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The second in a new series about mental health in old age, this article reviews policies and research evidence on services for people with dementia at the end of their lives, and looks at future commissioning priorities

Universities in both North America and Europe are under substantial pressure. We draw on the papers in this volume to describe those pressures and explore their consequences from an organizational standpoint. Building on the institutional logics perspective, field theories, world society theory, resource dependence, and organizational design scholarship, these papers show how the changing relationship between the state and higher education, cultural shifts, and broad trends toward globalization have led to financial pressures on universities and intensified competition among them. Universities have responded to these pressures by cutting costs, becoming more entrepreneurial, increasing administrative control, and expanding the use of rationalized tools for management. Collectively, these reactions are reshaping the field(s) of higher education and increasing stratification within and across institutions. While universities have thus far proven remarkably adaptive to these pressures, they may be reaching the limits of how much they can adapt without seriously compromising their underlying missions.

Compelling chemical, biochemical, clinical and epidemiological evidence supports the view that the antioxidant nutrients exert vital contributions towards the prevention or delayed onset of cancer and cardiovascular disease. The presence of antioxidants in fruit, vegetables, tea and red wine may help to explain why their presence in the diet is associated with reduced incidence of heart disease and cancer.

Examines the antioxidant activities of a range of hydroxy‐substituted phenolic acids by estimating their relative abilities to scavenge the ABTS_+ radical cation generated in the aqueous phase, expressed as the Trolox equivalent antioxidant capacity (TEAC value). These common food components have varying reducing abilities, dependent on the positions and extent of hydroxylation of their phenol ring. Reports the research results which suggest that some simple phenolic acids are most effective antioxidants, up to two to three times as active as vitamin C. Their relative abundance in fruits, oils, etc. indicates that they may be highly significant contributors to the overall dietary antioxidant intake. Para‐coumaric acid (4‐hydroxycinnamic acid) was found to have a TEAC value of 2.2mM (more than twice the antioxidant activity of vitamin C). Ferulic acid (3‐methoxy, 4‐hydroxycinnamic acid), the active component of oryzanol (rice bran oil) was found to have a TEAC value of 1.9 mM and gallic acid (3, 4, 5‐trihydroxybenzoic acid) a TEAC of 3.0mM (i.e. three times the antioxidant activity of vitamin C). Discusses the significance of these and other related compounds as food antioxidants and as non‐nutrient antioxidants in the diet.

Mental health problems in old age have attracted policy attention in the UK over the past decade. An important issue is how to improve services for people who have both mental health and other problems. This article sets out some of the challenges facing planners and commissioners in developing integrated services for older adults, by using the case study of people with dementia and incontinence problems. It uses integrated service models and observations from the EVIDEM‐C study to suggest some incremental actions that would help develop the long‐term strategy for integrated services.

These chapters were produced with support from the Daniel J. Evans School of Public Affairs at the University of Washington, the Law School at the University of Washington, the Philosophy Department of the University of Washington, and The John D. and Catherine T. MacArthur Foundation. We thank them for their support.

Indulgent parsimony (IP) was originally proposed as a marketing strategy for selling to recession‐shocked consumers shopping for less costly goods and services that would still give them comfort, relief from stress, and a feeling of money well spent. Given that recession spread to many nations there is ample reason to consider applying this marketing approach for the longer term. This paper aims to investigate this issue.

By learning to incorporate the IP concept into their value proposition, executives can address how to implement marketing strategies that will have traction with the very large segment of consumers.

IP, a frugal but emotionally supportive standard of value, remains a timely and appropriate approach to encouraging buying.

By using emotional appeals that add to the value proposition, IP gives marketers a useful tool to help them design strategies and forecast what types of offerings can succeed.

What makes IP an effective marketing strategy is that it seeks to simultaneously trigger practical/rational and emotionally‐driven motivators.

The purpose of this paper is to present proposed solutions and interventions to some of the major barriers to providing adequate access to healthcare in Kenya. Specific business models are proposed to improve access to quality healthcare in low- and middle-income countries. Finally, strategies are developed for the retail clinic concept (RCC).

Google Scholar, PubMed and EBSCOhost were among the databases used to collect articles relevant to the purpose in Kenya. Various governmental and news articles were collected from Google searches. Relevant business models from other sectors were considered for potential application to healthcare and the retail clinic concept.

After a review of current methodologies and approaches to business and franchising models in various settings, the most relevant models are proposed as solutions to improving quality healthcare in Kenya through the RCC. For example, authors reviewed physician recruitment strategies, insurance plans and community engagement. The paper is informed by existing literature and reports as well as key informants.

This paper lacks primary data collection within Kenya and is limited to a brief scoping review of literature. The findings provide effective strategies for various business and franchising models in healthcare.

The assembling of relevant information specific to Kenya and potential business models provides effective means of improving health delivery through business and franchising, focusing on innovative approaches and models that have proven effective in other settings.

To meet the multidimensional needs of patients, health services are increasingly implementing complex programmes of care through partnerships between public, private and voluntary sector organisations. The purpose of this paper is to explore the implementation process of a complex, multi-innovative regional health and social care partnership to coordinate end-of-life care in the South East of England.

The study adopted a pragmatic, pluralist design using primarily qualitative methods including observations, interviews, focus group and document review. Implementation theory provided the research framework.

While progress was made towards greater collaboration in the provision of end-of-life care, regional coordination of care among the 13 partner organisations was not achieved as envisioned. Low engagement stemming from national health system changes delayed decision making and shifted partners’ priorities. Individual stakeholder interest and motivation carried the elements that were successful.

The external political and economic environment hindered the involvement of some of the partners and suggests that a concept of “project resiliency” is particularly important for complex, multi-organisational projects which are implemented over time and by multiple stakeholders from different sectors. Future research should look further at what contributes to project resiliency and whether it might be operationalized so that projects can develop resilient factors for success.

Project resiliency is a new concept that bridges a gap in understanding how time-limited multi-organisational projects function amid a changing environment.

Businesses are under pressure to ensure social responsibility in their globalised supply chains. However, conventional factory audits are not providing adequate data about production workers’ well-being. Industry attempts to measure working conditions have shown bias and inconsistency, and there is no consensus on what to measure, or how. Well-being can be intangible and difficult to capture without appropriate theoretical and methodological frameworks. This paper investigates factors influencing the well-being of a Chinese factory’s workers, tests an innovative research method, and proposes interventions to improve well-being in factories.

This is a longitudinal study using the diaries of production workers at a large assembly manufacturing site in China. Workers left daily digital voice diaries about their day, which were analysed to identify factors related to their well-being at work.

The picture is more complex than the concerned Western narrative suggests. Workers’ personal and professional concerns extend beyond the criteria currently measured in audits, tending to be more relational and less about their physical state.

The current approach of auditing management practices neglects workers’ well-being. This study offers a more comprehensive view of well-being and tests a new method of investigation.

This is the first study to use diary methods in a Chinese factory. It addresses an issue supported by little empirical evidence. It is the first longitudinal study to hear from factory workers themselves about how they are and what impacts their well-being daily.