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This chapter analyzes political engagement. I find that people with anti as opposed to pro-immigration attitudes are more likely to prioritize their immigration preferences when evaluating candidates with different policy proposals. In addition, people with anti as opposed to pro-immigration attitudes are more likely to support politicians who agree with them on immigration but violate democratic norms. This suggests that the electoral agenda may continue to favor opponents of immigration. However, I argue that the dynamics are not inherent to anything about pro- and anti-immigration attitudes, and could shift overtime. I focus on the importance of status quo evaluations and preference extremity. I claim that the early twenty-first century status quo is particularly threatening to the anti-immigration side, but dynamics could shift overtime. This emphasizes moving beyond the cosmopolitan worldview to understand the nuances of how people with pro-immigration attitudes engage in politics.
Understanding prescription trends and costs of psychotropic drugs is essential to inform mental healthcare policy and practice. However, comprehensive national evidence across psychotropic drug classes is limited, and little is known on how prescription volumes changed during the COVID-19 pandemic.
Aims
We examined prescription trends and costs of psychotropic drugs in the UK and assessed changes in prescription volumes following the onset of the COVID-19 pandemic.
Method
We analysed national Prescription Cost Analysis data from 2013 to 2023, for six major psychotropic drug classes. Annual prescription volumes, total costs and average costs per drug were estimated. Linear regression was used to assess temporal trends and changes in prescription volume during the pandemic years. Costs were adjusted for inflation to 2023 prices.
Results
Between 2013 and 2023, psychotropic prescriptions grew 4% (95% CI 3.9–4.2) annually. Prescriptions for antidepressants, antipsychotics, stimulants and anti-dementia drugs increased, but not for hypnotics and anxiolytics and drugs used in substance dependence. In contrast, total costs declined by approximately £328 million, and the average cost per drug dropped from £11 to £5.9. Prescription volume remained unchanged during the pandemic years, except for anti-dementia medications, which showed an annual reduction of 17.2% (95% CI 7.8–26.6) relative to the underlying temporal trend during the study period.
Conclusions
Our observed rising prescription trend is consistent with global evidence on availability and use of psychotropic drugs. Furthermore, we found a decrease both in total drug costs and average costs per drug.
According to expectancy theory, people eat food that they expect will bring positive emotions. The present research aimed to identify food and non-alcoholic beverages UK adults most expected to bring positive emotions; test influences of high fat, salt and/or sugar (HFSS) and branding on expectancies; and investigate associations of expectancies with diet quality and comfort eating (i.e. eating induced by negative emotions). A representative sample of UK adults (n 1203; Mage = 47 years; 52 % women; 87 % white) viewed food and non-alcoholic beverage images and completed the Anticipated Effects of Food Scale-Brief, a food frequency questionnaire, and questions about comfort eating and sociodemographic background. We ranked means of positive expectancies, conducted multilevel modelling to test influences of HFSS and branding on expectancies and examined correlations among expectancies, diet quality and comfort eating. Participants more strongly expected eating branded HFSS (e.g. Cadbury Twirl chocolate) v. generic non-HFSS (e.g. prawn curry) would result in positive emotions [b = 0·10, se = 0·04, p = ·02, 95 % CI (0·02, 0·18)]. Greater positive expectancies for HFSS – branded and generic – were associated with worse diet quality, especially positive expectancies for ice cream sundaes, fizzy drinks and chocolate (rs = –0·14 to −0·19, ps < ·001). Greater positive expectancies for HFSS and negative expectancies for HFSS and non-HFSS were associated with more frequent comfort eating (rs = 0·08 to 0·30, ps < ·05). Targeting positive HFSS expectancies through food environment policy and behavioural programmes may be a promising strategy for improving diet quality and reducing comfort eating in the UK adult population. Adults who comfort eat may also benefit from challenging negative expectancies for all foods.
Engaging with International Political Economy scholarship on crisis, this article emphasises the need for a social reproduction approach that recognises the socially necessary labour that sustains life within conditions of everyday crisis. We set out a context-sensitive understanding of crisis, attentive to place-based struggles, and long-standing gendered, class, and racialised inequalities – an approach that chimes with calls for greater pluralism and engagement with diverse contexts in the development of social reproduction theorising. Our argument is illustrated through two cases: one from post-war Sri Lanka and the other from the UK during the COVID-19 pandemic. Seemingly distinct, these cases enable reflection on the development of social reproduction approaches grounded in the everyday spaces of both Global South and Global North. We suggest that there is something particularly productive in holding these geographies together in a discussion of crisis. Together, our cases demonstrate how crisis is entangled with the ongoing undermining of social reproduction. At the same time, the comparison keeps in view the multiscalar nature of crisis, showing how crises of social reproduction take shape through wider processes of state restructuring, colonial legacies, and geopolitics, while also recognising the forms of agency exercised in everyday efforts to sustain life.
This chapter explores the landscape of global AI regulation, and how these emerging technologies are being defined and conceptualised. It offers a comparative analysis across four major legislative orders, namely the European Union, the UK, China, and the USA. Each of these is adopting distinct frameworks for regulating AI, shaped by diverse ideological and normative attitudes towards human rights, innovation, and the preservation of state power. The chapter explores the legal and socio-ethical implications of governing AI, especially how differing stances on transparency and risk are set to influence its international development. Building upon current governance approaches to AI, this chapter draws on insights from interviews and focus groups with Law Enforcement Agency (LEA) experts to address the use of AI-powered solutions in law enforcement and the operational and societal challenges that they present; focusing on the impact and use value of advanced data processing and data analysis technologies for daily investigative work. Overall, the chapter contributes to a nuanced understanding of the multifaceted dimensions surrounding AI governance and its impact on law enforcement practices internationally.
Malaysia is a rapidly ageing country. Relative to the United Kingdom, its social protection systems are underdeveloped. What is more, its political structure and social practices are different from those of the United Kingdom. Accordingly, the political economy of ageing seems to suggest a stark contrast when the two countries are considered alongside one another. Nevertheless, when programmes concerning income for the retired and the provision of care services for the frail elderly are considered, there are more similarities than might have been expected. Both countries face problems with inadequate pension coverage, and the paper considers how more of the self-employed might be brought into savings plans. In both countries, there is debate on whether pension savings should be directed towards investments in the domestic economy. Both countries face a rapid increase in the number of the ‘oldest old’—those most likely to need support, and policymakers are asking themselves how provision for these people should be improved. This article points out how fiscal constraints have led policymakers in the United Kingdom as well as in Malaysia to encourage the family to increase the part they can play. But in both countries, family members, especially women, are no longer willing, or even able, to carry out ‘traditional’ roles. There are lessons to be learnt in both directions. Moreover, in both countries, more attention should be devoted to understanding and explaining the economic and societal consequences of demographic change.
The COVID-19 pandemic disrupted healthcare delivery and coincided with increased psychological distress worldwide. In the UK, restrictions on healthcare access, rapid adoption of remote consultations and pressures on mental health services may have influenced prescribing of psychotropic medications. However, evidence comparing prescribing trends across the four UK nations during the pandemic remains limited.
Aims
To examine trends in community prescribing of psychotropic medicines across England, Scotland, Wales and Northern Ireland before and during the COVID-19 pandemic.
Method
We conducted a repeated cross-sectional study of national Prescription Cost Analysis data-sets covering March 2019 to March 2023. Monthly utilisation of antidepressants, anxiolytics/hypnotics, antipsychotics and antidementia medicines was measured, using two indicators: number of items dispensed per 1000 inhabitants and defined daily doses per 1000 inhabitants per day. Interrupted time-series regression was applied to assess changes in prescribing levels and trends associated with the first (March 2020) and second (November 2020) UK national lockdowns.
Results
Psychotropic prescribing increased across most medicine classes during the study period. Antidepressant utilisation increased by 24.6% across the UK, representing the largest rise among psychotropic medicines. Antipsychotic prescribing increased by 2.7%; anxiolytic/hypnotic prescribing showed modest overall change (2.7%), but this varied between nations, increasing in Scotland (7.3%) and Northern Ireland (7.4%), and declining in Wales (−9.5%). Antidementia medicines increased modestly overall (9.3%), with variation between countries. Interrupted time-series analyses indicated that most changes occurred gradually rather than abrupt shifts following lockdowns.
Conclusions
Psychotropic prescribing increased during the COVID-19 period, but largely reflected continuation of pre-existing trends rather than immediate effects of lockdown restrictions.
Chapter 5 looks at the CBDC controversies in the UK, the US and Sweden.
In the UK there was a high-level discussion centred around a very critical House of Lords Report into the Bank of England’s CBDC proposals. There were also a large and critical public response to a joint Bank of England-HM Treasury ‘consultation’ on the subject. A memorable phrase from these discussions was that a CBDC was a solution in search of a problem.
In the US the Fed’s CBDC proposals ran into a whirlwind of opposition and sparked anti-CBDC bills in Congress. A number of senior Fed officials played an active role in public discussion of CBDCs, and almost all of them were critical of them. CBDCs were eventually prohibited by President Trump when he re-entered office in January 2025
Swedish discussions of CBDCs are interesting because of the way they highlight the connection between CBDCs and the prospect of a cashless economy. The Swedish case is also interesting because a report by Anna Kingberg-Batra in 2023 offered a blueprint for how cash payments could be protected as digital payments become ever more popular.
The chapter also offers a brief overview of CBDC initiatives at the world level – these are widespread but there are currently only five at the implementation level.
As an increasing number of psychiatrists complete training in the UK and move into post-qualification specialist practice in Canada, challenges can arise with adaptation and professional recognition. In this reflection, we examine our experiences over the past 5 years working in and delivering undergraduate and postgraduate medical education in Canada. Patients recognise the unique value of UK psychiatry training; however, this training can also present challenges. We explore some of these issues across the domains of undergraduate medical education, postgraduate psychiatry education and post-qualification specialist practice, using a comparative narrative.
The ongoing revolution in the field of genome editing (GE) has ignited intense debate around new genomic techniques (NGTs) in Europe. Their societal and ecological implications underscore their critical importance. However, the development and implementation of NGTs present significant challenges from a democratic perspective. Amid calls for democratizing NGTs governance, democratic innovations have been proposed as potential solutions. This paper investigates the efficacy of democratic innovations in democratizing NGT governance within the European context. Employing an assemblage democracy approach, we conduct an in-depth analysis of online documents and activities related to two important public engagement processes addressing NGTs in France and the United Kingdom. Our findings reveal context-specific challenges in each country and propose potential remedies to enhance democratization efforts. This research contributes to the ongoing debate on science governance and participatory democracy in Europe, offering insights for scholars engaged in the intersection of emerging technologies and democratic processes.
This chapter shifts attention to the indirect effects of international litigation, specifically, how grassroots mobilization can be shaped in the shadow of official law. It examines the case of the Blacklist Support Group (BSG), a network of construction workers in UK who were blacklisted for their union activism. Even without favorable rulings from the ECtHR, BSG activists used the litigation process to amplify their claims, attract media attention, and apply political pressure. The chapter introduces the concept of “on-stage” and “off-stage” mobilization to describe how workers adopted an instrumental approach to human rights, invoking them in public campaigns while continuing to ground their internal discourse and solidarity ties in class-based themes. Drawing on interviews, participant observation, media coverage, and parliamentary debates, the chapter shows how BSG’s strategic mobilization of human rights yielded concrete victories – including major settlements, exclusion of blacklisting firms from public contracts, and formal investigations into police surveillance – that reshaped the political terrain for labor activism.
This article critically appraises the UK Labour government’s early approach to parental leave reform following the 2024 election, comparing pre-election promises with post-election policy directions. Drawing on Daly’s conceptualisation of care as a policy good (Daly, 2002), we analyse Labour’s reforms across three overlapping dimensions central to their pre-election pledges: access and pay levels, leave design and entitlements, and inclusion of diverse families. We argue that Labour’s current approach adheres to liberal welfare principles, with market-oriented reforms prioritising economic productivity over care provision, perpetuating implicit maternalism while systematically excluding working-class, minority ethnic, and self and precariously employed families. In contrast, care-centred approaches pioneered elsewhere in Europe demonstrate that gender equality, social inclusion, and economic productivity are mutually reinforcing rather than competing objectives. Echoing calls from the Women and Equalities Committee for transformative change, we argue that Labour’s incremental approach cannot achieve reforms that work for parents or the economy without embracing care-centred policies.
Recent decades have seen a steady increase in antidepressant prescribing, but little is known about prescribing trends during and following the COVID-19 pandemic.
Aims
This preregistered systematic review, following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, aimed to investigate antidepressant prescribing trends for adults in the UK and Republic of Ireland during and after the pandemic. It also compared prescriptions by drug and location.
Method
We searched six databases: APA PsycInfo, CINAHL, MEDLINE, Scopus, medRxiv and Preprints.org. The review included primary research articles reporting trends in antidepressant prescriptions, including at least one time point after March 2020 in the UK and Republic of Ireland. This review has been preregistered on PROSPERO (ID: CRD42024498503).
Results
We identified 7,320 studies, of which ten met the search criteria for the review. Studies were grouped on the basis of time period (2020: n = 5; 2021: n = 3; 2022: n = 2), location (England, Scotland, Northern Ireland, Republic of Ireland, UK) and drug type (serotonin–noradrenaline reuptake inhibitors, selective serotonin reuptake inhibitors, tricyclics, and others (e.g. monoamine oxidase inhibitors)). Most studies (eight of ten) demonstrated increased antidepressant prescribing over time. Two studies highlighted a decrease between March and May 2020. Demographic variables reflected higher rates of prescribing for women, and the modal group receiving antidepressants comprised middle-aged adults.
Conclusions
The commonly reported increase in antidepressant prescribing corroborates pre-pandemic trends and may suggest further, increased demands for mental health support to meet the unique challenges of the pandemic. Future research is required to evaluate the appropriateness of treatment decisions and to explore psychosocial factors that influence individual prescribing choices.
Lameness remains an ongoing challenge to the health and welfare of UK sheep flocks. Whilst effective recommended practice exists in the UK in the form of the five-point plan (5PP), it is not always used or used effectively, particularly in relation to culling. A more in-depth understanding of farmer lameness management behaviours and decision-making is crucial for driving positive change. Behaviour change frameworks offer useful tools to do this, specifically the Behaviour Change Wheel and its central tenets of capability, opportunity and motivation (COM-B). This research sought to explore on-farm management practices surrounding lameness, particularly focused on the 5PP and culling in relation to COM-B. Findings are drawn from five online focus groups with UK farmers (n = 19) and one with veterinarians (n = 4). Thematic analysis led to the identification of themes in relation to the role of capability, opportunity and motivation to enact the steps of the 5PP, particularly culling. Culling, alongside prompt treatment, were the only tools used by all participants. Yet, culling practices did not always follow recommended advice. Factors that influenced behaviours included those self-controlled by farmers, e.g. records kept; outside of their control, e.g. space available, and those controlled by other actors, such as market prices. Considerations of the individual farm and the wider UK sheep sector context were important. Findings suggest a need for interventions aimed at encouraging good record-keeping, collective industry action against lameness and opportunities for vet-farmer interactions. These should be pursued together to achieve the goal of reducing lameness and subsequently improving sheep welfare.
In 2024, the Women and Equalities Select Committee in the UK Parliament published a report entitled Misogyny in Music. It included the recommendations that ‘music colleges, conservatoires and other educational settings need to do more to address the gendering of instruments, roles and genres and improve the visibility of and support for female role models’. While there is a dearth of policy levers available to implement this recommendation, this article critically analyses three existing policy/regulatory frameworks that could be used for its implementation in England. The article also highlights a significant limitation of the report – its exclusion of trans and non-binary musicians.
In a time of polycrisis, internal contestation, and strained transatlantic relations, European identity is timelier and more relevant than ever. Do EU public policies operating in a multilevel governance system contribute to European identity-building, and what can jeopardise the process of identity formation at the level of policy elites? The article adopts a social constructivist and discursive approach and brings to the fore the lacking process of EU socialisation via discursive practices as a key reason leading to failed identity-building. Focusing on EU Cohesion Policy in Wales (UK), Crete (Greece), and Silesia (Poland), the analysis employs primary data and grey literature sources, along with 64 semistructured elite interviews, to show that, despite key differences among the three cases, Cohesion Policy has not contributed significantly to European identity-building among policy elites at different government levels and among the public. This is because the coordinative discourse about EU policies is dominated by ideas about economic goals and practical aspects of policy-making, while the respective communicative discourse is controlled by domestic political elites and the media and is ultimately determined by broader national/regional political cultures about the purpose and limitations of EU membership. Overall, the article contributes to the literature on European identity-building, EU socialisation, and discourse by arguing that the way EU public policies are designed, implemented, and communicated do not favour the achievement of political goals, such as the cultivation of a shared European identity.
A framing case study describes the 2018 surge of migrants attempting to cross the English Channel from continental Europe to the UK in small boats to seek refugee status. The chapter then discusses international migration law. The chapter begins by presenting important concepts and historical trends from migration law, and the competing models of economic migration and crisis migration. It then describes in detail major components of the Refugee Convention, which sets international rules for determining whether an individual can be a refugee, creates rights for refugees, and shapes subsequent outcomes for individuals who are denied or lose refugee status. Finally, the chapter examines how international migration law interacts with topics discussed earlier in the book, including: law of the sea, human rights, armed conflict, criminal law, and environmental law.
Charitable status is inherently linked in many jurisdictions with the requirement that an entity must be established for public benefit. But, until recently the public benefit principle had relatively little impact on the operations of most established charities. However, in England and Wales, reforms linked to the Charities Act 2006 led to a new requirement for public benefit reporting in the trustees’ annual report (TAR) of every registered charity. This new narrative reporting requirement had the potential to affect the understanding of accountability by charities. The paper investigates the impact of that requirement through a study of over 1,400 sets of charity reports and accounts and subsequent qualitative work with trustees and others involved in preparing TARs.
This article reviews recent non-statutory attempts at charity fundraising regulation in the UK and Ireland. It explores the definition of success for each regime and examines whether broader policy lessons for fundraising regulation may be learnt from these implementation experiences to date. To this end, the article compares the UK framework for fundraising regulation (via the Fundraising Standards Board) with recent Irish proposals for non-statutory regulation. It also identifies the key challenges facing each regime. The article draws upon current Canadian, Dutch and American regulatory experiences and benchmarks these alternative non-statutory efforts against the Anglo-Irish models by way of comparative analysis. The article tackles the broader question of how we measure success in regulatory terms and argues for better identification of the constituency to be regulated, thereby enabling prioritisation of the salient performance indicators that should be included in any non-statutory framework.