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Cost-effectiveness of mental health interventions in schools
No full textAbstractChildren and young people spend much time in school and therefore the school setting provides an important setting in which to intervene to promote, protect and enhance mental health. This presentation will provide an overview of the importance of making an economic case for action within schools. A scoping review has been undertaken to map the types of interventions that have been subject to cost-effectiveness evaluation. Aspects of the strengths and weakness of the existing evidence are presented. Implementation and sustainability challenges are also discussed, given the need for collaboration between the health and education sectors.Disclosure of InterestNone Declare
Working differently, performing similarly: systems intelligence and job crafting as predictors of job performance in a three-wave longitudinal study
No full textIn light of a Volatile, Uncertain, Complex and Ambiguous (VUCA) world, the need for employee adaptability is a critical capacity to navigate challenges and facilitate employees thriving in organizations. One important capacity, systems intelligence, captures employees’ ability to think, adapt and act effectively in interactions with systems. In a three-wave longitudinal study, we examine the relationship between systems intelligence (SI), job crafting (JC), and job performance (JP) over time. We employ the job demands-resources model to demonstrate that SI increases JP, hypothesizing that job resources, as manifested in JC, act as mediator between personal resources (SI) and JP. Data were collected from employees in Pakistan working across the banking, telecommunications, information technology, and engineering sectors. In the first wave, 303 participants completed the survey using validated self-report measures, followed by 212 in the second wave, and 99 in the third wave, each two months apart. Our findings show that systems intelligence at Time 1 was positively related to job performance at Time 3 but not Time 2. We found no significant association of SI at Time 1 with JC at Time 2 or Time 3. JC at Time 2 did not mediate the effects of SI at Time 1 on JP at Time 3. However, JC (T1 & T2) had a significant positive effect on JP (T2 & T3). Overall, our findings suggest that the pathways from systems intelligence and job crafting to job performance are independent. This dual pathway to performance has important theoretical implications as well as practical implications for organizations. Organizations can improve team and individual productivity by fostering systems intelligence and promoting job crafting behaviours. This research directs the attention of leaders and HR functions to the value of tailored interventions in developing these abilities and achieving long-term success and adaptive performance in the workforce
Evaluating the cost-effectiveness of COVID-19 mRNA primary-series vaccination in Qatar: an integrated epidemiological and economic analysis
No full textQatar implemented a mass primary-series vaccination campaign to mitigate the impact of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to retrospectively evaluate the cost-effectiveness of this program both before and after onset of the omicron wave. An economic evaluation was conducted from the public healthcare system perspective between January 5, 2021, and September 18, 2023. Cost-effectiveness was determined using an epidemiological retrospective cohort study and health economic modeling that compared the cohort of individuals who received two vaccine doses with the unvaccinated cohort with respect to incidence of infection, incidence of severe COVID-19 forms, quality-adjusted life years (QALYs), and medical costs. During the pre-omicron phase, primary-series vaccination incurred an additional cost of 54,790,858 in direct medical costs. The incremental cost-effectiveness ratio (ICER) was 3,180 (95% CI: 4,484) and per severe COVID-19 outcome averted was 42,146-$88,354). Vaccination of individuals ≥50 years of age, those more clinically vulnerable to severe COVID-19, and those with multiple coexisting conditions was substantially more cost-effective. Cost-effectiveness of primary-series vaccination was substantially reduced during the omicron phase, but vaccination remained cost-effective. Sensitivity analyses confirmed the findings. Primary-series vaccination was cost-effective with an ICER below the 1 GDP per capita threshold during the pre-omicron phase and within the 1–3 GDP per capita thresholds during the omicron phase. Targeted vaccination strategies for those most vulnerable to COVID-19 were the most cost-effective and remained essential, even in situations of moderate vaccine effectiveness or reduced infection severity
Protecting animal cultures as World Heritage
No full textIt is becoming increasingly clear that animal cultures have intrinsic, irreplaceable value, and yet they are not adequately protected by preserving habitat. The time has come for UNESCO to explicitly protect non-human cultural heritage alongside human heritage
Essays in econometric theory
Get PDFWe design and analyse nonparametric techniques for understanding the structure of network data, inference on network statistics, and testing for shape constraints. In the first chapter, I look at symmetric binary exchangeable networks. Any such network can be characterised by a distribution over characteristics of nodes and a linking (graphon) function which gives the probability of link between any two nodes. To learn about the network structure, I propose a nonparametric estimator of the linking function. I provide conditions under which the estimator is uniformly consistent and a numerical procedure for choosing a tuning parameter. My procedure makes minimal assumptions and allows for moderate sparsity levels. In the second chapter, I propose a bootstrap procedure which allows for valid inference on network statistics. It uses my nonparametric linking function estimator from Chapter 1 to generate bootstrap networks with a similar dependence structure to the original network. I prove that the distribution of the bootstrap network is consistent for the distribution of the original network, and I provide conditions under which bootstrap consistently recovers distributions of a class of functions related to U-statistics. I find good performance in Monte Carlo simulations and apply my procedure to the data from Banerjee, Chandrasekhar, Duflo, and Jackson (2013). In the third chapter, we propose a test for whether a nonparametric regression mean satisfies a shape restriction that varies within the domain of the regressor (e.g. (inverted) U-shaped, S-shaped). Our procedure extends the methodology of Komarova and Hidalgo (2023) to the setting where the points at which the shape changes are unknown and must be estimated, and the shapes may only appear after controlling for covariates. We provide a generalised transformation which achieves the same asymptotic distribution but adds robustness to the test and credibility to the conclusions
Changes, continuities, and gender norms: exploring the household division of labour in Medellín, Colombia
Get PDFThe thesis explores how gender norms change in the context of Medellín, Colombia. It focuses on why men’s participation in unpaid household responsibilities appears resistant to change despite women’s increasing involvement in paid work. Based on 16 months of fieldwork, it critically examines the World Values Survey (WVS), commonly used to measure social norms by aggregating individual gender attitudes. The thesis argues that the design of the WVS, influenced by theories assuming linear development towards gender equality, oversimplifies the complexities of gender norm change. Using a multilevel feminist institutionalist framework, the research reveals that gender transformations have resulted in the co-existence of normative models, with more varied alternatives in Medellín’s society in flux, rather than straightforward and rapid shifts from old to new norms. A nested mixed-methods approach follows WVS variables across three levels of analysis (micro, meso, and macro), combining locally driven household surveys, qualitative interviews with survey respondents, and participant observation, to uncover the varied interpretations and responses to gender norms among socially situated actors. This approach challenges the presumed consensus reflected in survey data, revealing ambiguities and multiple meanings in how gender norms are understood and negotiated. Through its core focus, the thesis emphasises the potential of individuals and marginalised groups to transform gender norms, while also recognising the constraints these norms impose on their actions and strategies for change. This creates a tension in what forms of change are possible, highlighting both the agency and the limits of those working to shift deep-seated gender norms. The thesis further investigates men’s changing roles and the contextual factors, such as violence and informality, that shape trajectories of stability and change. It offers an intergenerational perspective that moves beyond traditional intra-household bargaining frameworks, providing a nuanced understanding of how gender norms are reproduced and contested in everyday life amidst rapid urbanisation and economic liberalisation. By linking micro-level interactions and negotiations within the family and community to meso-level changing institutions and gender norms at the macro-level, the thesis reconsiders gender norm change as a dynamic process filled with ambiguity and diversity. It underscores the need for context-specific interpretations of research tools like the WVS, informed by local realities and perspectives. It raises caution about carrying out cross-national comparisons based on these tools. These findings contribute to debates on rising female labour force participation in Latin America and the malleability of gender norms, attitudes, and social expectations at critical junctures
The single-pointed mind: theorising attention from South Asia
Get PDFThis thesis takes as its primary site of engagement a pervasive concept: attention. As an implicit analytic, attention has long been used by anthropologists to explain various arenas of socio-cultural life pointing to its centrality in our formation as human subjects. Yet, anthropologists have also tended not to pay attention to attention itself – it has infrequently featured explicitly as a point of theoretical and ethnographic exploration. As part of an attempt to explicitly engage with this psycho-bodily capacity, I argue for a move away from the treatment of attention only as a self-evident aspect of experience, as is the case in much extant scholarship. Instead, I contend that a mature anthropology of attention should also focus on the ideological constitution of this psycho-bodily capacity – that is as a major site of emic theorisation and moral concern. This recognises more fully the importance of attention as a crucial ground of valorisation, contestation and anxiety through which diverse cultures and groups attempt to make up the self in particular ways. As proof of the value of this approach, the following account offers an attentionalist reading of north Indian culture and history. Drawing on ethnographic fieldwork in Banaras as well as archival research, a number of well-worn areas of South Asian anthropology – colonial history, ritual, aesthetics and theories of self – are re-interpreted through an attentional lens. In each case, I explore how a particular ideology of attention – built around single-pointedness – is vital to how different social actors in Banaras attempt to shape their lives and their interiority. This reflects in part longstanding religious and ethical positions as well as the fact that since the colonial period, single-pointed attention, has provided a centralising value for an idealised conception of national subjectivity, offering a basis for an imaginary of Indian superiority grounded in introspective capacity
Essays in asset management
Get PDFThis thesis contains three essays on the trading behavior and product market innovation of asset managers. The first chapter finds that political beliefs shape professional investors’ interpretations of fiscal policy and, consequently, their asset allocation decisions. Using daily data on Congressional Budget Office cost releases for U.S. legislative proposals, I find that fixed-income mutual fund managers who oppose the current president’s party trade more aggressively and pessimistically in response to news of anticipated rising federal budget deficits. Compared to politically aligned managers, they reduce their positions in long-term Treasury and corporate bonds more significantly while increasing their holdings in Treasury Inflation-Protected Securities. This partisan-driven trading exerts a temporary price impact on Treasury securities and long-term corporate bonds. The second chapter (with Li An, Shiyang Huang, and Dong Lou) documents that despite the removal of all regulatory barriers by 1997, long-short equity mutual funds have seen disappointing growth over the past two decades. We shed new light on this puzzle by documenting a novel set of facts: long-short mutual funds: 1) hold a substantial amount of cash (in excess of cash-collateral requirements) and have an average market beta of 0.6; 2) generate a 5% annual alpha on risky holdings but do not outperform their long-only peers in total returns; and 3) face much higher flow-performance sensitivities and more volatile flows, and use cash buffers more aggressively. These findings challenge prevailing explanations for this puzzle—such as client restrictions, lack of short-selling skills, or high short-selling costs and risks—and motivate a new framework centered on investor clientele and flow responses. The third chapter (with Jiaxing Tian) investigates the decline of traditional mutual funds, focusing on the substitution of mutual funds by collective investment trusts (CITs) in the 401(k) pension investment, and offers insights from both demand and supply sides. Employing several datasets, we demonstrate that CITs are adopted due to their lower fees, comparable returns, and customized nature, aligning with investor preferences sensitive to cost rather than financial transparency. Moreover, mutual fund companies with positive signals, such as past returns and ratings, are incentivized to introduce CITs to reduce auditing costs and gain market shares in 401(k)s. The surge of CITs in 401(k) menus has implications for pension plan governance, with better-governed plans more likely to incorporate CITs. Our findings suggest potential welfare improvements in this delegated asset management model, with investors benefiting from lower total investment costs and mutual fund companies gaining inflow stability. Overall, our research contributes to understanding the dynamics of non-mutual fund investments and their implications for financial markets and investors
Data and Code for: The Socio-Economic Distribution of Choice Quality: Evidence from Health Insurance Choice in the Netherlands
No full textProject using micro-data on health and health care in the Netherlands to study how health deductible choice quality varies with socio-economic characteristics. The code above notes which variables in the Netherlands data to access for which parts of the analysis. The README file explains in more depth as well. The data are accessed through a secure link to a server with the files
Additional file 1 of The cost-effectiveness of specialist hospital discharge and intermediate care services for patients who are homeless
No full textAbstract Background Recognising the diverse healthcare needs of the population, there is a growing emphasis on tailoring hospital discharge processes to address the unique challenges faced by individuals who are homeless, aiming to enhance the efficiency and effectiveness of post-hospitalisation care for this vulnerable demographic. This study aimed to evaluate the costs and consequences of specialist hospital discharge and intermediate care (support after discharge) services for people who are homeless in England. Methods We estimated the comparative costs and consequences of different types of specialist care provided by 17 homeless hospital discharge and intermediate care services. We compared ‘clinically-led’ (multidisciplinary) services with those that were ‘housing-led’ (uniprofessional). A retrospective observational study was conducted to estimate effectiveness and costs for two 'intervention groups'(clinically-led and housing-led) and a previously published RCT for 'standard care'. Use of resources data for specialist care was sourced through linkage with Hospital Episode Statistics. The measure of effectiveness was the number of bed days avoided (in terms of hospital stays for all readmissions in the follow-up period) per homeless user. Additional secondary analysis of three services looked at quality-adjusted life years (QALYs) and service delivery costs. The perspective adopted was NHS in England. Results Data from the comparative analysis showed that specialist homeless hospital discharge (HHD) care is likely to be cost-effective compared with standard care. Patients accessing specialist care use fewer bed days per year (including both planned and unplanned readmissions). Patients using specialist care have more planned readmissions to hospital and, overall, use more NHS resources than those who use standard care. We interpret this as a positive outcome indicating that specialist care is likely to work more effectively than standard care to improve access to healthcare for this marginalised group. Specialist care remained cost-effective over a range of sensitivity analyses. Secondary analyses of three specific schemes found better QALY outcomes, but results are not generalisable to all 17 schemes. Conclusion Specialist HHD services are likely to be cost-effective for the NHS compared with standard care, although further research is needed to access patient level data for both costs and outcomes to conduct a rigorous statistical analysis between groups and address possible underlying biases due to data coming from non-randomised study design