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24 pages, 1228 KB  
Article
Rights-Based Priorities for Children with SEND in the Post-COVID-19 Era: A Multi-Method, Multi-Phased, Multi-Stakeholder Consensus Approach
by Emma Ashworth, Lucy Bray, Amel Alghrani, Seamus Byrne and Joanna Kirkby
Children 2025, 12(7), 827; https://doi.org/10.3390/children12070827 - 23 Jun 2025
Viewed by 419
Abstract
Background: The provision of education, health, and social care for children with special educational needs and disabilities (SEND) in England has long been criticised for its inequities and chronic underfunding. These systemic issues were further exacerbated by the onset of the COVID-19 pandemic [...] Read more.
Background: The provision of education, health, and social care for children with special educational needs and disabilities (SEND) in England has long been criticised for its inequities and chronic underfunding. These systemic issues were further exacerbated by the onset of the COVID-19 pandemic and the accompanying restrictions, which disrupted essential services and resulted in widespread unmet needs and infringements on the rights of many children with SEND. This study aimed to use a three-phase consensus-building approach with 1353 participants across five stakeholder groups to collaboratively develop evidence-informed priorities for policy and practice. The priorities sought to help address the longstanding disparities and respond to the intensified challenges brought about by the pandemic. Methods: A total of 55 children with SEND (aged 5–16), 893 parents/carers, and 307 professionals working in SEND-related services participated in the first phase through online surveys. This was followed by semi-structured interviews with four children and young people, ten parents/carers, and 15 professionals, allowing for deeper exploration of lived experiences and priorities. The data were analysed, synthesised, and structured into five overarching areas of priority. These were subsequently discussed and refined in a series of activity-based group workshops involving 20 children with SEND, 11 parents/carers, and 38 professionals. Results and Conclusions: The consensus-building process led to the identification of key priorities for both pandemic response and longer-term recovery, highlighting the responsibilities of central Government and statutory services to consider and meet the needs of children with SEND. These priorities are framed within a children’s rights context and considered against the rights and duties set out in the United Nations Convention on the Rights of the Child (1989). Priorities include protecting and promoting children with SEND’s rights to (1) play, socialise, and be part of a community, (2) receive support for their social and emotional wellbeing and mental health, (3) feel safe, belong, and learn in school, (4) “access health and social care services and therapies”, and (5) receive support for their parents/carers and families. Together, they highlight the urgent need for structural reform to ensure that children with SEND receive the support they are entitled to—not only in times of crisis but as a matter of routine practice and policy. Full article
(This article belongs to the Section Global Pediatric Health)
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20 pages, 9570 KB  
Article
Digital Humanities for the Heritage of Political Ideas in Medieval Bologna
by Marco Orlandi and Rosa Smurra
Heritage 2025, 8(7), 239; https://doi.org/10.3390/heritage8070239 - 20 Jun 2025
Viewed by 505
Abstract
This paper outlines a methodology for creating an educational and informative communication system for non-specialised audiences in order to preserve and pass on the heritage of ideas and practices adopted in the medieval political and administrative sphere. Through the combined use of digital [...] Read more.
This paper outlines a methodology for creating an educational and informative communication system for non-specialised audiences in order to preserve and pass on the heritage of ideas and practices adopted in the medieval political and administrative sphere. Through the combined use of digital technologies (such as GISs, 3D modelling and virtual tours), historical sources can potentially reveal how political and administrative aspects affected different areas within the medieval city, not just the main seats of power. Bologna, a prestigious medieval university metropolis, is chosen as a case study because of the remarkable wealth of documentation in its archives from the city’s political culture in the Middle Ages. Written historical sources, including documentary and narrative texts, are among the primary tools employed in the study of European medieval urban communities in general. Documentary sources help us understand and reconstruct the complexities of civic administration, urban policies and the economy, as well as how citizens experience them daily. The involvement of citizens in the political and administrative life of late medieval cities is explored through the management and digital processing of historical documentation. Digital humanities tools can facilitate this analysis, offering a perspective that sheds light on the formation of the pre-modern state. Although digital databases and repositories have significantly contributed to preserving and digitally archiving historical sources, these are often aimed exclusively at the academic level and remain underutilised as privileged didactic and educational tools for a broad audience. Full article
(This article belongs to the Section Cultural Heritage)
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14 pages, 231 KB  
Article
Out of Reach: Social Connections and Their Role in Influencing Engagement Between Forcibly Displaced People and Police Scotland
by Bryony Gemma Nisbet and Nicole Vidal
Soc. Sci. 2025, 14(5), 306; https://doi.org/10.3390/socsci14050306 - 15 May 2025
Viewed by 594
Abstract
Forcibly displaced people in Scotland face multiple barriers in accessing health, social care, and policing services. This paper explores how social connections shape engagement with these services, particularly the role of police in community safety and wellbeing. Drawing on qualitative interviews and social [...] Read more.
Forcibly displaced people in Scotland face multiple barriers in accessing health, social care, and policing services. This paper explores how social connections shape engagement with these services, particularly the role of police in community safety and wellbeing. Drawing on qualitative interviews and social connections mapping workshops, this study examines how third-sector organisations act as key intermediaries, shaping how people access statutory services. The findings show that while community policing and partnerships with trusted organisations can improve accessibility, concerns about racial discrimination, the underreporting of hate crime, and the lack of language support continue to undermine confidence in policing. Additionally, the growing reliance on police officers to respond to mental health crises reflects wider gaps in specialist service provision. This paper argues for a shift towards a cross-sector approach that strengthens community-led safety strategies, reduces police involvement in non-criminal matters, and improves language and cultural competency within public services. Strengthening institutional accessibility and trust-building initiatives is key to improving engagement with policing and health and social care services for forcibly displaced communities. Full article
(This article belongs to the Special Issue Health and Migration Challenges for Forced Migrants)
15 pages, 233 KB  
Article
No Animal Left Behind: A Thematic Analysis of Public Submissions on the New Zealand Emergency Management Bill
by Steve Glassey
Pets 2024, 1(2), 120-134; https://doi.org/10.3390/pets1020010 - 11 Jul 2024
Cited by 1 | Viewed by 1769
Abstract
This article presents a thematic analysis of submissions made on New Zealand’s Emergency Management Bill. While a key focus is on the importance and frequency of animal welfare concerns raised by submitters, the analysis also examines other critical themes to provide context on [...] Read more.
This article presents a thematic analysis of submissions made on New Zealand’s Emergency Management Bill. While a key focus is on the importance and frequency of animal welfare concerns raised by submitters, the analysis also examines other critical themes to provide context on the range of issues addressed. The impact of the “No Animal Left Behind” campaign launched by Animal Evac New Zealand in mobilising public engagement on animal welfare provisions is also assessed. Sixty-one percent (n = 191) of public submissions on the Bill raised the importance of including animals in new emergency management legislation and at least 48% (n = 149) of all public submissions were directly attributed to the campaign. Key animal welfare concerns include the need for clear statutory powers and requirements, better coordination and resourcing, and recognition of the human–animal bond. Other prominent non-animal-related themes relate to strengthening community resilience, improving Māori participation in emergency management, and enhancing readiness and response capabilities. Specific recommendations are made for legal changes to better protect animal welfare, including amending key provisions to explicitly address animal rescue and evacuation, mandating animal welfare emergency plans, strengthening animal seizure and disposal processes, and enhancing accountability for animal emergency response charities. With improving animal disaster management law being the most common issue identified, it is logical for a government to apply deliberative democracy to ensure animals are better protected in New Zealand emergency management reforms. The findings underscore the importance of comprehensive, multi-faceted reform to create a world-leading emergency management framework. Full article
17 pages, 338 KB  
Article
The Impact of Fourteen Years of UK Conservative Government Policy on Open Access Youth Work
by Bernard Davies
Youth 2024, 4(2), 492-508; https://doi.org/10.3390/youth4020034 - 7 Apr 2024
Cited by 3 | Viewed by 3753
Abstract
This article reviews the impacts of the UK Conservative Party’s government policies on ‘open access youth work’ since 2010, giving particular attention to the period since 2018 and to impacts in England. After clarifying the practice’s distinctive features, it outlines the ‘austerity’ demolition [...] Read more.
This article reviews the impacts of the UK Conservative Party’s government policies on ‘open access youth work’ since 2010, giving particular attention to the period since 2018 and to impacts in England. After clarifying the practice’s distinctive features, it outlines the ‘austerity’ demolition of its local provision and—amid continuing wider financial pressures—changes in the role and contributions of the voluntary youth sector. It lists a range of ‘gesture’ funds for financing responses to young people’s needs and interests as the government has defined them and uses the Youth Investment Fund (YIF) as a case study of how this money has been made available and allocated. Initiatives taken by the Department of Digital, Media, Culture and Sport (DCMS) are then examined: its Youth Review, National Youth Guarantee, review of the statutory guidance to local authorities, and support for ‘youth volunteering’. Two key developments are then considered that, by early 2024, were diverting and inhibiting an even partial sustained reinstatement of the lost open access youth work facilities. One, at the policy level, is the redefinition of ‘youth work’ by governments and by some within the youth work sector itself as a wide range of out-of-school practices with young people; the other, at the point of delivery, is the on-going difficulties in recruiting youth workers, especially those with direct practice experience. Finally, two possible tentative suggestions for some reinstatement of open access youth work provisions are then discussed. Full article
9 pages, 226 KB  
Communication
Food Systems Transformation in Scotland—The Journey to, Vision of, and Challenges Facing the New Good Food Nation (Scotland) Act
by Mary Brennan
Sustainability 2023, 15(19), 14579; https://doi.org/10.3390/su151914579 - 8 Oct 2023
Cited by 1 | Viewed by 1872
Abstract
Building on growing global and local calls for food systems transformation, and years of policy and legislative consultation (2009–2022), the Scottish Parliament unanimously passed transformational food systems legislation in June 2022. Built on a clear vision, clarity of purpose, a common set of [...] Read more.
Building on growing global and local calls for food systems transformation, and years of policy and legislative consultation (2009–2022), the Scottish Parliament unanimously passed transformational food systems legislation in June 2022. Built on a clear vision, clarity of purpose, a common set of outcomes, an agreed direction of travel, strong partnership working, sufficient time, and independent oversight, the Good Food Nation (GFN) (Scotland) Act is an innovative legislative framework designed to foster a healthier, fairer, and more sustainable Scottish food system for all. It places, for the first time, statutory responsibilities on the Scottish Government and relevant authorities (all Scottish local authorities and public health boards) to develop and implement national and local GFN plans, and importantly, makes provision for the establishment of a new independent, statutory Scottish Food Commission to oversee the implementation, with significant powers of oversight and scrutiny and a formal remit to make recommendations to any Scottish ministers and relevant authorities regarding issues/actions relevant to the Good Food Nation Plans. This paper outlines Scotland’s agriculture, food, and drink sector, reviews its food policy and GFN journey since the establishment of the Scottish parliament in 1999, critiques the core principles, stated outcomes, key provisions, and planned timescales of the GFN (Scotland) Act, reflects on its transformational potential, and considers unresolved concerns and remaining tensions. Full article
(This article belongs to the Special Issue Sustainable Food System Transition)
40 pages, 26385 KB  
Article
Heritage and Environment: Greenery as a Climate Change Mitigation Factor in Selected UNESCO Sites in Krakow
by Agata Zachariasz, Dorota Jopek and Laura Kochel
Sustainability 2023, 15(15), 12041; https://doi.org/10.3390/su151512041 - 6 Aug 2023
Cited by 3 | Viewed by 3628
Abstract
The quantity and condition of urban greenery directly affect the quality of life of residents and space users. This quality is linked to measures that reduce the negative impact of climate change. It was assumed that urban greenery should not only be protected [...] Read more.
The quantity and condition of urban greenery directly affect the quality of life of residents and space users. This quality is linked to measures that reduce the negative impact of climate change. It was assumed that urban greenery should not only be protected but also should have its stock increased, which is not easy in a historical, compact structure under statutory conservation. This paper discusses the issue of green areas in the strict city centre of Krakow, a UNESCO World Heritage Site since 1978. The study area includes two medieval towns that had their town charters issued in the 13th and 14th centuries, which together formed a central town and a satellite town. Kazimierz and Stradom were subjected to a detailed investigation. A review of the literature and other sources made it possible to identify changes in the structure of green spaces in terms of chronology and quantity. Changes in the area, accessibility and the legal provisions arising from the various forms of statutory conservation and their consequences were analysed. Multi-criteria analyses of the historical urban structure and the types, forms and potential for introducing greenery into the historical area were also performed. The intention was to strengthen green infrastructure, which is a key element in climate change mitigation. Full article
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20 pages, 909 KB  
Article
Spatial Planning at the National Level: Comparison of Legal and Strategic Instruments in a Case Study of Belarus, Ukraine, and Poland
by Maciej Nowak, Viktoriya Pantyley, Małgorzata Blaszke, Liudmila Fakeyeva, Roman Lozynskyy and Alexandru-Ionut Petrisor
Land 2023, 12(7), 1364; https://doi.org/10.3390/land12071364 - 7 Jul 2023
Cited by 8 | Viewed by 2910
Abstract
Comparisons of spatial planning systems still require in-depth reflection, especially in Central and Eastern European countries. This article compares national (central) government approaches to spatial planning in Belarus, Ukraine and Poland, answering the following research questions: (1) How are spatial planning issues regulated [...] Read more.
Comparisons of spatial planning systems still require in-depth reflection, especially in Central and Eastern European countries. This article compares national (central) government approaches to spatial planning in Belarus, Ukraine and Poland, answering the following research questions: (1) How are spatial planning issues regulated nationally? Which topics do laws focus on? What values and objectives are laws particularly emphasizing? (2) Are there any central/national strategic documents dealing with spatial planning, and which spatial issues do they address mostly? The article covers two key issues: comparing national approaches to spatial planning systems and comparing spatial planning issues in the three countries. We focus on statutory approaches and those contained in central-level strategic acts. In each country, spatial planning issues are covered by numerous laws, generating confusion when interpreting individual provisions. Our study makes an important, innovative contribution to the academic discussion by proposing a way of comparing and analyzing approaches of national authorities to spatial planning. Full article
(This article belongs to the Special Issue Patrimony Assessment and Sustainable Land Resource Management)
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11 pages, 851 KB  
Article
Population-Based, Spatial Analysis of Specialised Ambulatory Palliative Care in Mecklenburg-Western Pomerania, Germany, on the Basis of Reimbursement Data
by Maren Leiz, Kilson Moon, Laura Kerstin Rehner, Ulrike Stentzel, Franziska Radicke, Wolfgang Hoffmann and Neeltje van den Berg
Int. J. Environ. Res. Public Health 2023, 20(3), 2231; https://doi.org/10.3390/ijerph20032231 - 26 Jan 2023
Cited by 1 | Viewed by 1779
Abstract
In rural areas, healthcare providers, patients and relatives have to cover long distances. For specialised ambulatory palliative care (SAPV), a supply radius of max. 30 km is recommended. The aim of this study was to analyse whether there are regional disparities in the [...] Read more.
In rural areas, healthcare providers, patients and relatives have to cover long distances. For specialised ambulatory palliative care (SAPV), a supply radius of max. 30 km is recommended. The aim of this study was to analyse whether there are regional disparities in the supply of SAPV and whether it is associated with the distance between the SAPV team’s site and the patient’s location. Therefore, anonymised data of the Association of Statutory Health Insurance Physicians of the Federal State of Mecklenburg-Western Pomerania (M-V) were retrospectively analysed for the period of 2014–2017. Identification as a palliative patient was based on palliative-specific items from the ambulatory reimbursement catalogue. In total, 6940 SAPV patients were identified; thereof, 48.9% female. The mean age was 73.3 years. For 28.3% of the identified SAPV patients (n = 1961), the SAPV teams had a travel distance of >30 km. With increasing distance, the average number of treatment days per patient increased. It was found that there are regional disparities in the provision of SAPV services in M-V and that local structures have an important impact on regional supply patterns. The distance between the SAPV team’s site and the patient’s location is not the only determining factor; other causes must be considered. Full article
(This article belongs to the Special Issue Public Health, Mapping and Spatial Analysis)
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18 pages, 1104 KB  
Article
From Acts of Care to Practice-Based Resistance: Refugee-Sector Service Provision and Its Impact(s) on Integration
by Emmaleena Käkelä, Helen Baillot, Leyla Kerlaff and Marcia Vera-Espinoza
Soc. Sci. 2023, 12(1), 39; https://doi.org/10.3390/socsci12010039 - 11 Jan 2023
Cited by 11 | Viewed by 5691
Abstract
The UK refugee sector encompasses welfare provision, systems advocacy, capacity development and research. However, to date there has been little attention on refugees’ experiences of the support provided by these services or on the views of the practitioners who deliver them. This paper [...] Read more.
The UK refugee sector encompasses welfare provision, systems advocacy, capacity development and research. However, to date there has been little attention on refugees’ experiences of the support provided by these services or on the views of the practitioners who deliver them. This paper draws from interviews and workshops with thirty refugee beneficiaries of an integration service in Scotland and twenty practitioners to shed light on how refugees and practitioners perceive and provide meaning to the work of the refugee sector. We identify refugee sector organisations as crucial nodes in refugees’ social networks and explore the multiple roles they play in the integration process. Firstly, we confirm that refugee organisations act as connectors, linking refugees with wider networks of support. Secondly, we demonstrate that the work of the refugee sector involves acts of care that are of intrinsic value to refugees, over and above the achievement of tangible integration outcomes. Finally, we demonstrate that this care also involves acts that seek to overcome and subvert statutory system barriers. We propose to understand these acts as forms of “practice-based resistance” necessitated by a hostile policy environment. The findings expand on understandings of the refugee sector, its role in integration and the multi-faceted nature of integration processes. Full article
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13 pages, 313 KB  
Article
The Migratory Pathways of Labourers and Legislation: From Érin to Aotearoa
by Richard Shaw
Genealogy 2022, 6(4), 83; https://doi.org/10.3390/genealogy6040083 - 10 Oct 2022
Cited by 2 | Viewed by 2218
Abstract
This article addresses the process and consequences of colonisation by studying the migration of both legislative frameworks and one person who helped give those structures material effect in Aotearoa New Zealand. It situates the story of my great-grandfather—who migrated from Ireland in 1874, [...] Read more.
This article addresses the process and consequences of colonisation by studying the migration of both legislative frameworks and one person who helped give those structures material effect in Aotearoa New Zealand. It situates the story of my great-grandfather—who migrated from Ireland in 1874, participated in te pāhua (the plunder) of Parihaka pā in 1881, and returned to Taranaki in 1893 to farmland taken from Māori—in the context of an institutional environment adapted from Irish antecedents to the particulars of Aotearoa. More specifically, I wish to (1) assess the extent to which statutory provision for the confiscation of Māori land and the establishment of the New Zealand Armed Constabulary was based on Irish templates; (2) connect those arrangements to the social and economic transformation my ancestor underwent; and (3) explore the significance of that historical legacy for descendants of my great-grandfather. Full article
(This article belongs to the Special Issue Critical Family History and Migration)
18 pages, 359 KB  
Article
Teachers’ Perceptions of Supporting Young Carers in Schools: Identifying Support Needs and the Importance of Home–School Relationships
by Amy Warhurst, Sarah Bayless and Emma Maynard
Int. J. Environ. Res. Public Health 2022, 19(17), 10755; https://doi.org/10.3390/ijerph191710755 - 29 Aug 2022
Cited by 11 | Viewed by 4686
Abstract
Recognition and support for young carers has improved steadily in the past two decades; with stronger legislation and more visibility and awareness of the challenges that many of the YC face, especially with respect to their education. Recent UK-based initiatives providing toolkits and [...] Read more.
Recognition and support for young carers has improved steadily in the past two decades; with stronger legislation and more visibility and awareness of the challenges that many of the YC face, especially with respect to their education. Recent UK-based initiatives providing toolkits and guidance for school staff have provided much needed direction for schools, to support the loosely defined statutory requirements. The aim of the current research was to hear from school staff about their experiences in identifying and supporting young carers, to better understand any enablers and barriers. The thematic analysis of the interview data from 18 school staff was organized into two main themes: perceptions regarding the characteristics of young carers; and perceptions regarding the importance of home–school communication. Each superordinate theme contained several sub-themes. Overall, the teachers perceived many difficulties identifying young carers who did not volunteer this information and felt that the main enabler of identification was the trust relationships between the school and the pupil and parents. Once identified, the schools perceived the main areas of need that they could provide support for were the emotional wellbeing of the pupils and additional academic opportunities. They spoke too of the difficulties balancing the provision of this extra support within the constraints of the school context, both in terms of the school day, and the competing priorities relating to academic and social–emotional needs. School staff recognized that extra time outside of school was difficult for young carers to attend. Other subthemes are discussed with consideration to enablers and barriers. The implications for the dissemination of good practice, and addressing policy are considered. Full article
(This article belongs to the Special Issue Young Carers: Research, Policy and Practice)
8 pages, 247 KB  
Perspective
Blue Nitrogen: A Nature-Based Solution in the Blue Economy as a Tool to Manage Terrestrial Nutrient Neutrality
by Adam D. Hughes, George Charalambides, Sofia C. Franco, Georgina Robinson and Paul Tett
Sustainability 2022, 14(16), 10182; https://doi.org/10.3390/su141610182 - 16 Aug 2022
Cited by 6 | Viewed by 3466
Abstract
There is growing concern about the impact of rising nutrient loading on aquatic ecosystems and on human health, due to increased urbanisation and associated sewage effluents. This has led to a policy focus on land-use change or agricultural practice change as nutrient mitigation [...] Read more.
There is growing concern about the impact of rising nutrient loading on aquatic ecosystems and on human health, due to increased urbanisation and associated sewage effluents. This has led to a policy focus on land-use change or agricultural practice change as nutrient mitigation strategies, but these fail to consider the ultimate downstream receiving environments such as marine ecosystems. Within the UK there has been increasing recognition that housing density in certain sensitive locations is impacting the conservation status of marine features, through the increase in nutrient loading to the marine environment. In order to comply with the statutory obligations to protect these marine features, the competent authorities have required developers to mitigate the impact of these additional nutrients. Current approaches include converting agricultural land to woodland and wetland habitats that release less nitrogen than the agricultural land they replace. This difference is used to offset the nutrient loading from the new development, but such a terrestrial-focused catchment-based mass balance approach has a number of limitations. Current solutions for nutrient neutrality in the UK take a narrow land-focused approach that fails to acknowledge the potential contribution of the marine environments to mitigate nutrient enrichment. We propose that marine nature-based solutions offer an economically and ecologically viable alternative to terrestrial schemes, that can reduce the nitrogen loading to the marine environment, increase ecosystem service provision and increase biodiversity. Full article
(This article belongs to the Special Issue Sustainable Blue Economy and Marine Management)
17 pages, 1088 KB  
Article
Value for Money: Local Authority Action on Clean Energy for Net Zero
by Katherine Sugar and Janette Webb
Energies 2022, 15(12), 4359; https://doi.org/10.3390/en15124359 - 15 Jun 2022
Cited by 9 | Viewed by 3281
Abstract
Local authorities are well placed to realise co-benefits of integrated local energy systems; however, in the UK they have no statutory energy mandate. Planning and developing clean energy are discretionary, and persistent budget reductions, combined with the lack of strategic direction from the [...] Read more.
Local authorities are well placed to realise co-benefits of integrated local energy systems; however, in the UK they have no statutory energy mandate. Planning and developing clean energy are discretionary, and persistent budget reductions, combined with the lack of strategic direction from the UK government for more localised energy provision, limit local capacity, expertise and resources. Nevertheless, some local authorities have led energy initiatives but have been unable to stimulate investment at the pace and scale required to align with net zero greenhouse gas targets. Using evidence from such initiatives, this paper discusses the institutional changes needed to enable local authorities to act. It examines existing climate and local energy plans, and their integral socio-economic value. Using this evidence, investment opportunities from locally led net zero programmes are identified. EU technical assistance funds provided a particularly successful route to local energy developments: based on value of investment secured against initial funding, it is estimated that GBP 1 million technical assistance funding to every local authority would lead to GBP 15 billion investment in local energy. Other potential funding innovations are assessed and the paper concludes with recommendations for policy and resource measures needed to convert local ambition into clean energy and energy saving investment at scale. Full article
(This article belongs to the Special Issue The Future of Smart Local Energy System)
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14 pages, 953 KB  
Article
The Cost-Effectiveness Analysis of an Integrated Mental Health Care Programme in Germany
by Annabel Sandra Mueller-Stierlin, Uemmueguelsuem Dinc, Katrin Herder, Julia Walendzik, Matthias Schuetzwohl, Thomas Becker and Reinhold Kilian
Int. J. Environ. Res. Public Health 2022, 19(11), 6814; https://doi.org/10.3390/ijerph19116814 - 2 Jun 2022
Cited by 2 | Viewed by 3174
Abstract
The network for mental health (NWpG = Netzwerk psychische Gesundheit) is an umbrella association for non-medical community mental health care facilities across Germany which are enabled to provide multi-professional mental health care packages including medical and psychosocial services reimbursed by German statutory health [...] Read more.
The network for mental health (NWpG = Netzwerk psychische Gesundheit) is an umbrella association for non-medical community mental health care facilities across Germany which are enabled to provide multi-professional mental health care packages including medical and psychosocial services reimbursed by German statutory health insurances since 2009. The aim of this study is to analyse the cost-effectiveness of providing NWpG mental health care packages plus treatment as usual (NWpG) to treatment as usual alone (TAU) in Germany. In a prospective, multicenter, controlled trial over 18 months, a total of 511 patients (NWpG = 251; TAU = 260) were observed in five regions, four times at six-month intervals. The EQ-5D-3L and the Client Sociodemographic and Service Receipt Inventory (CSSRI) were used to estimate quality-adjusted life-years and total costs of illness. Propensity score-adjusted cost–utility analysis was applied using the net benefit approach. No significant differences in costs and QALYs between NWpG and TAU groups were identified. The probability of NWpG being cost-effective compared to TAU was estimated below 75% for maximum willingness to pay (MWTP) values between 0 and 125,000 EUR. The additional provision of the NWpG package is not cost-effective compared to TAU alone. Full article
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