Nia Williams and James B. Kirkbride
There is growing evidence that several social determinants influence mental health outcomes, but whether or not community-based prevention strategies are effective in intervening…
Abstract
Purpose
There is growing evidence that several social determinants influence mental health outcomes, but whether or not community-based prevention strategies are effective in intervening on these social determinants to improve mental health is unclear. The purpose of this study was to synthesise the state of knowledge on this topic in the UK context, by conducting an umbrella review of the relevant systematic review literature.
Design/methodology/approach
The authors searched five electronic databases for systematic reviews of community-based interventions that addressed any social determinant of mental health (SDOMH) in the UK, provided that mental health outcomes were measured. They also reported the results according to PRISMA guidelines and synthesised narratively.
Findings
The search yielded 1,101 citations, of which 10 systematic reviews met inclusion criteria. These reviews included 285 original studies, of which 147 (51.6%) were from the UK. Two reviews focussed on children and young people, with the remainder based on working-age adult populations. The authors identified five categories of SDMOH, where financial insecurity and welfare advice interventions were addressed by the largest number of reviews (n = 4), followed by reviews of interventions around social isolation and support (n = 3) and housing regeneration initiatives (n = 2). Results across all social determinants and mental health outcomes were highly heterogenous, but evidence most consistently supported the effectiveness of interventions addressing financial and welfare support on mental health outcomes.
Originality/value
This review highlights the paucity of high quality, causal evidence from the UK and beyond on the effectiveness of interventions on the social determinants of mental health; severe methodological heterogeneity hampers progress to identify scalable interventions to improve population mental health.
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James Kirkbride, Steve Letza and Clive Smallman
The purpose of this paper is to compare the response in the UK, the USA and China to the need to provide effective protection in law to disgruntled minority shareholders.
Abstract
Purpose
The purpose of this paper is to compare the response in the UK, the USA and China to the need to provide effective protection in law to disgruntled minority shareholders.
Design/methodology/approach
The study draws upon official comment and case law across the three jurisdictions in order to assess the scope and availability of minority actions.
Findings
The importance of shareholder rights through alternative actions is an important aspect of controlling the behaviour and actions of the Board of Directors and an important part of corporate governance. This paper seeks to compare the development and scope of derivative rights in the UK, the USA and in China and provides an assessment and insight into the differences in approach and in the political and legal structures with the consequent likely impact on the role and contribution of derivative claims in the control and governance of Boards in the different jurisdictions.
Originality/value
The study should prove of interest to scholars of comparative corporate law.
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James Kirkbride, Jeremy Coid, Craig Morgan, Paul Fearon, Paola Dazzan, Min Yang, Tuhina Lloyd, Glynn Harrison, Robin Murray and Peter Jones
Genetic and environmental factors are associated with psychosis risk, but the latter present more tangible markers for prevention. We conducted a theoretical exercise to estimate…
Abstract
Genetic and environmental factors are associated with psychosis risk, but the latter present more tangible markers for prevention. We conducted a theoretical exercise to estimate the proportion of psychotic illnesses that could be prevented if we could identify and remove all factors that lead to increased incidence associated with ethnic minority status and urbanicity. Measures of impact by population density and ethnicity were estimated from incidence rate ratios [IRR] obtained from two methodologically‐similar first episode psychosis studies in four UK centres. Multilevel Poisson regression was used to estimate IRR, controlling for confounders. Population attributable risk fractions [PAR] were estimated for our study population and the population of England. We considered three outcomes; all clinically relevant ICD‐10 psychotic illnesses [F10‐39], non‐affective psychoses [F20‐29] and affective psychoses [F30‐39]. One thousand and twenty‐nine subjects, aged 18‐64, were identified over 2.4 million person‐years. Up to 22% of all psychoses in England (46.9% within our study areas) could be prevented if exposures associated with increased incidence in ethnic minority populations could be removed; this is equivalent to 66.9% within ethnic minority groups themselves. For non‐affective psychoses only, PAR for population density was large and significant (27.5%); joint PAR with ethnicity was 61.7%. Effect sizes for common socio‐environmental risk indicators for psychosis are large; inequalities were marked. This analysis demonstrates potential importance in another light: we need to move beyond current epidemiological approaches to elucidate exact socio‐environmental factors that underpin urbanicity and ethnic minority status as markers of increased risk by incorporating gene‐environment interactions that adopt a multi disciplinary perspective.