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Yes / Payment incentives are known to influence healthcare but little is known about the impact of paying directly for achieved outcomes. In England, novel purchasing (commissioning) of National Health Service (NHS) stop smoking services, which paid providers for quits achieved whilst encouraging new market entrants, was implemented in eight localities (primary care trusts (PCTs)) in April 2010. This study examines the impact of the novel commissioning on these services. Accredited providers were paid standard tariffs for each smoker who was supported to quit for four and 12 weeks. A cluster-controlled study design was used with the eight intervention PCTs (representing 2,138,947 adult population) matched with a control group of all other (n=64) PCTs with similar demographics which did not implement the novel commissioning arrangements. The primary outcome measure was changes in quits at four weeks between April 2009 and March 2013. A secondary outcome measure was the number of new market entrants within the group of the largest two providers at PCT-level. The number of four-week quits per 1,000 adult population increased per year on average by 9.6% in the intervention PCTs compared to a decrease of 1.1% in the control PCTs (incident rate ratio 1108, p<0001, 95% CI 1059 to 1160). Eighty-five providers held 'any qualified provider' contracts for stop smoking services across the eight intervention PCTs in 2011/12, and 84% of the four-week quits were accounted for by the largest two providers at PCT-level. Three of these 10 providers were new market entrants. To the extent that the intervention incentivized providers to overstate quits in order to increase income, caution is appropriate when considering the findings. Novel commissioning to incentivize achievement of specific clinical outcomes and attract new service providers can increase the effectiveness and supply of NHS stop smoking services.

As the environmental problems worsen, green restaurants are an essential strategy for survival in the restaurant industry. Even though previous researchers have investigated the intention to visit a green restaurant with norm activation theory, they did not consider the characteristics of prosocial behavior and the green restaurant and the impact of other external factors, such as types of information cues and social class, was overlooked. Considering these points, the primary objectives of this study were to extend existing theory with perceived burdensomeness and social connectedness and to identify the difference in the impact of types of information cues and a moderating role of social cues. Using an experimental design with hypothetical scenarios, respondents were randomly assigned to one of two different scenarios (intrinsic cues vs. extrinsic cues). The results showed that the participants who received intrinsic cues responded lower than the participants who received extrinsic cues in the awareness of consequences, perceived burdensomeness, and social connectedness. Antecedents of personal norm in the extended norm activation theory had a positive impact on personal norm. In the case of the moderating role of social class, there were interaction effects between social class and information in every construct except perceived burdensomeness. Further discussion and implications are provided in the main body of this study.

This dissertation explores how social class matters in young men’s everyday relationship to digital media. The aim is to contribute to the existing knowledge about how young people incorporate digital media in their everyday lives by focusing on the structural premises of this process. It also presents an empirically grounded critique of popular ideas about young people as a “digital generation”, about the internet as a socially transformative force, and about class as an increasingly redundant category. The empirical material consists of qualitative interviews with 34 young men (16-19 years) from different class backgrounds, upper secondary schools and study programmes. Drawing on the conceptual tools of Pierre Bourdieu, three classes are constructed: the “cultural capital rich”, the “upwardly mobile”, and the “cultural capital poor”. The analysis shows that class, through the workings of habitus, structures the young men’s relationship to school and future aspirations. This also engenders class-distinctive ways of conceiving leisure and digital media use. Through their class habitus and taste, the young men tend to orient themselves and navigate in different ways in what they perceive as a space of digital goods and practices, endowed with different symbolic value in school and society. The “cultural capital rich” are drawn to-wards practices capable of yielding symbolic profit in the field of education and beyond, whereas the other classes gravitate towards the “illegitimate” digital culture but deal with this different ways. These findings indicate that there are social and cultural continuities at play within recent technological changes. They also expose the structural differences hidden by sweeping statements about young people as a “digital generation”. Finally, they show that class, contrary to popular beliefs about “the death of class”, still represents a pertinent analytical category.

This study analyzes narratives of individual Jewish experiences of discrimination and genocidal violence in Hungary during the period of 1920–1945. The aim is to increase our knowledge and understanding of the events through an investigation of survivor testimonies concerning anti-Jewish laws and the Holocaust. The main focus is on how survivors perceived the treatment to which they and their fellow Jews were exposed, and how they responded to the persecution they faced. Perceptions and responses are analyzed through multiple factors such as gender, age, social class, and geographical place. The period under investigation stretches from 1920, when the law of Numerus Clausus (a quota system influencing admission to universities) was introduced, until the end of the Second World War in early 1945. Focus is placed on the war years, especially on 1944, the year of German occupation and the fascist Arrow Cross rule. Experiences from the labour service system, the Jewish houses in Budapest, and the ghettos, as well as of hiding and resistance, are some of the recurring themes which are examined here. Extensive interviews, along with eyewitness reports and memoirs, form the empirical basis of the study. The results demonstrate the complexity of individual experiences during times of upheaval, and the importance of the above factors is evident within the testimonies. The survivors’ experiences greatly depended on gender, age, social class, geographical place, civil status, religious orientation, as well as “race”. However, the importance of the different factors changed over time. For instance, in the beginning of this period, discrimination had a direct impact on adult males, while children, women, and the elderly were indirectly affected. Furthermore, persons belonging to the upper classes could circumvent the anti-Jewish laws in various ways. Ultimately, differences in treatment decreased, according to the testimonies. Women, children, and the elderly also became victims, as did individuals from all social classes.

O objetivo do estudo foi analisar a relação dos marcadores de desigualdade em saúde, com destaque para a posição socioeconômica, com a autoavaliação da saúde bucal e da saúde geral da população adulta brasileira em 2013. Estudaram-se 59.758 indivíduos com 18 anos ou mais de idade, que participaram da Pesquisa Nacional de Saúde 2013, um inquérito domiciliar de base populacional. As variáveis dependentes do estudo foram a autoavaliação da saúde bucal (dentes e gengivas) e autoavaliação da saúde geral, sendo ambas analisadas como positiva, regular e negativa. As variáveis independentes foram os marcadores de desigualdade em saúde (cor ou raça, região de residência, nível de escolaridade completo, renda domiciliar per capita e classe social). Odds ratios (OR) brutos e ajustados e intervalos de confiança de 95% (IC 95%) foram calculados usando modelos de regressão logística multinomial. Os resultados referentes à autoavaliação da saúde geral foram estratificados segundo o sexo. A prevalência da autoavaliação de saúde bucal positiva foi 67,4%, 26,7% para regular e 5,9% para negativa, enquanto para a saúde geral foram 66,2%, 28,0% e 5,8%, respectivamente. As mulheres avaliam pior sua saúde geral do que os homens. Após ajuste pelas variáveis de controle, as chances de autoavaliar a saúde bucal como negativa foi significativamente mais elevadas entre os indivíduos com renda domiciliar per capita de até um salário mínimo (OR=4,71; IC95%: 2,84-7,83), sem escolaridade (OR=3,28; IC95%: 2,34-4,61), da classe social destituídos de ativos (OR=3,03; IC95%: 2,12-4,32) e residentes da região nordeste (OR=1,50; IC95%: 1,19-1,89). Em relação à autoavaliação da saúde geral nos homens, as chances de avaliar pior foram significativamente mais elevadas entre os indivíduos de menor renda domiciliar per capita, com pior nível de escolaridade, pessoas fora da força de trabalho, moradores das regiões Nordeste e Norte e que se declararam pardos e pretos. Enquanto nas mulheres, as chances de avaliar pior seu estado de saúde geral foram maiores entre as de pior nível de escolaridade, menor renda domiciliar per capita, que se encontravam fora da força de trabalho, que se declararam não brancas e moradoras das regiões Nordeste e Norte do país. A tipologia de classe social utilizada neste estudo foi válida para capturar desigualdades na autopercepção da saúde bucal e da saúde geral de adultos, à semelhança da renda domiciliar per capita e da escolaridade, com diferenciais apenas na força de associação, a depender do desfecho e do sexo. A compreensão da relação dos marcadores de desigualdade da autoavaliação da saúde bucal e da saúde geral pode levar ao melhor direcionamento de políticas públicas para grupos sociais mais vulneráveis, contribuindo para a redução das iniquidades em saúde que persistem no Brasil. / The objective of the study was to analyze the relationship between health inequality markers, with emphasis on the socioeconomic position, with the self-assessment of oral health and general health of the Brazilian adult population in 2013. A total of 59,758 individuals aged 18 years and older participated in the National Health Survey 2013, a population-based household survey. The dependent variables on the study were selfassessment of oral health (teeth and gums) and self-assessment of general health, both of which were analyzed as positive, regular and negative. The independent variables were the markers of health inequality (color or race, residence area, education, per capita household income and social class). Crude and adjusted odds ratios (OR) and 95% confidence intervals (95% CI) were computed using multinomial logistic regression models. Results regarding general self-rated health were stratified by gender. The prevalence of self-assessment of positive oral health was 67.4%, 26.7% for regular and 5.9% for negative, while for general health were 66.2%, 28.0% and 5.8%, respectively. Women evaluate their overall health worse than men. After adjustment, the probability of rating their oral health as negative was significantly higher among individuals with a per capita household income up to a minimum wage (OR=4.71, 95%CI: 2.84-7.83), no schooling (OR=3.28, 95%CI: 2.34-4.61), of the social class devoid of assets (OR=3.03, 95%CI: 2.12-4.32) and living in the northeast region (OR=1.50, 95%CI: 1.19-1.89). Regarding the self-assessment of general health in men, the odds of evaluating worse were significantly higher among individuals with lower per capita household income, with lower educational level, people outside the work force, residents of the Northeast and North regions, and declared themselves brown and black. While in women, the chances of a worse evaluation of their general health status were higher among those with the lowest level of schooling, lower per capita household income, who were outside the work force, who declared themselves as nonwhites and residents of the Northeast and North regions of the country. The social class typology used in this study was valid to capture inequalities in self-perception of oral health and general health of adults, similar to per capita household income and education, with differentials only in strength of association, depending on the outcome and gender. Understanding the relationship between the inequality markers of oral health selfassessment and general health can lead to improvement of public policies to vulnerable social groups, contributing to the reduction of health inequities that persist in Brazil.

The aim of the study was to investigate the impact of the intersection of race, gender and social class on women leaders’ work experience and career progression in order to come up with strategies for gender transformation at leadership level in corporate South Africa. The problem statement of this research study concerns the indication in the annual report of the Commission for Employment Equity (Department of Labour 2012) that there is under-representation of women, especially African and Coloured women, at top management level relative to the economically active population. The Women Empowerment and Gender Equality Bill was published in the Government Gazette No. 37005 of 6 November 2013. This Bill aims to enforce compliance with the stipulated minimum representation of women at senior levels in both the private and public sectors. This study, with its objective of reaching an understanding of the impact of the intersection of race, gender and social class on women’s career progression, is therefore timeous. Getting the perspective of woman CEOs across race and class on how to transform gender at leadership level could add an important voice to transformation and could be of benefit to decision makers in business and in government. Based on this problem statement the following research questions were formulated: - To what extent does the intersection of race, social class and gender impact on women CEOs’ experience in their work roles and career progression? - How might an understanding of women leaders’ experiences in their roles assist with strategies to transform gender at leadership level in corporate South Africa? Qualitative research methodology was chosen as the appropriate methodology and grounded theory was employed. Purposive, snowball and theoretical sampling methods were used to identify fourteen participants (13 CEOs and one chairman).The life story method was employed for in-depth semi-structured interviews from which rich descriptive data was collected and which was analysed using grounded theory. Findings confirmed that the intersection of race, gender, age and class does have an impact on women’s career progression and their life experiences. The dominant social identity was race for blacks and gender whites; class and age were the overlay. In terms of strategies for gender transformation, first-order constructs from the participants were related to abstract second-order constructs from the literature, which led to the formulation of the WHEEL Theoretical Model. The theoretical model is an integration of different elements required for the formulation of strategies for gender transformation at leadership level. The different elements were women themselves; domestic and family support; the organisation; society and government. Despite some limitations that were encountered, the aim of the study was achieved by making a contribution not only to the development of theory related to strategies for gender transformation at leadership level, which other scholars can build from, but also to the gaining of insights into the intersection of multiple social identities and their impact which can be used by business leaders and policymakers to address inequalities in organisations. In addition, this research study made various recommendations for future research / Business Management / DBL