Explore the vast range of titles available.

During a tumultuous period when financial speculation began rapidly to outpace industrial production and consumption, Victorian financial journalists commonly explained the instability of finance by criticizing its inherent artifice drawing persistent attention to what they called \"fictitious capital.\" In a shift that naturalized this artifice, this critique of fictitious capital virtually disappeared by the 1860s, being replaced by notions of fickle investor psychology and mental equilibrium encapsulated in the fascinating metaphor of \"psychic economy.\" In close rhetorical readings of financial journalism, political economy, and the works of Dickens, Eliot, and Trollope, Kornbluh examines the psychological framing of economics, one of the nineteenth century's most enduring legacies, reminding us that the current dominant paradigm for understanding financial crisis has a history of its own. She shows how novels illuminate this displacement and ironize ideological metaphors linking psychology and economics, thus demonstrating literature's unique facility for evaluating ideas in process. Inheritors of this novelistic project, Marx and Freud each advance a critique of psychic economy that refuses to naturalize capitalism.

The prevalence of overweight and obesity in young children rose sharply during the COVID-19 pandemic. Here we estimate the potential future health and economic effects of these trends in England. Using publicly available annual Body Mass Index (BMI) data from 2006-2022, we calculated the increase in overweight/obesity prevalence (BMI ≥85th reference percentile) during the COVID-19 pandemic among children aged 4-5 and 10-11, and variation by deprivation and ethnicity. We projected the impact of child BMI trends on adult health measures to estimate added lifelong medical and social costs. During 2020-2021 there were steep increases in overweight and obesity prevalence in children. By 2022, overweight and obesity prevalence in children aged 4-5 returned to expected levels based on pre-pandemic trends. However, overweight and obesity prevalence in children aged 10-11 persisted and was 4 percentage points (p<0.001) higher than expected, representing almost 56,000 additional children. The increase was twice as high in the most compared with the least deprived areas. The additional lifelong healthcare cost in this cohort will amount to £800 million with a cost to society of £8.7 billion. We did not find an increase in maternal obesity associated with the COVID-19 pandemic, however, prevalence grew faster in the post pandemic period. The return of overweight and obesity prevalence to pre-pandemic trends in children aged 4-5 provides a clear policy target for effective intervention to tackle this growing and serious population health concern.

Previous product placement trials in supermarkets are limited in scope and outcome data collected. This study assessed the effects on store-level sales, household-level purchasing, and dietary behaviours of a healthier supermarket layout. This is a prospective matched controlled cluster trial with 2 intervention components: (i) new fresh fruit and vegetable sections near store entrances (replacing smaller displays at the back) and frozen vegetables repositioned to the entrance aisle, plus (ii) the removal of confectionery from checkouts and aisle ends opposite. In this pilot study, the intervention was implemented for 6 months in 3 discount supermarkets in England. Three control stores were matched on store sales and customer profiles and neighbourhood deprivation. Women customers aged 18 to 45 years, with loyalty cards, were assigned to the intervention (n = 62) or control group (n = 88) of their primary store. The trial registration number is NCT03518151. Interrupted time series analysis showed that increases in store-level sales of fruits and vegetables were greater in intervention stores than predicted at 3 (1.71 standard deviations (SDs) (95% CI 0.45, 2.96), P = 0.01) and 6 months follow-up (2.42 SDs (0.22, 4.62), P = 0.03), equivalent to approximately 6,170 and approximately 9,820 extra portions per store, per week, respectively. The proportion of purchasing fruits and vegetables per week rose among intervention participants at 3 and 6 months compared to control participants (0.2% versus -3.0%, P = 0.22; 1.7% versus -3.5%, P = 0.05, respectively). Store sales of confectionery were lower in intervention stores than predicted at 3 (-1.05 SDs (-1.98, -0.12), P = 0.03) and 6 months (-1.37 SDs (-2.95, 0.22), P = 0.09), equivalent to approximately 1,359 and approximately 1,575 fewer portions per store, per week, respectively; no differences were observed for confectionery purchasing. Changes in dietary variables were predominantly in the expected direction for health benefit. Intervention implementation was not within control of the research team, and stores could not be randomised. It is a pilot study, and, therefore, not powered to detect an effect. Healthier supermarket layouts can improve the nutrition profile of store sales and likely improve household purchasing and dietary quality. Placing fruits and vegetables near store entrances should be considered alongside policies to limit prominent placement of unhealthy foods. ClinicalTrials.gov NCT03518151 (pre-results).

Background Chlamydia is a major public health concern, with high economic and social costs. In 2016, there were over 200,000 chlamydia diagnoses made in England. The highest prevalence rates are found among young people. Although annual testing for sexually active young people is recommended, many do not receive testing. General practice is one ideal setting for testing, yet attempts to increase testing in this setting have been disappointing. The Capability, Opportunity, and Motivation Model of Behaviour (COM-B model) may help improve understanding of the underpinnings of chlamydia testing. The aim of this systematic review was to (1) identify barriers and facilitators to chlamydia testing for young people and primary care practitioners in general practice and (2) map facilitators and barriers onto the COM-B model. Methods Qualitative, quantitative, and mixed methods studies published after 2000 were included. Seven databases were searched to identify peer-reviewed publications which examined barriers and facilitators to chlamydia testing in general practice. The quality of included studies was assessed using the Critical Appraisal Skills Programme. Data (i.e., participant quotations, theme descriptions, and survey results) regarding study design and key findings were extracted. The data was first analysed using thematic analysis, following this, the resultant factors were mapped onto the COM-B model components. All findings are reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Four hundred eleven papers were identified; 39 met the inclusion criteria. Barriers and facilitators were identified at the patient (e.g., knowledge), provider (e.g., time constraints), and service level (e.g., practice nurses). Factors were categorised into the subcomponents of the model: physical capability (e.g., practice nurse involvement), psychological capability (e.g.: lack of knowledge), reflective motivation (e.g., beliefs regarding perceived risk), automatic motivation (e.g., embarrassment and shame), physical opportunity (e.g., time constraints), social opportunity (e.g., stigma). Conclusions This systematic review provides a synthesis of the literature which acknowledges factors across multiple levels and components. The COM-B model provided the framework for understanding the complexity of chlamydia testing behaviour. While we cannot at this juncture state which component represents the most salient influence on chlamydia testing, across all three levels, multiple barriers and facilitators were identified relating psychological capability and physical and social opportunity. Implementation should focus on (1) normalisation, (2) communication, (3) infection-specific information, and (4) mode of testing. In order to increase chlamydia testing in general practice, a multifaceted theory- and evidence-based approach is needed. Trial registration PROSPERO CRD42016041786

The aim of this study was to build a detailed, integrative profile of the correlates of young adults' feelings of loneliness, in terms of their current health and functioning and their childhood experiences and circumstances. Data were drawn from the Environmental Risk Longitudinal Twin Study, a birth cohort of 2232 individuals born in England and Wales in 1994 and 1995. Loneliness was measured when participants were aged 18. Regression analyses were used to test concurrent associations between loneliness and health and functioning in young adulthood. Longitudinal analyses were conducted to examine childhood factors associated with young adult loneliness. Lonelier young adults were more likely to experience mental health problems, to engage in physical health risk behaviours, and to use more negative strategies to cope with stress. They were less confident in their employment prospects and were more likely to be out of work. Lonelier young adults were, as children, more likely to have had mental health difficulties and to have experienced bullying and social isolation. Loneliness was evenly distributed across genders and socioeconomic backgrounds. Young adults' experience of loneliness co-occurs with a diverse range of problems, with potential implications for health in later life. The findings underscore the importance of early intervention to prevent lonely young adults from being trapped in loneliness as they age.

The COVID-19 pandemic led to changes in alcohol consumption in England. Evidence suggests that one-fifth to one-third of adults increased their alcohol consumption, while a similar proportion reported consuming less. Heavier drinkers increased their consumption the most and there was a 20% increase in alcohol-specific deaths in England in 2020 compared with 2019, a trend continuing through 2021 and 2022. This study aimed to quantify future health, healthcare, and economic impacts of changes in alcohol consumption observed during the COVID-19 pandemic. This study used a validated microsimulation model of alcohol consumption and health outcomes. Inputted data were obtained from the Alcohol Toolkit Study, and demographic, health and cost data from published literature and publicly available datasets. Three scenarios were modelled: short, medium, and long-term, where 2020 drinking patterns continue until the end of 2022, 2024, and 2035, respectively. Disease incidence, mortality, and healthcare costs were modelled for nine alcohol-related health conditions. The model was run from 2020 to 2035 for the population of England and different occupational social grade groups. In all scenarios, the microsimulation projected significant increases in incident cases of disease, premature mortality, and healthcare costs, compared with the continuation of pre-COVID-19 trends. If COVID-19 drinking patterns continue to 2035, we projected 147,892 excess cases of diseases, 9,914 additional premature deaths, and £1.2 billion in excess healthcare costs in England. The projections show that the more disadvantaged (C2DE) occupational social grade groups will experience 36% more excess premature mortality than the least disadvantaged social group (ABC1) under the long-term scenario. Alcohol harm is projected to worsen as an indirect result of the COVID-19 pandemic and inequalities are projected to widen. Early real-world data corroborate the findings of the modelling study. Increased rates of alcohol harm and healthcare costs are not inevitable but evidence-based policies and interventions are required to reverse the impacts of the pandemic on alcohol consumption in England.

Key workers are vulnerable to adverse mental health. To ensure service sustainability during COVID-19, Resilience Hubs were established across England offering outreach, screening, and mental health support. This evaluation aimed to describe wider service use, associated costs, and satisfaction among Hub clients (key workers) accessing Hub support. Clients accessing support across four Hubs were invited to complete a service use questionnaire, between 5 and 8 months post referral, collecting satisfaction, wider service use and cost data. Exploratory linear regression assessed the relationship between demographic variables and service use. Most Hub clients reported Hub contact post referral (219/299, 73.2%), with many accessing mental health support (171/299, 57.2%) or on waitlists (34/299, 11.4%). Satisfaction was high, with median helpfulness rated 92 (out of 100), and many stating that Hubs either fully (148/299, 49.5%) or partially (54/299, 18.1%) met their needs. Mental health support accounted for most service use, with higher total service use and costs when including Hub services (£514 versus £213). Key workers have complex needs. Hub services helped clients to access support, with high reported satisfaction indicating that Hubs met clients needs. Further research is required to assess how service use varies according to occupation or demographic characteristics, and whether Hubs are clinically and cost-effective.

Medication errors are common in primary care and are associated with considerable risk of patient harm. We tested whether a pharmacist-led, information technology-based intervention was more effective than simple feedback in reducing the number of patients at risk of measures related to hazardous prescribing and inadequate blood-test monitoring of medicines 6 months after the intervention. In this pragmatic, cluster randomised trial general practices in the UK were stratified by research site and list size, and randomly assigned by a web-based randomisation service in block sizes of two or four to one of two groups. The practices were allocated to either computer-generated simple feedback for at-risk patients (control) or a pharmacist-led information technology intervention (PINCER), composed of feedback, educational outreach, and dedicated support. The allocation was masked to general practices, patients, pharmacists, researchers, and statisticians. Primary outcomes were the proportions of patients at 6 months after the intervention who had had any of three clinically important errors: non-selective non-steroidal anti-inflammatory drugs (NSAIDs) prescribed to those with a history of peptic ulcer without co-prescription of a proton-pump inhibitor; β blockers prescribed to those with a history of asthma; long-term prescription of angiotensin converting enzyme (ACE) inhibitor or loop diuretics to those 75 years or older without assessment of urea and electrolytes in the preceding 15 months. The cost per error avoided was estimated by incremental cost-effectiveness analysis. This study is registered with Controlled-Trials.com, number ISRCTN21785299. 72 general practices with a combined list size of 480 942 patients were randomised. At 6 months' follow-up, patients in the PINCER group were significantly less likely to have been prescribed a non-selective NSAID if they had a history of peptic ulcer without gastroprotection (OR 0·58, 95% CI 0·38–0·89); a β blocker if they had asthma (0·73, 0·58–0·91); or an ACE inhibitor or loop diuretic without appropriate monitoring (0·51, 0·34–0·78). PINCER has a 95% probability of being cost effective if the decision-maker's ceiling willingness to pay reaches £75 per error avoided at 6 months. The PINCER intervention is an effective method for reducing a range of medication errors in general practices with computerised clinical records. Patient Safety Research Portfolio, Department of Health, England.

Background Physical activity (PA) may positively stimulate the brain, cognition and mental health during adolescence, a period of dynamic neurobiological development. High-intensity interval training (HIIT) or vigorous PA interventions are time-efficient, scalable and can be easily implemented in existing school curricula, yet their effects on cognitive, academic and mental health outcomes are unclear. The primary aim of the Fit to Study trial was to investigate whether a pragmatic and scalable HIIT-style VPA intervention delivered during school physical education (PE) could improve attainment in maths. The primary outcome has previously been reported and was null. Here, we report the effect of the intervention on prespecified secondary outcomes, including cardiorespiratory fitness, cognitive performance, and mental health in young adolescents. Methods The Fit to Study cluster randomised controlled trial included Year 8 pupils ( n  = 18,261, aged 12–13) from 104 secondary state schools in South/Mid-England. Schools were randomised into an intervention condition ( n  = 52), in which PE teachers delivered an additional 10 min of VPA per PE lesson for one academic year (2017–2018), or into a “PE as usual” control condition. Secondary outcomes included assessments of cardiorespiratory fitness (20-m shuttle run), cognitive performance (executive functions, relational memory and processing speed) and mental health (Strength and Difficulties Questionnaire and self-esteem measures). The primary intention-to-treat (ITT) analysis used linear models and structural equation models with cluster-robust standard errors to test for intervention effects. A complier-average causal effect (CACE) was estimated using a two-stage least squares procedure. Results The HIIT-style VPA intervention did not significantly improve cardiorespiratory fitness, cognitive performance (executive functions, relational memory or processed speed), or mental health (all p  > 0.05). Subgroup analyses showed no significant moderation of intervention effects by sex, socioeconomic status or baseline fitness levels. Changes in cardiorespiratory fitness were not significantly related to changes in cognitive or mental health outcomes. The trial was marked by high drop-out and low intervention compliance. Findings from the CACE analysis were in line with those from the ITT analysis. Conclusion The one-academic year HIIT-style VPA intervention delivered during regular school PE did not significantly improve fitness, cognitive performance or mental health, but these findings should be interpreted with caution given low implementation fidelity and high drop-out. Well-controlled, large-scale, school-based trials that examine the effectiveness of HIIT-style interventions to enhance cognitive and mental health outcomes are warranted. Trial registration ISRCTN registry, 15,730,512 . Trial protocol and analysis plan for primary outcome prospectively registered on 30th March 2017. ClinicalTrials.gov , NCT03286725 . Secondary measures (focus of current manuscript) retrospectively registered on 18 September 2017.

Socioeconomic status (SES) and income inequality are now recognized as important determinants of health, and there is growing interest in uncovering the intermediary psychosocial pathways through which the socioeconomic context affects physical well-being (Marmot in The status syndrome: how social standing affects our health and longevity, Henry Holt, New York, 2004; Wilkinson and Pickett in The Spirit Level: why more equal societies almost always do better, Allen Lane, London, 2009). We adopted the applied framework of self-determination theory (SDT; Deci and Ryan in Psychol Inq 11:227–268, 2000) and hypothesized that fulfillment of the basic psychological needs for autonomy, competence, and relatedness would mediate the relationships that SES and income inequality have to self-rated health. An online community sample of American participants (N = 1,139) completed a detailed demographic survey and provided self-reports of need fulfillment and health complaints. Structural equation models controlled for impression management and self-deceptive enhancement. Controlling for sex and age, need fulfillment was predicted positively by subjective SES and objective household income and negatively by state-level income inequality; in turn, need fulfillment predicted lower levels of health complaints. These findings suggest that SDT provides a useful framework for the study of SES, income inequality, and health, and that basic psychological needs are an important mechanism through which socioeconomic contexts influence health.