather than on developments in the clinical and educational fields.
United Kingdom Health Security Agency (UKHSA) guidance related to mask use for health care workers in a non-aerosol generating procedure (AGP) setting has remained as Level 2 water repellent paper mask (surgical mask) only. Energetic respiratory events, such as coughing, can generate vast numbers of droplets and aerosols. Coughing, considered to be a non-AGP event, frequently occurs in the relatively small, confined space of an ambulance (∼25 m3). The report seeks to explore whether existing research can provide an indication of the risk to ambulance staff, via aerosol transmission, of an acute respiratory infection (ARI) during a coughing event within the clinical setting of an ambulance.
Methods:
International bibliographic databases were searched (CINAHL Plus, SCOPUS, PubMed, and CENTRAL) using appropriate search strings and a combination of relevant medical subject headings with appropriate truncation. Methodological filters were not applied. Papers without an English language abstract were excluded from the review. Grey literature was sought by searching specialist databases OpenGrey and GreyNet, as well as key organizations’ websites. The initial search identified 2,405 articles. Following screening, along with forward and backward citation of key papers identified within the literature search, 36 papers were deemed eligible for the scoping review.
Discussion:
Attempts to replicate a clinical environment to investigate the risk of transmission of airborne viruses to health care workers during a coughing event provided evidence for the generation of respirable aerosol particles and thus potential transmission of pathogens. In cases of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), potential to infect versus true airborne transmission is a debate that continues, but there is general consensus that a large variation of cough characteristics and aerosol generation amongst individuals exists. Studies widely endorsed face masks as a source control device, but there were conflicting views about the impact of mask leakage.
Conclusion:
Further research is required to provide clarity of the risk to health care workers when caring for a coughing patient in the confined clinical ambulance setting and to provide an evidence base to assist in the determination of appropriate respiratory protective equipment (RPE).
The chapter analyses the market for stewardship, as it has been developing in the UK. The 2020 UK Stewardship Code more clearly than previous stewardship codes (both in the UK and elsewhere) articulates the concept of a market for stewardship. The UK Code 2020 takes into account the position of end-investors and beneficiaries. The hope is that stewardship will be delivered because those whose money is invested ask for it. We agree that stewardship does start with those who contribute the funds invested in the market. The focus on end-investors and beneficiaries is, however, not enough. By limiting the analysis to these groups, the UK government overlooks the fact that it is itself a financial contributor to the market. A study commissioned by the Competition and Markets Authority (CMA) finds, for example, that 90% of the revenue of investment consultants and fiduciary managers derives from pensions. The government contributes to pension investments through the provision of tax credit. It is a significant financial investor in the market. Tax credit also deprives end-investors and beneficiaries of a financial incentive to oversee asset owners, asset managers and other service providers. We suggest that the UK government should act as a steward in relation to its own investment and tailor tax credit to investments that are stewardship-active.
Most UK patent litigation takes place in England and Wales, where it is heard by either the Patents Court (larger, more complex and/or more valuable cases) or the Intellectual Property Enterprise Court (smaller, less complex and/or less valuable cases). These are both specialised courts. It is normal in both courts for issues of infringement and validity of the patent to be heard together. The intellectual property bar in England and Wales consists of a considerable number of highly specialised and skilful advocates, most of whom have a Science, Technology, Engineering and Mathematics (STEM) degree as well as a legal qualification. They are instructed by both large multinational firms and small boutique firms of lawyers, and they are well known for being innovative, particularly with regard to procedural questions. Although there is a reasonable volume of UK patent litigation, disputes concerning injunctions are relatively infrequent.