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The purpose of this paper is to examine the decision to contract school meal services and the associated nutritional and financial impacts on school districts. Given the increase in the use of competitive contracting of public school meal services and the critical role that school meal services play in public health, this is an important subject to investigate.

A case study was performed using one US school district with privatized food service. Face-to-face interviews were conducted with school food service decision makers. Other data collection included the analysis of public documents such as the school district’s budgets and financial statement reports (the cost per lunch and breakfast meals, the cost for labor, contract, transport, supplies and food expenses) and school food service policies (contract policies). Supplementary data pertaining to district social-demographic profiles and full-time equivalent enrollment figures were also collected from state departments.

Analysis of interviews revealed that positive financial motivations and impacts were dominant factors related to contracting food services in the district. A significant finding was the relatively short turnaround in the district’s negative financial situation as a result of contracting out the food services. These findings provide valuable insight and support for rural school districts in similar negative financial situations seeking to contract out food services.

Many studies have examined contracting out of technical services, such as transport and waste management, and social services, such as correctional services and health; however, there is a lack of studies documenting the effects of contracting out of school meal services.

Routine general practice (GP) care is rarely comprehensively described in clinical trials. This paper examines routine GP care within the lifestyle approach to managing panic (LAMP) study. The aim of this paper is to describe/discuss routine GP care for panic disorder (PD) patients within both study arms in the LAMP study. An unblinded pragmatic randomised controlled trial in 15 East of England GP practices (2 primary care trusts). Participants met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PD with/without agoraphobia. Follow-up measures recorded at 20 weeks/10 months following randomisation. Control arm, unrestricted routine GP care (practice appointments, referrals and prescriptions). Trial arm, occupational therapy-led lifestyle treatment comprising lifestyle review of fluid intake, diet pattern, exercise, caffeine, alcohol and nicotine. Primary outcome measure: beck anxiety inventory. At baseline, participants attended 2-3 times more GP appointments than population average, reducing at 10 months to 1.6 times population average for routine GP care and 0.97 population average for lifestyle arm. At 10 months, 33% fewer referrals (6 referrals; 0 mental health) than at baseline (9 referrals; 2 mental health) were made for lifestyle arm patients compared with 42% increase (from 12 referrals; 8 mental health at baseline to 17 referrals; 7 mental health) in GP care arm. Selective serotonin reuptake inhibitors were prescribed most often. Benzodiazepines and beta-blockers were prescribed more often than tricyclic against current clinical guidelines. In conclusion, we found that PD patients at baseline were high healthcare resource users. Treatment in both study arms reduced resource use. Routine GP care requires further review for this patient group.

The purpose of this paper is to assert the link between the process of EU accession, the consolidation of democratic processes and the improvement of economic and tourism infrastructure to incoming tourism flows.

The methodology of this paper involves explanation of an analysis exploring links between governmental systems and the order necessary for economic development and tourism. The argument is supported by the recent history of tourism development in three countries, two within the EU and one outside.

Accession to the EU (especially in the case of Eastern European countries) constitutes a way to emulate the democratic freedoms and greater economic prosperity of existing EU member states. Tourism is one of the areas of economy that benefits from the stability and growth EU membership can bring. Accession to the EU has had beneficial effects for acceding in terms of political stability and tourism growth.

The opportunities that EU membership can bring to tourism development for example (also strategies to exploit these opportunities) depend to a large degree on the international relations between the EU and its rivals. The extent to which tourism demands ebb and flow is governed by a range of factors, but the issues of conflict and security are game breakers. Understanding the factors and trends involved in the peaceful resolution of conflict (democratic model) or use of force to resolve conflict (military model) is key in the analysis of future tourism opportunities.

Following the rapid shift to online learning due to COVID-19, this paper aims to compare the relative efficacy of face-to-face and online university teaching methods.

A scoping review was conducted to examine the learning outcomes within and between online and face-to-face (F2F) university teaching programmes.

Although previous research has supported a “no significant difference” position, the review of 91 comparative studies during 2000–2020 identified 37 (41%) which found online teaching was associated with better learning outcomes, 17 (18%) which favoured F2F and 37 (41%) reporting no significant difference. Purpose-developed online content which supports “student-led” enquiry and cognitive challenge were cited as factors supporting better learning outcomes.

This study adopts a pre-defined methodology in reviewing literature which ensures rigour in identifying relevant studies. The large sample of studies (n = 91) supported the comparison of discrete learning modes although high variability in key concepts and outcome variables made it difficult to directly compare some studies. A lack of methodological rigour was observed in some studies.

As a result of COVID-19, online university teaching has become the “new normal” but also re-focussed questions regarding its efficacy. The weight of evidence from this review is that online learning is at least as effective and often better than, F2F modalities in supporting learning outcomes, albeit these differences are often modest. The findings raise questions about the presumed benefits of F2F learning and complicate the case for a return to physical classrooms during the pandemic and beyond.