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  • Long-term clinical and cost-effectiveness of collaborative care (versus usual care) for people with mental–physical multimorbidity: cluster-randomised trial

  • Elizabeth M. Camacho, Linda M. Davies, Mark Hann, Nicola Small, Peter Bower, Carolyn Chew-Graham, Clare Baguely, Linda Gask, Chris M. Dickens, Karina Lovell, Waquas Waheed, Chris J. Gibbons, Peter Coventry
  • Journal:
    The British Journal of Psychiatry / Volume 213 / Issue 2 / August 2018
    Published online by Cambridge University Press:
    15 May 2018, pp. 456-463
    Print publication:
    August 2018
    • Article
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  • Background

    Collaborative care can support the treatment of depression in people with long-term conditions, but long-term benefits and costs are unknown.

    Aims

    To explore the long-term (24-month) effectiveness and cost-effectiveness of collaborative care in people with mental-physical multimorbidity.

    Method

    A cluster randomised trial compared collaborative care (integrated physical and mental healthcare) with usual care for depression alongside diabetes and/or coronary heart disease. Depression symptoms were measured by the symptom checklist-depression scale (SCL-D13). The economic evaluation was from the perspective of the English National Health Service.

    Results

    191 participants were allocated to collaborative care and 196 to usual care. At 24 months, the mean SCL-D13 score was 0.27 (95% CI, −0.48 to −0.06) lower in the collaborative care group alongside a gain of 0.14 (95% CI, 0.06-0.21) quality-adjusted life-years (QALYs). The cost per QALY gained was £13 069.

    Conclusions

    In the long term, collaborative care reduces depression and is potentially cost-effective at internationally accepted willingness-to-pay thresholds.

    Declaration of interest

    None.

  • Moral(ity and) Economy: Work, Workfare, and Fairness in Provincial Hungary

  • Chris Hann
  • Journal:
    European Journal of Sociology / Archives Européennes de Sociologie / Volume 59 / Issue 2 / August 2018
    Published online by Cambridge University Press:
    21 February 2018, pp. 225-254
    • Article
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  • The relationship between morality and economy has been muddied in the course of disciplinary specialization. While dominant paradigms in economics abstract from the moral dimension, recent approaches to morality and ethics in anthropology neglect the material economy. E. P. Thompson’s “moral economy” has been an influential bridging concept in recent decades, but recent inflationary usage has highlighted shortcomings. Following an overview of the disciplinary debates, the moral dimension of economic life is illustrated in this paper with reference to work as a value between the late 19th and early 21st centuries in Hungary. Contemporary workfare is explored with local examples. It is shown how discourses of work and fairness are being extended into new ethical registers to justify negative attitudes towards a new category of migrants.

  • Backwardness Revisited: Time, Space, and Civilization in Rural Eastern Europe

  • Chris Hann
  • Journal:
    Comparative Studies in Society and History / Volume 57 / Issue 4 / October 2015
    Published online by Cambridge University Press:
    05 October 2015, pp. 881-911

  • Anthropology, the relativizing countercurrent to Enlightenment notions of civilization and progress, has long challenged notions of backwardness. By contrast, Marxist-Leninist regimes had no doubts about the world-historical backwardness of the largely agrarian societies in which they came to power, which they sought to transform through rapid industrialization. According to some indicators, this socialist civilizing mission was rather successful. Yet memories are mixed, and complicated by the reappearance of typical features of backwardness in the postsocialist era. This article explores changing political economies and the spatiotemporal imaginaries of elites and villagers in Hungary. Historical and theoretical insight is drawn from Ferenc Erdei (1910–1971), a left-leaning populist whose analysis of rural Hungary has more general relevance. Case materials are presented from a region of the Great Plain that in the longue durée exemplifies the “development of underdevelopment” on the margins of Western capitalism. Civilizational transformations were instigated from the east in the socialist decades, but their vehicle was a collectivist ideology that remained alien. The politics and economics of time now render villagers susceptible to populist imaginaries entirely different from those of Erdei.

Market and Society
  • The Great Transformation Today
  • Edited by Chris Hann, Keith Hart
  • Published online:
    08 August 2009
    Print publication:
    14 May 2009
  • Karl Polanyi's 1944 book, The Great Transformation, offered a radical critique of how the market system has affected society and humanity since the industrial revolution. This volume brings together contributions from distinguished scholars in economic anthropology, sociology and political economy to consider Polanyi's theories in the light of circumstances today, when the relationship between market and society has again become a focus of intense political and scientific debate. It demonstrates the relevance of Polanyi's ideas to various theoretical traditions in the social sciences and provides perspectives on topics such as money, risk, work and the family. The case studies present materials from around the world, including Britain, China, India, Jamaica and Nigeria. Like Polanyi's original work, the critical engagement of these essays will be of interest to a wide readership.

  • 14 - Embedded socialism? Land, labor, and money in eastern Xinjiang

  • Edited by Chris Hann, Keith Hart, Goldsmiths, University of London
  • Book:
    Market and Society
    Published online:
    08 August 2009
    Print publication:
    14 May 2009, pp 256-271

  • Summary

    Introduction

    “Nineteenth century civilization has collapsed,” declares Karl Polanyi in the opening sentence of The Great Transformation. His ensuing analysis focuses on the emergence of the self-regulating market as a world-historical aberration, contrasting both with the great agrarian empires and with the non-literate societies studied by anthropologists. Yet the work remains full of ambiguity: did Polanyi mean the “self-regulating” as a realistic descriptor or did he mean the idea of such a market? It is in any case a very Eurocentric narrative. It is concerned in particular with Britain, where Polanyi conceived his study of “the political and economic origins of our time” in the late 1930s.

    “Our time” today is quite different. It is tempting now to proclaim the collapse of twentieth-century civilization, but this collapse demands a more complex explanation than the Polanyi prototype. Such an account would need to address, first, the attrition of that “embedded liberalism” (Harvey 2005a, following Ruggie 1982) which came to characterize the advanced capitalist countries in the decades after Polanyi's dramatic indictment of pre-welfare state “disembedding.” As Keith Hart and I point out in our Introduction to this volume, this metaphor has been a continuous source of confusion. I distinguish here between general moral embedding and political embedding. Polanyi shows in his magnum opus that the conditions for the catastrophic existential moral and social disruption of human communities in industrial communities were the work of the capitalist state.

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