This research examines the different social costs that have a bearing on the form and content of regulatory intervention underpinning the Auto-Enrolment (AE) pensions’ regime and whether these are recognised within current UK legislation. AE requires employers to assess the workforce and, subject to qualifying criteria, enrol them into a pension and make contributions to the pension. Workers are also required to contribute to the pension although they can choose to leave the scheme, Since its introduction in 2012, more than 4.7 million workers in the UK have now been enrolled into a pension which they did not choose highlighting the impact of the regulatory intervention. The starting point for my research is to consider the history of pension legislation in the UK and the circumstances leading up to the introduction of AE. The next step is to consider whether this legislative intervention is paternalistic and, if so, whether justified. I then consider whether the implementing legislation functions as it was intended or whether there are any unintended consequences. Parliamentary debate at the inception of AE illustrates an intention to ensure that individuals save more for themselves for their own good. Behavioural economics was widely referred to as authority on the hypothesis that individuals do not make rational financial decisions for themselves, justifying legislative intervention to ensure that private pension saving is the default position for all workers in the UK. Paternalistic legislation can be difficult to justify where individual choice is overridden entirely and so the legislation allows for individuals to opt out – soft paternalism or nudge. There is an assumption that low opt-out rates indicate that individuals now agree that the pension saving is in their best interests, justifying the intervention. However, there has been a marked dearth of research into AE savers' actual perceptions of how the schemes work for them. My research has come to close this gap and also allows drawing up some normative conclusions regarding the proper framework for offering and regulating AE in the UK. In particular, participants were asked to discuss their own choices and actions within their workplace pension and understanding of pensions’ information. Employers and professional advisers were also interviewed to build a complete picture of the practical implementation of AE. In considering these findings my work considers whether there are negative or unintended consequences of the policy change and how these are dealt with.

<p> Today&rsquo;s emerging patient centered health movement is focused not on a specific condition or demographic, but rather on shifting the balance of power and enabling access to information to drive decision-making in healthcare. This takes place through electronic health records as well as more generalized sources. The uptake of social media is contributing to an innovation in patient centered healthcare: information and support on a global scale is coming not only from the formal healthcare system, but also within online social networks. Today, through computer-mediated interactions, patients are not only seeking information, they are curating and sharing information. Subsequently, patients are also creating information, establishing a novel ecosystem of engagement that has the potential to disrupt the current healthcare system. </p><p> This dissertation explores an online health community, BCSM (which stands for &ldquo;breast cancer social media&rdquo;), established using Twitter, a largely public and searchable social media platform. Drawing primarily from social network theory, disruptive innovation, and ecological systems theory, this research identifies essential characteristics within the community that may inform future development and support for patient centered healthcare. To conduct this research, a blended approach of netnography &ndash; referring to the approach of ethnography applied to the study of online cultures and communities &ndash; and in-depth interviews with BCSM participants were employed. </p><p> Data collected via interviews and tweets using the hashtag #bcsm provide evidence of clinical support, emotional support, information sharing, and knowledge translation. Underpinning this activity is the opportunity to associate not only with peers, but also with individuals of varying roles (including patients, providers, advocates, researchers, and caregivers). As evidenced by the data collected, educational opportunities flow in both directions. </p><p> This work contributes to the larger corpus of health-related literature in the identification and naming of a significant community element that has seen little focused attention: cross-peer engagement, a term used to highlight the interaction amongst individuals of differing status, ability, or rank. This research also documents the formation of microspurs, defined as relationships that form as a result of community participation. These come in many forms and range from expanding a personal support network to participation in federal policy work. Findings suggest that the future of healthcare will not revolve around hospitals and bounded systems. Instead, patients will demand an expanded set of entry points for health information sharing, knowledge transfer, condition management, and general support.</p>

No / Lay involvement in public health programmes occurs through formalised lay health worker (LHW) and other volunteer roles. Whether such participation should be supported, or indeed rewarded, by payment is a critical question. With reference to policy in England, UK, this paper argues how framing citizen involvement in health only as time freely given does not account for the complexities of practice, nor intrinsic motivations. The paper reports results on payment drawn from a study of approaches to support lay people in public health roles, conducted in England, 2007e9. The first phase of the study comprised a scoping review of 224 publications, three public hearings and a register of projects. Findings revealed the diversity of approaches to payment, but also the contested nature of the topic. The second phase investigated programme support matters in five case studies of public health projects, which were selected primarily to reflect role types. All five projects involved volunteers, with two utilising forms of payment to support engagement. Interviews were conducted with a sample of project staff, LHWs (paid and unpaid), external partners and service users. Drawing on both lay and professional perspectives, the paper explores how payment relates to social context as well as various motivations for giving, receiving or declining financial support. The findings show that personal costs are not always absorbed, and that there is a potential conflict between financial support, whether sessional payment or expenses, and welfare benefits. In identifying some of the advantages and disadvantages of payment, the paper highlights the complexity of an issue often addressed only superficially. It concludes that, in order to support citizen involvement, fairness and value should be considered alongside pragmatic matters of programme management; however policy conflicts need to be resolved to ensure that employment and welfare rights are maintained. / National Institute for Health Research Service Delivery and Organisation Programme (project number 08/1716/206).

Congressional concern about homeless students resulted in the McKinney-Vento Act (MCKV) in 2001, which provides funds to local educational agencies (LEAs). MCKV is almost a decade old, yet no evaluations of its academic effectiveness have been reported. Using a systems theory framework, this study answered research questions (RQs) involving whether normally housed students in Grade 6 scored higher than homeless students in Grade 6 in reading (RQ 1) and math (RQ 2) on end-of-grade (EOG) test scores and whether homeless students in Grade 6 from LEAs that received MCKV funding scored better in reading (RQ 3) and math (RQ 4) on EOG test scores than those from LEAs that did not. Data from 2006 and 2007 were provided by the North Carolina (NC) Department of Public Instruction. About 20% of the state's LEAs received MCKV grants, which created a treatment group (funded LEAs) and a control group (nonfunded LEAs). Based on t tests, the normally housed students scored significantly higher on EOG reading and math tests. Using untreated control group designs with matched pretests (Grade 5 EOG test scores) and posttests (Grade 6 EOG test scores), 2 x 2 ANOVAs with repeated measures failed to reject the null hypotheses for RQs 3 and 4. This study did not support the hypotheses that MCKV grants improved the academic achievement of homeless students. MCKV provides valuable services, but in NC, it does not support training programs for teachers, counselors, and social workers on improving academic achievement. The positive social change implication of this study is that concerned educators can use these results to lobby legislators to fund training to improve academic performance of homeless students in order to help break the cycle of homelessness.

No description available.