bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Analysis of Child Maintenance Schemes in Five Countries
Authors: Skinner Christine , Hakovirta Mia , Davidson Jacqueline
Published: March 2017

The aims of this special issue were twofold: to provide international research evidence of child maintenance schemes in five countries and to produce a comparative analysis of that research, to show how child maintenance outcomes differ across countries. The research data were collected using a vignette technique. This set up two fictional families, specifying sets of characteristics in order to explore how child maintenance schemes deal with key factors. Decision processes and payment outcomes are explored for applicants who are, for example, lone parent families on low incomes, divorcing families on middle incomes or reconstituted cohabiting families where a new child is born to the non-resident parent; the effects of changes in employment status and shared care arrangements are also considered. This final paper provides a comparative analysis of the vignettes to show how child maintenance outcomes differ across countries, and summarises the key themes that emerge from the individual country papers. Ultimately, the comparative analysis demonstrates that we have only scratched the surface in understanding similarities and differences internationally across child maintenance schemes. This is partly because of the complex interaction between child maintenance schemes and social security systems, which is not always transparent.
The Convergence of Welfare State Indicators in Europe: Evidence from Panel Data
Authors: Paetzold Jörg
Published: March 2017

This paper investigates whether there is a convergence in welfare state programmes among the ‘old’ EU Member States. To identify such trends, the study relies on net pension and net unemployment replacement rates, as well as on public social expenditure data. Empirically, a sample of 14 economies (EU-15 excluding Luxembourg) between 1980 and 2005 is used. The empirical findings reveal the presence of a convergence process, driven by a strong catch-up in social protection levels in the southern Member States. Furthermore, convergence in replacement rates is substantially less pronounced than convergence in public social expenditure. In sum, the results indicate that the converging trend of public social expenditure and unemployment benefits has continued in advanced industrialised countries and over time. These findings confirm and expand on earlier studies (Caminada et al. 2001; Starke et al. 2008; Schmitt and Starke 2011).
The Political Sustainability of the NDC Pension Model: The Cases of Sweden and Italy
Authors: Schoyen Mi Ah , Stamati Furio
Published: March 2017

Since the early 1990s we have seen pension reforms in a large number of advanced welfare states, and the most impressive reforms have happened in countries with Bismarckian pension systems. Some of these countries have adopted a particularly innovative pension model which is based on pay-as-you-go financing and benefits that are a function of lifetime contributions. The approach is known as the notional defined contribution (NDC) model. This article examines what has happened to the public pension systems in Sweden and Italy after they were among the first to adopt the NDC model in the mid-1990s. By focusing on the degree of political consensus and conflict in the national pension policy debate since the NDC formula was introduced, the article offers an empirical assessment of the degree of political sustainability enjoyed by these landmark reforms. The paper shows that reform processes do not end with legislation. For reforms to have a lasting impact, whether they are left to work as intended also matters. The ‘post-adoption’ policy trajectory depends on a number of factors related to policy design, economic context and political ownership.
The EU Asylum, Immigration and Border Control Regimes: Including and Excluding: The “Deserving Migrant”
Authors: El-Enany Nadine
Published: March 2017

It can be argued the EU Reception Conditions Directive constitutes an improvement on international refugee law in that it creates entitlements to welfare for asylum seekers. However, this development is limited in two important respects. First, the Directive has often either not been fully implemented or has been poorly implemented, resulting in vast differences in practice and inadequate levels of protection across the Union. Second, the effect of the EU's immigration and border control practices is to limit access to EU territory for all migrants, irrespective of their motivations for moving. Migrants' departure points are being pushed further afield and their journeys to the EU are becoming more dangerous. Thus, the EU's highly restrictive immigration and border control policy de facto undermines the protective elements that might otherwise result from the Reception Conditions Directive.
Social Protection for Migrant Workers: National and International Policy Challenges
Authors: van Ginneken Wouter
Published: March 2017

In the current global context, many migrant workers, and in particular women and irregular workers, are not - or are very inadequately - covered by social security and other social protection programmes. Current human rights standards related to migrant workers and families have so far had little impact on this situation. This article first examines various national approaches to extending social security to migrant workers in low-, middle- and high-income countries, such as through affiliation to the social security systems in countries of employment and countries of origin. It then attempts to assess the impact of regional and other international migration and social security agreements, particularly within the European Union. It also explores the potential impact of wider ratification of ILO and UN Conventions on migrant workers, which would ensure basic social and labour protection, in particular for irregular migrant workers. The article concludes with some key policy challenges for the future, including for improved regional and global governance.
Comparative Welfare State Analysis with Survey-Based Benefit: Recipiency Data: The ‘Dependent Variable Problem’ Revisited
Authors: van Oorschot Wim
Published: March 2017

This paper aims to contribute to the debate on the ‘dependent variable problem’ in comparative welfare state analysis, by focusing on ‘benefit recipiency’ as a hitherto largely neglected type of indicator for understanding cross-national and longitudinal variation between welfare states. The pros and cons of the commonly used indicators of social rights and social expenditure are summarised in order to provide a background for a conceptual and methodological assessment of the added value provided by the inclusion of benefit recipiency data in analysis. In addition, we explore the empirical potentialities of benefit recipiency data. We present and discuss the results of analyses of EU-SILC data for the EU 27 countries, using them to calculate and compare rates of access to a series of benefits among working age populations, as well as the relative amounts of benefits received. Our main conclusion is that benefit recipiency data are a promising source for comparative welfare state analysis. However, like other data sources, they are not without problems, and more work needs to be done to assess their value, relative to more commonly used indicators.
The New Politics of the Welfare State? A Case Study of Extra-Parliamentary Party Politics in Norway
Authors: Allern Elin H. , Bay Ann-Helén , Saglie Jo
Published: March 2017

According to the literature on the ‘new politics of the welfare state’, party politics plays a minor role in welfare policy outputs today. In this article, we ask what the degree of politicisation is below the level of government. Focusing on two specific policy areas – pension reform and anti-poverty policy – and both substantive and procedural aspects of politicisation in the case of Norway, we identify party policies and map intra-party decision-making prior to the 2005 general election. We first conclude that neither policy area seemed to be strongly politicised, but nonetheless, there were limits to the ‘de-politicisation’ of welfare policy even in a consensual state like Norway. Hence, we show – or confirm – that counter-forces might exist between and within political parties in advanced industrial societies, yet to varying degrees across welfare policy fields.
The Privacy Protection of the Sick Employee: The Dutch Case from a Comparative Perspective
Authors: van der Helm Ivo
Published: March 2017

This article deals with the protection of an employee's health data when the employer has to pay sick pay and reintegrate the sick employee. The Regulations of the Council of Europe and the European Union require that domestic law offers appropriate/adequate safeguards for the protection of health data when they are processed for employment purposes. There is a discussion of way in which the Dutch system provides these safeguards, compared with systems in other European countries. It appears that legal safeguards for the protection of health data in the Dutch system are comparable with those in other European countries. In practice, however, there may be a risk in the Dutch system that the company doctor will provide the employer with medical information, even when he/she is not permitted to do so. The doctor's independent position and the observance of patient confidentiality may, in some cases, come under pressure. The author proposes changing the organisation of company doctors in the Netherlands so as to strengthen their position.
Overview of Recent Cases before the Court of Justice of the European Union (January – June 2013)
Authors: van der Mei Anne Pieter
Published: March 2017

In the period January–June 2013 the Court of Justice of the European Union (CJEU or the Court) delivered various interesting rulings which are worth reporting. Two rulings stand out: Jeltes, in which the Court was asked whether the so-called ‘ Miethe case law’ concerning the right of unemployment benefits of wholly unemployed frontier workers, developed under the coordination regime of Regulation 1408/71, is still relevant under the new regime governed by Regulation 883/2004; and Giersch, in which the Court was asked whether Member States may make entitlement to (portable) student financial aid conditional upon (prior) residence on national territory In addition, this overview includes a number of possibly less eye-catching but nonetheless interesting cases concerning overlap of benefits (van den Booren, Wencel), aggregation rules for family and orphan benefits (Dumont de Chassart) and third country nationals (Hadj Ahmed).
Equally to All? The Significance of Collectively Negotiated Sickness Benefits in Cross-Nordic Social Policy Analysis
Authors: Järvi Laura , Kuivalainen Susan
Published: March 2017

Most previous research on social welfare has focused on the statutory part of welfare delivery. By examining collectively-negotiated sickness benefits, this article introduces occupational welfare into cross-national analyses of social policy and explores how this changes the Nordic welfare model. Instead of limiting its focus to one average worker wage, the article examines five different occupations representing both low-skilled and high-skilled workers, as well as public and private sector employees. Using the stylised case method and examining three different durations of sickness, the study shows that employees in different occupations have different rights in relation to occupational benefits during sickness. Although the results found by the analysis vary with length of sickness, the article concludes that, in general, occupational welfare has a reinforcing effect on the existing differences between occupations generated by public benefits. The analysis presents evidence of not-so-equal aspects of the Nordic welfare model.
Gender and Class: Comparing the Situation of Single-Parent Households in Seven European Countries
Authors: Szelewa Dorota
Published: March 2017

This article centres on the intersection of the dimensions of class and gender Its main goal is to present an overview of the kinds of constraints and opportunities provided by the combinations of different policy tools for various income profiles in Denmark, Finland, Germany, the Netherlands, Norway, Sweden and the United Kingdom. Adopting a focus on single parents, differences within this group are identified by using disposable income micro-simulations for different household profiles in applying the capabilities approach, giving special attention to the level of agency over choices in work-life balance. In order to measure the class effects of policy mixes, this article proposes an alternative approach to the comparative analysis of family support. It adopts a particular focus on single-parent families. (1) for four different income profiles: at levels of 0.5, 1.0, 1.5 and 2.0 times the average wage; (2) for in-work and out-of-work situations; and (3) by using a tax-benefit model, which analyses gross income from work along with social benefits (unemployment insurance benefits, housing benefits, child benefits, and child care subsidies) minus tax, mandatory social contributions, housing costs and childcare fees. The adopted unit of stylised comparison is a single-parent family with a child aged three, with the assumption that the family uses formal childcare.
Overview of Recent Cases before the Court of Justice of the European Union (July–September 2013)
Authors: van der Mei Anne Pieter
Published: March 2017

In the period July–December 2013 the Court of Justice of the European Union (CJEU) delivered various interesting rulings which are worth reporting. Two rulings stand out: Brey, which concerned the entitlement of economically inactive Union citizens to minimum subsistence benefits other than classic social assistance; and United Kingdom v Council, in which the Court was asked whether the EU legislature can use its power to coordinate social security schemes to extend Regulation 883/2004 to the European Economic Area. In addition, this overview includes rulings in cases concerning pensions (Gardella and Časta), family benefits (Hliddal and Bornand, and Lachheb and Lachheb), health insurance for pensioners (van der Helder and Farrington) and the portability of student financial aid (Prinz and Seeberger, Elrick, and Thiele Meneses).1
In-Work Benefits: Effective Social Protection or ‘Emperor's New Clothes’?
Authors: Cousins Mel
Published: March 2017

In work benefits (IWBs) were initially introduced in the UK and USA in the 1970s and have expanded greatly in scope and geographical coverage in recent decades.1 Recent studies by organisations such as the OECD have presented a generally positive picture of IWBs, but a review of the evidence suggests that their achievements are less clear-cut and more contestable than might be expected. The purpose of this article is to examine the role of in-work benefits (IWBs) in four OECD countries (France, New Zealand, UK and the USA) in order to establish the impact these benefits have had on employment and poverty and to assess the extent to which they meet their objectives.

Drawing on a review of the international literature and an in-depth study of the four countries concerned, this article argues that IWBs can play a useful role in increasing the employment rate of specific groups. However, the impact of IWBs is limited and their effect on overall employment is small. The large-scale expansion of IWBs in the UK and USA would appear to be driven by particular policy views in these societies rather than by the policy outcomes achieved by IWBs, and this trend is unlikely to be replicated, especially in continental Europe.
The Duty to Work without a Wage: A Legal Comparison between Social Assistance Legislation in Germany, the Netherlands and the United Kingdom
Authors: Eleveld Anja
Published: March 2017

Since the rise of the activation paradigm in the 1990s, the duty to work without a wage has become widespread in European social assistance legislation. This paper investigates in a precise way the extent to which the duty to work without a wage follows the legal logic of a contractual relationship and how this duty is related to the fundamental right to an adequate standard of living. A comparison between German, Dutch and British social assistance legislation shows that the duty to work without a wage increasingly takes the form of a reciprocity requirement. That is, instead of re-integrating into regular paid work, recipients of social assistance are required to show that they are worthy of attaining basic social rights, not only by improving their capability to work but, above all, by showing a willingness to work. It concludes that the duty to work without a wage enhances governmental control over recipients of social assistance rather than improving their employability and notes that, in this respect, the Dutch social assistance regime seems to be stricter than the German and British ones.
Increasing Pension Ages in Greece and Ireland: A Question of Legitimate Expectations
Authors: Dewhurst Elaine , Diliagka Dafni
Published: March 2017

This paper examines the changes to pension ages in Greece and Ireland precipitated by the global financial crisis and introduced as a result of the Greek and Irish bail-outs. The paper analyses whether pensioners in the two jurisdictions had a legitimate expectation that such changes would not occur or whether they had a legitimate expectation that such changes would not be introduced without transitional measures. It concludes that, while there is no existing legal protection of the legitimate expectation in either case, there are some moral arguments in support of the introduction of transitional measures to ensure that pensioners can make the necessary adjustments to their financial affairs in the light of the changes in pension law.
Should Social Rights Be Included in Interpretations of the Convention by the European Court of Human Rights?
Authors: Dahlberg Maija
Published: March 2017

The European Court of Human Rights frequently incorporates socio-economic rights in its applications of the Convention as a result of its broad interpretations of civil and political rights, while at the same time emphasising that the Convention does not actually entail socio-economic rights. This article analyses the arguments concerning the inclusion of social rights in the Court's interpretation of the provisions of the Convention. Analysis is through use of a case law study which examines how the Court legitimises the inclusion of social rights in its interpretations of the Convention despite their absence from the text of the Convention itself. Existing social rights arguments are categorised under the Convention rights provisions, revealing the extent to which including social rights within the interpretations of the Convention provisions has become established practice.
Fathers' Leave and Fathers' Involvement: Evidence from Four OECD Countries
Authors: Huerta Maria C. , Adema Willem , Baxter Jennifer , Han Wen-Jui , Lausten Mette , Lee Raehyuck , Waldfogel Jane
Published: March 2017

In recent years, several OECD countries have taken steps to promote policies encouraging fathers to spend more time caring for young children, thereby promoting a more gender equal division of care work. Evidence, mainly for the United States and United Kingdom, has shown fathers taking some time off work around childbirth are more likely to be involved in childcare related activities than fathers who do not take time off. This article reports on a first cross-national analysis of the association between fathers' leave taking and fathers' involvement when children are young. It uses birth cohort data of children born around 2000 from four OECD countries: Australia, Denmark, the United Kingdom and the United States. Results show that the majority of fathers take time off around childbirth independent of the leave policies in place. In all countries, except Denmark, important socio-economic differences between fathers who take leave and those who do not are observed. In addition, fathers who take leave, especially those taking two weeks or more, are more likely to carry out childcare related activities when children are young. This study adds to the evidence that suggests that parental leave for fathers is positively associated with subsequent paternal involvement.
National Healthcare Planning and the Internal Market: A Conceptual View on the Impact of EU Law on Member States' Regulatory Autonomy in the Field of Healthcare
Authors: Walus Andreas
Published: March 2017

Public healthcare is a fundamental task of welfare states. Its real character is ambiguous though as, on the one hand, healthcare is a cornerstone of social security while, on the other, it is an enormous economic sector. At the same time, maintenance of healthcare services constitutes one of the biggest financial burdens on public budgets and will remain so for the foreseeable future.

In order to cope with this challenging subject matter, Member States have evolved a wealth of healthcare regulations. Considering the potential cross-border economic activity in the healthcare sector by patients and healthcare providers, the question of the compatibility of national healthcare planning with European Union Law arises. This article analyses how Member States' healthcare planning is both limited and preserved by European primary law and by the CJEU's case law. The study reveals a surprising result.
The Crisis Imperative, Reform Dynamics and Rescaling in Greece and Portugal
Authors: Petmesidou Maria , Glatzer Miguel
Published: March 2017

This article compares the welfare reform dynamics and rescaling processes over the last few years in Greece and Portugal. It comprises four main sections. After an introduction, the second section briefly describes the salient features of social security, healthcare and labour market policy in the two countries in the years prior to the crisis. It also sets out the major dimensions of comparison. The third section provides a short account of the unfolding of the crisis and the common pressures for structural adjustment, while the fourth section examines the policy options and outputs in the above three policy domains under the bail-out. In the light of the major points of comparison put forward, the interplay of external and internal factors in welfare state reform and rescaling are analysed in section five. The conclusion briefly points to restrictions and challenges in the post-crisis era.
Accommodating Social Security and Freedom of Religion
Authors: Pieters Danny
Published: March 2017

In this article I explore how national and European law deal with situations where the right to social security, and, more broadly, the law on social security, seem to conflict with the freedom of religion. The article begins by specifying what is meant by the terms ‘social security’ and ‘freedom of religion’. It attempts to illustrate areas of real or apparent conflict between the freedom of religion and social security law, referring to case law and practice in a variety of Western countries. It then deals with religious objections to participation in social security schemes as such, with the definition of suitable work from a religious perspective and with health care coverage in light of religious objections. In conclusion, it seeks to develop an approach that can be followed for solving cases of real or apparent tension between social security law and the freedom of religion.
Right to Hospital Care and Prioritisation from a Law and Politics Perspective – The Experiences of Norway and Denmark
Authors: Aasen Henriette Sinding , Hartlev Mette , Magnussen Anne-Mette
Published: March 2017

As members of the Nordic family of welfare states, both Norway and Denmark are characterised by universal access to health care. Legislation and individual rights have increasingly been used as tools to promote and protect patients' equal access to health care services. At the same time both countries are struggling with increasing health care expenditures, waiting lists and a demand to prioritise health care resources in light of new and expensive treatment options. This calls for political space to adjust prioritisation policies and procedures. The article analyses the regulation of access to hospital care in Norway and Denmark, from a law and politics perspective. We explore similarities and differences between the two countries with respect to the objectives of the regulation and formulation of the right to hospital care, and how the interplay between law and politics – and juridification and politicisation – is expressed and managed in the regulation. We conclude that even though there are differences between the two countries in the extent of juridification, the regulation in both countries still leaves room for continued political governance of issues related to the prior itisation of health care services.
National Welfare Systems, Residency Requirements and EU Law: Some Brief Comments
Authors: Dougan Michael
Published: March 2017

This short paper summarises recent developments in the case law of the Court of Justice of the European Union concerning the rights to residency and equal treatment of economically inactive migrant Union citizens. Rulings such as Dano and Alimanovic have signalled a hardening of judicial attitudes, retreating from some of the more generous case law delivered by the Court in the past. That change perhaps plays to broader political concerns about the free movement of Union citizens in certain Member States – not least the United Kingdom, where such issues are playing a prominent role in the public debate about whether or not to remain a Member State of the European Union.
Under Pressure? – Swedish Residence-Based Social Security and EU Citizenship
Authors: Erhag Thomas
Published: March 2017

This article analyses the impact of free movement of persons on Swedish residence-based social security in the areas of old-age pensions, health care and social assistance. Since becoming a member of the EU in 1995 Sweden has made both minor and larger adaptations of various residence concepts in social security law. The article describes these legislative changes and analyses the practical implications for migration as well as whether the changes have had a deeper impact on values in Swedish social security. The analysis shows that the Swedish legislator and courts are struggling to strike a balance between residence-based social security and free movement of persons. An early – and also a major – change was to turn the guarantee-level pension into a pro-rata scheme. To follow up the consequences of this, a special non-contributory benefit had to be introduced to prevent an inflow of applicants into social assistance. However, this benefit has proved to be vulnerable to mobility. The implementation of Directive 2004/38 was made without any real changes of social security legislation. At a later stage this led to difficulties in the application of the various residence-concepts in Swedish law. The legislator is now using various techniques to improve access to residence-based benefits and, at the same time, ensure a minimum coverage for migrants to ensure that the basic values of Swedish social security as well as international obligations are fulfilled.
Social Security Rights under Decision No 3/80 of the EEC-Turkey Association Council: Developments in the EU and in the Netherlands
Authors: Minderhoud Paul
Published: March 2017

This article deals with the recent developments of Decision No 3/80 of the EEC-Turkey Association Council in the EU and in the Netherlands. Decision No 3/80 established social security measures for workers of Turkish nationality moving within the Community (now Union) and members of their family living with them. Decision No 3/80 has mainly had an impact in two Member States: the Netherlands and Germany. In this article I will limit myself to the Netherlands, where the social security system has become much more territorially-based since the year 2000. The importance attached to residence in the design of the Dutch social security system showcases the revitalisation of nationstate approaches to the delivery of welfare at a time when EU rules are interfering more and more in the everyday life of EU citizens. The second part of this article analyses the discussion raised by the Akdas judgment of the EC], which gave Turkish nationals more rights than EU nationals, and the Demirci judgment, which reversed this advantage for Turkish workers with dual nationality. It also deals with the 2012 initiative of the European Union in replacing Decision No 3/80 by a new Association Council Decision and the legal and political challenges of this new initiative.
Overview of Recent Cases before the Court of Justice of the European Union (January–June 2016)
Authors: van der Mei Anne Pieter
Published: March 2017

In the first half of 2016 (the reporting period), the Court of Justice of the European Union (EU) delivered various interesting rulings concerning the rights to social (security) benefits of Union citizens who exercise their free movement rights. The rulings touch upon a variety of issues, including the right of Union citizens who have only resided in another Member State for a short period of time to claim social assistance (Garcsía-Nieto); the competence of Member States to make entitlement to social security benefits falling within the scope of Regulation 883/20042004 on the coordination of social security systems1 conditional on lawful residence in their territory (Commission v United Kingdom); Member States' declarations on the application of the coordination rules to their social benefit systems (Commission v Malta); the principle of equal treatment of benefits, income, facts or events (Knauer); the pension rights of civil servants who resign (Commission v Cyprus); the aggregation rules for unemployment benefits (M.); and student financial aid offered in the form of public transport subsidies (Commission v the Netherlands).
Nationalistic attitudes and voting for the radical right in Europe
Authors: Lubbers Marcel , Coenders Marcel
Published: March 2017

Voting for radical right-wing parties has been associated most strongly with national identity threats. In Europe, this has been framed by the radical right in terms of mass-migration and European integration, or other politicians bargaining away national interests. Perhaps surprisingly given the radical right’s nationalist ideology, nationalistic attitudes are hardly included in empirical research on the voting behaviour. In this contribution, we test to what extent various dimensions of nationalistic attitudes affect radical right voting, next to the earlier and new assessed effects of perceived ethnic threat, social distance to Muslims, Euroscepticism and political distrust. The findings show that national identification, national pride and an ethnic conception of nationhood are additional explanations of radical right voting. National identification’s effect on radical right voting is found to be stronger when populations on average perceive stronger ethnic threat.
Sex Hormone/Cortisol Ratios Differentially Modulate Risk-Taking in Men and Women
Authors: Barel Efrat , Shahrabani Shosh , Tzischinsky Orna
Published: March 2017

The present study aimed to extend the original focus of the dual-hormone hypothesis on testosterone and cortisol involvement in risk-taking to other sex hormones: estrogen and progesterone. The study also examined two alternative models for the proposed relationship between cortisol and sex steroids and for their joint influence on risk-taking: interaction and ratio terms. In all, 40 women and 37 men were tested for circulating sex hormones and provided self-reports on risk-taking. The findings suggest that sex hormone–cortisol ratios differentially modulate risk-taking in men and women: In men, high ratios were associated with risk-taking, whereas in women the opposite pattern was found. The findings are discussed in light of evolutionary assumptions regarding sex differences in neuroendocrine mechanisms, suggesting sex differences in neural sensitivity to sex hormones in risk-taking.
Near-field wave enhancement and ‘quasi-surface’ longitudinal waves in a segmented thick-walled hollow cylindrical waveguide
Authors: Ziaja-Sujdak Aleksandra , Cheng Li , Radecki Rafal , Staszewski Wieslaw Jerzy
Published: March 2017

Thick-walled structures with varying geometry are challenging for guided wave inspection due to the multimodal behaviour and the complex scattering of the wave modes. This article investigates the influence of the geometrical transitions on the propagation of the elastic waves in thick-walled cylindrical structures and proposes a structural evaluation technique based on the identified wave phenomena. In particular, a near-field wave enhancement effect caused by the crack-wave interaction and by the thickness changes in a waveguide is explored. Additionally, formation and propagation of the so-called longitudinal ‘quasi-surface’ waves are investigated, as they are found to be a main contributor to the observed wave enhancement phenomenon. The proposed new damage identification technique utilising the enhancement effect is validated numerically and experimentally on a beam and a hollow cylindrical structure.
Force-feeding political prisoners on hunger strike
Authors: Weingarten Michael
Published: March 2017

A Palestinian administrative detainee in Israel asked for the author to care for him as an independent physician while in hospital on two hunger strikes, lasting 66 and 55 days, respectively. Hunger striking is placed in the context of other forms of food refusal and artificial feeding. The various perspectives on the challenge of the medical care of hunger strikers are reviewed, as seen by the state, the public, the doctor and the patient. Institutional statements on the management of hunger strikers are reviewed and the local political considerations are highlighted. In conclusion, a trusting doctor–patient relationship is presented as the crucial element for securing a successful outcome, preserving the prisoner's life and dignity with no significant political damage incurred by the State.
Endovascular treatment for chronic lower extremity ischaemia with sub-acute deterioration
Authors: Yuan Liangxi , Guo Songlin , Dong Jian , Zhou Jian , Lu Qingsheng , Bao Junmin , Jing Zaiping
Published: March 2017

Objectives:

The purpose of this study is to report the efficacy of endovascular treatment for patients with sub-acute (14-day to 2-month) deterioration of chronic lower extremity ischaemia.

Materials and Methods:

Between June 2013 and May 2015, 26 consecutive patients (22 men, 4 women; mean age, 68.6 years; range, 50–86 years) were treated for sub-acute deterioration of chronic lower extremity ischaemia in our hospital. All patients were treated with catheter-directed thrombolysis initially and then adjunctive percutaneous transluminal angioplasty and/or stenting was performed to correct underlying lesions.

Results:

The 26 intra-arterial thrombolysis procedures were all performed in native lower arteries including 8 iliac, 13 femoropopliteal and 5 diffuse occlusions involving the iliac and femoropopliteal segments. Lesion length decreased from 194 mm (70–350 mm) to 92 mm (20–270 mm) after the thrombolytic procedures, and the residual lesions were corrected with percutaneous transluminal angioplasty alone in 4 (15.4%) limbs and stenting in 22 (84.6%) patients. No cross-joint stenting was seen in the 22 affected limbs that used stents. Throughout the treatment process, nine patients with intermittent claudication achieved an unrestricted walking distance, and 17 patients with rest pain or foot ulcers showed significant symptom improvement. The mean ankle-brachial index increased from 0.42 ± 0.16 preoperatively to 0.81 ± 0.25 postoperatively ( p < 0.01).

Conclusion:

Endovascular therapy with catheter-directed thrombolysis and percutaneous transluminal angioplasty/stenting is feasible for sub-acute deterioration of chronic lower extremity ischaemia patients with favourable midterm results.
Experiences of patients undergoing pulmonary rehabilitation during an exacerbation of chronic respiratory disease
Authors: Vincent Emma E , Chaplin Emma J , Williams Johanna EA , Harvey-Dunstan Theresa , Greening Neil J , Steiner Michael C , Morgan Mike D , Singh Sally J
Published: March 2017

Chronic obstructive pulmonary disease (COPD) is characterized in the later stages by acute exacerbations that often require hospitalization. Pulmonary rehabilitation is recommended for patients with COPD to aid symptom control, improve quality of life and increase physical activity. We have previously reported a large intervention trial commenced during a hospital admission. The aim of this sub-study was to evaluate the patients’ experiences of discharge following the hospitalization for an acute exacerbation of COPD. During a programme of early rehabilitation (ER) patient perceptions, experiences and healthcare use were collated during the month that followed their discharge. ER (started during their admission) was comprised of exercise training techniques that were modified to suit the environment of acute illness, together with an education and self-management programme. Each patient was then supported on the programme by telephone contact, following their discharge home, at 48 hours, 2 weeks and 4 weeks. We collected information in relation to the walking and exercise progression; we monitored patient recall of healthcare use, compliance/understanding of medical therapy, as well as their wider perceptions that may have influenced the recovery process. Healthcare use was captured using GP records and data analysis. Of the 100 patients, 47 males, (mean (standard deviation)) 71 (9.3) years, FEV1 1.14 L (0.6), BMI 26.6 (6.9), pack smoked years 45.8 (29.6), ethnicity White British 97%, were discharged home following an acute exacerbation of their respiratory symptoms, to an ER programme. At 48 hours following discharge, a minority (20%) of patients stated their symptoms were ‘feeling better’; 15% highlighted that they found the prescribed ‘exercise difficult’; 44% of patients felt at the end of the month that prescribed exercise programme had a ‘positive effect’ on their recovery from their exacerbation; 38% of patients felt their family had a positive effect on their recovery; 11% felt their family hindered. Patients reported a mean confidence score of 8.21 (2.1) for exercise that did not vary over the three contacts ( p = 0.166). A similar mean confidence score of 7.76 (2.6) was reported for walking with a non-statistical change also noted ( p = 0.223). When patient recall of primary health care contact was compared with actual use, there was statistical significance shown ( p = 0.002); patients underestimated the amount of care they received. The data indicate that patients do recover at home within the support of an early intervention. Patients are positive about the benefit of ER in the process of recovery; however, this is uncontrolled data.
Quercetin Has Antimetastatic Effects on Gastric Cancer Cells via the Interruption of uPA/uPAR Function by Modulating NF-κb, PKC-δ, ERK1/2, and AMPKα
Authors: Li Hai , Chen Chen
Published: March 2017

Gastric cancer (GC) is a malignancy with few effective treatment options after metastasis occurs. Quercetin (Qu) intake has been associated with reduced incidence and slow development of GC, probably due to its anti-proliferative and apoptotic effects, but it is unclear whether Qu can inhibit the metastatic activity. The urokinase plasminogen activator (uPA)/uPA receptor (uPAR) system plays an important role in cancer metastasis. In this study, we measured both uPA activity and uPAR expression in GC and pericarcinous tissues, and we investigated the correlation between uPAR expression and the migratory and invasive activities of various GC cell lines. GC BGC823 and AGS cells were subjected to treatment with 10 μM Qu for 72 hours and uPAR knockdown, alone or in combination, before evaluating cell metastasis. The results showed that uPA activity and uPAR expression were higher in GC tissues than in pericarcinous tissues. Migratory and invasive activities of GC cell lines positively correlated with uPAR expression. Qu treatment decreased BGC823 and AGS cell migration and invasion, accompanied by reduced uPA and uPAR protein expression. Both Qu treatment and uPAR knockdown decreased matrix metalloproteinase-2 and -9 activity and blocked Pak1-Limk1-cofilin signaling. Qu treatment was associated with inhibition of NF-κb, PKC-δ, and ERK1/2, and with AMPKα activation. Specific inhibitors of NF-κb, PKC, and ERK1/2, and an AMPKα activator suppressed uPA and uPAR expression in GC cells. Collectively, Qu showed an antimetastatic effect on GC cells via the interruption of uPA/uPAR function and modulation of NF-κb, PKC-δ, ERK1/2, and AMPKα. This suggests that Qu is a promising agent against GC metastasis.
Food Revolution
Authors: Gardner Christopher D. , Hauser Michelle E.
Published: March 2017

Recent research has found important links between poor dietary choices, a toxic food environment, and high national and global burdens of chronic diseases. These findings serve as an impetus for a Food Revolution. The Gardner Nutrition Studies Research Group, along with a diverse range of collaborators, has been focusing on solution-oriented research to help find answers to the problems that plague the current food system. Research topics include (1) a recently completed weight loss diet study contrasting Healthy Low-Fat to Healthy Low-Carbohydrate diets among 609 overweight and obese adults; (2) a quasi-experimental study conducted among Stanford undergraduates that examined social and environmental, rather than health-focused, motivations for dietary change; (3) links between dietary fiber, the human microbiome, and immune function; and (4) ongoing collaborations with university chefs to create unapologetically delicious food for campus dining halls that is also healthy and environmentally sustainable. Most of these approaches emphasize plant-based diets. The decreased consumption of animal products has created some concern over the ability of one to obtain adequate protein intake. Evidence is presented that adequate protein is easily obtainable from vegetarian, vegan, and other diets that contain significantly less meat and fewer animal foods than the standard American diet.
Burnout and its relationship to empathy in nursing: a review of the literature
Authors: Hunt Patricia A , Denieffe Suzanne , Gooney Martina
Published: March 2017

Compassion and empathy are viewed as important by both nurses and patients. The positive emotions that nurses feel as a result of compassionate and empathic practice are known as compassion satisfaction, whilst the negative consequences are known as burnout and compassion fatigue. Empathy has two distinct components: emotional empathy, which involves feeling the emotions of another, and cognitive empathy, which relates to self-regulation of the emotion felt. The purpose of this literature review is to examine the relationship between burnout and empathy in the nursing literature. The results suggest that the relationship between these constructs is complex, and an ability to self-regulate emotions during empathic engagement may reduce the risk of burnout. The implications for nurses, health care organisations, educators and health care policy makers are discussed. This review provides insight into how adaptive empathic engagement may reduce the risk of burnout.
A cross-sectional analysis of the factors that shape adult nursing students' values, attitudes and perceptions of compassionate care
Authors: McSherry Wilfred , Bloomfield Sarah , Thompson Roy , Nixon Valerie A , Birch Carole , Griffiths Nicola , Fisher Shani , Boughey Adam J
Published: March 2017

Nursing students are the future of nursing, and are situated between the expectation of the public (that the public will receive compassionate care) and the profession (that the profession will continue to develop technically to meet the needs of the changing healthcare economy). Research has focused on the factors affecting registered nurses' values in care. However, less is known regarding the factors that shape nursing students' values, attitudes/and perceptions of compassionate care. Six focus group discussions with 23 adult branch nursing students (years 1–3) from a UK university were conducted to ascertain the nursing students' understanding of personal and professional values, factors influencing these values, and whether they felt these values influenced the way they provided compassionate care. Qualitative thematic analysis resulted in five themes, three of which were the focus of this paper: general values, fundamental nursing and nursing values. Participants considered a range of influencers of their general values, and demonstrated a transparency between their personal and professional values, with respect and dignity being important. Fundamental nursing was complex to consider but was considered to orientate around the provision of care in a compassionate way.
Using Appreciative Inquiry to develop, implement and evaluate a multi-organisation ‘Cultivating Compassion’ programme for health professionals and support staff
Authors: Curtis Katherine , Gallagher Ann , Ramage Charlotte , Montgomery Julia , Martin Claire , Leng Jane , Theodosius Catherine , Glynn Angela , Anderson John , Wrigley Martha
Published: March 2017

The ‘Cultivating Compassion’ project was developed in response to a research and innovation call relating to compassion training for National Health Service staff in the South East of England. The project aims included the following: the use of Appreciative Inquiry to develop, implement and evaluate a sustainable and evidence-based programme of compassion awareness training through engaging with a diverse group of health professionals and support staff; an evaluation of a ‘train the trainers’ approach; and an evaluation of ‘compassion lead’ roles and a multi-modal compassion toolkit. The project team included academics from two universities and one medical school, NHS staff from three separate organisations and service users. The participants recruited to the study included doctors, nurses, receptionists, chaplains and others working in close contact with service users from within four NHS organisations in the South East of England. The main findings from the project using thematic analysis from participant focus groups and interviews identified project enablers and inhibitors, the value of project resources, and shifts in perspectives. Project conclusions highlighted the importance of effective senior-level support and organisational leadership in cultivating compassion within a healthcare organisation and the importance of the integration of compassion-promoting resources within existing staff development initiatives.