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The purpose of this paper is to evaluate the evidence on the extent to which personal debt impacts on mental health, and mental health on personal debt.

The paper systematically reviews the English‐language, peer‐reviewed literature, 1980‐2009, drawing on 14 databases across the medical, business, legal, and social science fields.

From 39,333 potential papers identified, 39,283 were excluded, and 50 were reviewed using a narrative analysis approach. Among nine longitudinal studies, three controlled for psychiatric morbidity or psychological wellbeing at baseline, income/wealth, and other socio‐economic variables. From these, two reported indebtedness or an increase in debt levels associated with subsequently poorer mental health, while one study found no such relationship. While methodological limitations make it difficult to definitively demonstrate whether indebtedness causes poorer mental health, plausible data exist which indicate that indebtedness may contribute to the development of mental health problems, and mediate accepted relationships between poverty, low income, and mental disorder.

Existing research either uses definitions of “debt” which lack specificity, or definitions of “mental health” which are too broad‐brushed. A more sensitive set of core questions is needed. Further longitudinal research is also a key priority.

Those working with people with debt problems need to be aware of the potential risk of reduced mental wellbeing or mental disorder.

The mental health of individuals living with indebtedness has become a recent concern for the health and financial services sectors. However, no systematic reviews have so far been conducted.

The aim of the project was to evaluate the short‐term treatment outcomes of patients treated in a medium secure service for people with intellectual disability. A total of 138 patients, 77 discharged and 61 current inpatients, treated over a six‐year period were included in the audit. Information on demographic and clinical variables was collected on a pre‐designed data collection tool and analysed using appropriate statistical methods. The median length of stay for the discharged group was 2.8 years. About 90% of this group were discharged to lower levels of security and about a third went directly to community placements. None of the clinical and forensic factors examined was significantly associated with length of stay for this group. There was a ‘difficult to discharge long‐stay’ group which had more patients with criminal sections, restriction orders, history of abuse, fire setting, personality disorders and substance misuse. However, when regression analysis was done, most of these factors were not predictive of the length of stay. Clinical diagnosis or offending behaviour categories are poor predictors of length of hospital stay, and there is a need to identify empirically derived patient clusters using a variety of clinical and forensic variables. Common datasets and multi‐centre audits are needed to drive this.

Delay in histologically confirming rectal cancer may lead to late treatment as histological confirmation is required prior to chemo-radiotherapy or surgical intervention. Multidisciplinary colorectal meetings indicate that there are patients who require multiple tissue biopsy episodes prior to histologically confirming rectal cancer. The purpose of this paper is to examine a quality improvement (QI) measure’s impact on tissue biopsy process diagnostic yield.

The authors performed the study in two phases (pre- and post-QI), between February 2012 and April 2014 in a district general hospital. The QI measures were derived from process mapping a rectal cancer diagnostic pathway. The primary outcome was to assess the tissue biopsy process diagnostic yield. The secondary outcome included total breaches for a 62-day target in the pre- and post-QI study phases.

There was no significant difference in demographics or referral mode in both study phases. There were 81 patients in the pre-QI phase compared to 38 in the post-QI phase, 68 per cent and 74 per cent were referred via the two-week wait urgent pathway, respectively. Diagnostic tissue biopsy process yield improved from 58.1 to 77.6 per cent after implementing the QI measure (p=0.02). The 62-day target breach was reduced from 14.8 to 3.5 per cent (p=0.42).

Simple QI measures can achieve significant improvements in rectal cancer diagnostic tissue biopsy process yields. A multidisciplinary approach, involving process mapping and cause and effect modelling, proved useful tools.

A process mapping exercise and QI measures resulted in significant improvements in diagnostic yield, reducing the episodes per patient before histological diagnosis was confirmed.

The purpose of this paper is to understand better the formation of an industry and the movement toward agglomeration by examining the development of the furniture manufacturing industry of Western North Carolina and Virginia.

In this general review, the initiation and growth of the furniture industry is traced, applying the theory of agglomeration and noting isomorphic tendencies and the primacy of the search for legitimacy among constituents.

The paper finds first of all, the pioneering efforts of Thomas Wrenn in High Point brought the industry to the region. An initial wave of furniture manufacturers followed closely behind Wrenn as the industry gained legitimacy and status in North Carolina. Important elements in building the industry included the establishment of the Southern Furniture Manufacturers Association and the Southern Furniture Market in High Point. A second wave of furniture producers arrived on the scene after the First World War. This group benefited from cooperative actions of the survivors of the first wave and brought the Western North Carolina and Virginia area to the forefront of the furniture manufacturing industry in the USA. Finally, the paper comments on the current state of the industry in relation to the threat of foreign competition.

The furniture industry is not alone in the need to understand the impact of globalization. Practitioners and researchers alike should be aware of the costs to stakeholder groups, such as employees and local communities.

Describes a wellness programme among 260 employees at Cadbury Trebor Bassett who were charged with implementing a global information‐technology project to a strict deadline.

Provides the viewpoints of the company, the expert charged with introducing the programme, and a number of the participants.

Reveals that sickness absence fell significantly and productivity rose sharply among the employees involved. Moreover, key health measurements taken before and after the programme revealed important improvements in all areas.

Argues that employees can find it reassuring that, at a time when they are working under pressure, their company is monitoring their health and investing in their well‐being.

Demonstrates that teams and individuals can perform beyond expectations, and even improve their health in high‐performance conditions, if they are empowered to take charge of their health.

This chapter explores the role of diversity in the emergence of circular business models by focusing on circular economy innovative born-global start-ups. Diversity refers to a wide range of characteristics that differentiate an individual or group. These include legally protected and/or demographic characteristics, such as age, as well as identity-shaping characteristics, such as cognitive traits and experience. Diversity in organizations has been mostly explored in terms of the former, i.e., culture, age or ethnicity as a key factor in organizational innovation and enhanced performance. This chapter offers a more holistic view on the role of diversity in relation to emerging circular business models. It shows how diversity of previous knowledge, experience, ethnicity and the shared ideation of the organization's founders can be used as compatible and complementary inputs, which can lead to the emergence of a global circular business model by using integration, coordination and fast scaling up. The analysis is on the level of firm micro-foundations. Using data from three circular born-global companies from a single country context, the study identifies different types of diversity as contributing to the emergence of these business model and their configuration. We conclude that circular born-global business models are nurtured by the shared ideation and values of the business model founders, while the design of the business model is enabled by the diversity of competences and capabilities stemming from the founders' knowledge, past experience and diaspora networks. Such a perspective suggests that managers need to adopt a holistic approach in employing diversity in business model configuration in relation to common drivers and ideation, and organizational purpose.

Since the birth of this country, Americans have had a love affair with ice cream. Statistics show that United States residents consume more ice cream per capita than residents of any other country in the world. In recent years, with the advent of what are called “designer” ice creams such as Haagen Dazs, Bassetts, and Carvel, the population's passion for this dessert has increased even more. However, it is this author's strong belief that we spend much more time eating the stuff than writing about it. Some cookbooks are available, but not one periodical is devoted exclusively to ice cream, and the majority of articles in general interest magazines focus only on the competition for a share of the market among manufacturers of premium ice cream. There are two classic textbooks in the field, and they devote a good deal of print to examining and explaining the composition, butterfat content, percentage of air, and other qualities of ice cream. Obviously, it is much more fun just to sit down and enjoy a big bowl of vanilla, America's favorite flavor, and let someone else write about it.

Interviews Paul Jackson, chairman of Media Smart, which is a UK media literacy programme founded in 2002 and focusing on advertising; it is aimed at schoolchildren aged six to 11, is funded by the media industry and supported by Ofcom, the UK government and the European Commission. Introduces the Responsible Advertising and Children group, which Jackson also chairs and which represents European advertisers, agencies and media; it believes that media literacy for children is more effective than outright advertising bans. Outlines the Media Smart programme, which consists of three modules with materials and a DVD, and includes an introduction to advertising, commercial advertisements aimed at children, and non‐commercial advertising; perhaps the most interesting section is on controversies. Notes Jackson’s intention that Media Smart stay focused on advertising, rather than widening its scope in the way that Concerned Children’s Advertisers has done in Canada.

Since the development of the COVID-19 vaccinations, questions surrounding race have been prominent in the literature on vaccine uptake. Early in the vaccine rollout, public health officials were concerned with the relatively lower rates of uptake among certain racial/ethnic minority groups. We suggest that this may also be patterned by racial/ethnic residential segregation, which previous work has demonstrated to be an important factor for both health and access to health care.

In this study, we examine county-level vaccination rates, racial/ethnic composition, and residential segregation across the U.S. We compile data from several sources, including the American Community Survey (ACS) and Centers for Disease Control (CDC) measured at the county level.

We find that just looking at the associations between racial/ethnic composition and vaccination rates, both percent Black and percent White are significant and negative, meaning that higher percentages of these groups in a county are associated with lower vaccination rates, whereas the opposite is the case for percent Latino. When we factor in segregation, as measured by the index of dissimilarity, the patterns change somewhat. Dissimilarity itself was not significant in the models across all groups, but when interacted with race/ethnic composition, it moderates the association. For both percent Black and percent White, the interaction with the Black-White dissimilarity index is significant and negative, meaning that it deepens the negative association between composition and the vaccination rate.

The analysis is only limited to county-level measures of racial/ethnic composition and vaccination rates, so we are unable to see at the individual-level who is getting vaccinated.

We find that segregation moderates the association between racial/ethnic composition and vaccination rates, suggesting that local race relations in a county helps contextualize the compositional effects of race/ethnicity.