We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Drawing on over four decades of research and writing on the political economy of the UK and United States, David Coates offers a masterly account of the Anglo-American condition and the social and economic crisis besetting both countries.
Charting the rise and fall of the social settlements that have shaped and defined the postwar years, Coates traces the history of the two economies through their New Deal and then their Reaganite periods - ones labelled differently in the UK, but similarly marked by the development of a Keynesian welfare state and then a Thatcherite neoliberal one.
Coates exposes the failings and shortcomings of the Reagan/Thatcher years, showing how the underlying fragility of a settlement based on the weakening of organized labour and the extensive deregulation of business culminated in the financial crisis of 2008.
The legacies of that crisis haunt us still - a squeezed middle class, further embedded poverty, deepened racial divisions, an adverse work-life balance for two-income families, and a growing crisis of housing and employment for the young. Flawed Capitalism deals with each in turn, and makes the case for the creation of a new transatlantic social settlement - a less flawed capitalism - one based on greater degrees of income equality and social justice.
As members of the millennial generation come to their maturity on each side of the Atlantic, Flawed Capitalism offers the critical intellectual tools that they will need if they are ever to break decisively with the failed public policies of the past.
What is the future for progressive politics in advanced capitalism? With its political fortunes so low, how might the Left move forward?
These essays from leading left intellectuals - Dean Baker, Fred Block, David Coates, Hilary Wainwright, Colin Crouch, Wolfgang Streeck, Leo Panitch, Sam Gindin and Matthew Watson - reflect on the scale and nature of the task that the Left now faces and consider the following questions: (1) What in modern capitalism has brought the Left to this impasse?; (2) What role has the Left played in its own failings?; (3) What lessons can be learnt for progressive politics going forward?; and (4) What are the immediate options and how can they best be pursued?
The views and opinions expressed vary, but all offer searching insights into the task the Left now faces. All point to the intellectual and practical experience on which the Left now needs to draw as it deals with its contemporary challenges. These essays represent a major statement on the future for centre-left politics and offer a frank appraisal of the Left's current capacity to keep conservatism at bay and to strengthen radical politics again.
Assessing the cost utility of health technologies for pediatric patients requires robust utility values for child health states, but the methods for valuing these pediatric health states are much less established than those for valuing adult health states. This is partly because the elicitation of preferences for child health states poses many normative, ethical, and practical challenges.
Methods
This presentation examines the conceptual issues in the valuation of health states in children by addressing the following questions.
(i) Normative theories of health state values: What are we attempting to elicit?
(ii) Sources of preferences: Whose preferences should we elicit, and from which perspective?
(iii) Valuation methodologies: How should we elicit preferences?
(iv) Attaching different values to child and adult health: Is a lack of consistency problematic?
To answer these questions, we used desk research (non-systematic literature reviews) and findings from a two-part workshop held in April 2021. The workshop included 25 participants with expertise in health economics, health state valuation, child health, health technology assessment (HTA) decision-making, and ethics.
Results
We identified a lack of consensus on what is being elicited for both adults and children. Many HTA agencies recommend that the public be involved in utility generation exercises, but some criteria for defining who constitutes a member of the public exclude children. Of the many candidate sample types, perspectives, and methodologies, only a few were deemed relevant, acceptable, and feasible for use in the child health context. In addition, there were diverging views on whether it is possible to compare and integrate adult and child value sets with different properties.
Conclusions
Several questions remain to be answered before the public and other stakeholders can have confidence in child health state valuation protocols. We propose a research agenda, including both empirical and conceptual work, to inform future methodological development and to help HTA agencies make recommendations about how child utility values should be generated.
Effective nutrition policies require timely, accurate individual dietary consumption data; collection of such information has been hampered by cost and complexity of dietary surveys and lag in producing results. The objective of this work was to assess accuracy and cost-effectiveness of a streamlined, tablet-based dietary data collection platform for 24-hour individual dietary recalls (24HR) administered using INDDEX24 platform v. a pen-and-paper interview(PAPI) questionnaire, with weighed food record (WFR) as a benchmark. This cross-sectional comparative study included women 18–49 years old from rural Burkina Faso (n 116 INDDEX24; n 115 PAPI). A WFR was conducted; the following day, a 24HR was administered by different interviewers. Food consumption data were converted into nutrient intakes. Validity of 24HR estimates of nutrient and food group consumption was based on comparison with WFR using equivalence tests (group level) and percentages of participants within ranges of percentage error (individual level). Both modalities performed comparably estimating consumption of macro- and micronutrients, food groups and quantities (modalities’ divergence from WFR not significantly different). Accuracy of both modalities was acceptable (equivalence to WFR significant at P < 0·05) at group level for macronutrients, less so for micronutrients and individual-level consumption (percentage within ±20 % for WFR, 17–45 % for macronutrients, 5–17 % for micronutrients). INDDEX24 was more cost-effective than PAPI based on superior accuracy of a composite nutrient intake measure (but not gram amount or item count) due to lower time and personnel costs. INDDEX24 for 24HR dietary surveys linked to dietary reference data shows comparable accuracy to PAPI at lower cost.
This study provides a morphological and phylogenetic characterization of two novel species of the order Haplosporida (Haplosporidium carcini n. sp., and H. cranc n. sp.) infecting the common shore crab Carcinus maenas collected at one location in Swansea Bay, South Wales, UK. Both parasites were observed in the haemolymph, gills and hepatopancreas. The prevalence of clinical infections (i.e. parasites seen directly in fresh haemolymph preparations) was low, at ~1%, whereas subclinical levels, detected by polymerase chain reaction, were slightly higher at ~2%. Although no spores were found in any of the infected crabs examined histologically (n = 334), the morphology of monokaryotic and dikaryotic unicellular stages of the parasites enabled differentiation between the two new species. Phylogenetic analyses of the new species based on the small subunit (SSU) rDNA gene placed H. cranc in a clade of otherwise uncharacterized environmental sequences from marine samples, and H. carcini in a clade with other crustacean-associated lineages.
Most reports on the outcome of children who present with heart failure, due to heart muscle disease, are from an era when ventricular assist devices were not available. This study provides outcome data for the current era where prolonged circulatory support can be considered for most children.
Methods & Results:
Data was retrieved on 100 consecutive children, who presented between 2010 – 2016, with a first diagnosis of unexplained heart failure. Hospital outcome was classified as either death, transplantation, recovery of function or persistent heart failure. Median age at presentation was 24 months and 58% were < 5 years old. Hospital mortality was 12% and 59% received a heart transplant. Most, 79%, of the transplants were carried out on patients with a device. Recovery of function was observed in 18% and 10% stabilised on oral therapy. Eighty-four percent of the deaths occurred in the <5 year old group. Shorter duration of support was associated with survival (34 days in survivors versus 106 in non-survivors, p = 0.01) and 72% were on an assist device at time of death.
Conclusion:
Heart failure in children who require referral to a transplant unit is a serious illness with a high chance of either transplantation or death. Modifications in assist devices will be required to improve safety, especially for children < 5 years old where the donor wait may be prolonged. The identification of children who may recover function requires further study.
Anecdotal reports suggest that children and young adults with CHD frequently experience pain in their legs. The purpose of this pilot study, performed by Little Hearts Matter patient organisation, was to assess the burden of leg pains in this group and begin to investigate associated factors and consequences for daily living.
Methods
An internet-based survey was distributed by Little Hearts Matter patient organisation. After anonymisation and collation, responses were analysed and compared with their healthy siblings.
Results
Of the 220 patients who responded, 94% reported leg pains compared with 30% of siblings (n=107; p<0.001). In respondents, pain was typically reported to occur in the lower legs or around the knees or ankles, often associated with crying and screaming (49.0%) and most commonly occurring at night-time (82.0%). Individuals taking aspirin and those who were more active were more likely to report leg pains. Older age was associated with leg pain that occurred with stress (p=0.02) and at night (p=0.05). Analgesia (64.1%) or massage (53.9%) was the preferred option for alleviation. There was no gender bias, association with diagnosis, surgical history, and/ or relationship with diagnosed orthopaedic issues.
Conclusion
Leg pains are more frequent in those with CHD compared with their healthy siblings. Aetiology is uncertain, but pains share many common characteristics with benign “growing pains”.
“Every gun that is made, every warship launched, every rocket fired, signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed.”
Dwight D. Eisenhower
“My Lord, you can do anything you like with bayonets, except sit on them.”
Talleyrand
You might be forgiven for thinking that, with this degree of economic difficulty and social distress all around them, the full attention of the political class in both the United States and the United Kingdom would be focused on these two features of life alone. But, of course, the full attention of those who govern us is not so singularly focused, because in each case those in power in Washington, DC and in London do more than govern internally. They also move around the world stage as important and intrusive players. They each supervise economies, one major export of which are armaments sold to governments and individuals abroad;* and they each rely on societies, part of whose stability is underwritten by both the legacies and the contemporary practice of empire. There is an external dimension to the flaws of contemporary capitalism in both the UK and the US. We therefore need both to understand the linkage between external role and internal weakness in each case, and to see that – in consequence – going beyond the internal flaws of each economy and society will require, as one element of reform, a major resetting of those external roles.
The most immediate costs of empire are most visible in the empire which is most immediate: namely the American one. The British empire is now very much a thing of the past, and the British like to think of themselves as fully post-imperial. But to the degree that they do, they partially delude themselves: because the economy and the society of the contemporary UK continues to be shaped by the legacies of an empire now gone. Those longer and more subtle costs of empire await America down the line; which is why here it makes sense to focus on the immediate costs of empire through American data and the longer consequences of empire through British data.
“People are fed up. They are fed up with not being able to get somewhere to live, they are fed up with waiting for hospital appointments, they are fed up with zero-hour contracts, they are fed up with low pay, they are fed up with debt, they are fed up with not being able to get on with their lives because of a system that’s rigged against them.”
Jeremy Corbyn
“My generation has not served its children well”.
Will Hutton
Modern economies can be very similar in their basic principles of organization and in their associated strengths and weaknesses, and still sustain very different kinds of societies. Economies have their logics, but societies also have their histories. The logics may be similar but the histories can be different – and in the US and UK cases they most definitely are. They are different in the ways in which the two societies were originally constructed and have developed over time. They are also different in the ways in which they now struggle to cope with the common set of economic problems released upon them by the shared nature of their flawed capitalisms. This overlap of the similar and the different is what allows so rich a cultural exchange between the two societies, with the similarities facilitating the exchange and the differences making the exchange perennially fascinating. Americans play baseball. The English play cricket. Nothing could be more different than that; and yet each sport carries the marks of a shared experience of imperialism. American baseball calls its end-of-season play-offs “The World Series”, although only North American teams are permitted to participate. The Japanese and the Cubans play baseball too – a legacy of previous decades of American dominance – but they are not invited. The English now regularly lose at cricket to teams from countries that only play the game because once they were British colonies. In the heyday of empire and as late as the early-1950s, the English always won at cricket, unless playing teams from the white dominions; but as this is being drafted, the national test team just lost a series of five-day games 4-0 to the Indians.
“The reason they call it the American Dream is because you have to be asleep to believe it.”
George Carlin
“I know enough about this country to know that Donald Trump is not a fluke … that nothing will change until America reckons with race.”
Kali Holloway
“The American Dream is back.”
Donald J. Trump
Unlike any other major industrialized economy, the American one sits on top of a consciously-created society, one put together after 1620 by a mixture of voluntary and involuntary migration – the trans-oceanic movement of immigrants and slaves – into a land mass whose native inhabitants were an early casualty of that migration. Carefully editing US history to downplay the ethnic cleansing and forced slavery elements within it, contemporary American apologists regularly assert that – precisely because of its unique design – the society so consciously created turned out to be morally, socially and economically superior to the societies that the first generations of American transplants had left behind. As the American national anthem has it, the United States understands itself to be “the land of the free and the home of the brave” – understands itself, that is, as a country that possesses a unique trio of advantages: a unique set of dominant values focused around individualism and personal freedom, a uniquely prosperous economy based on private ownership, and a uniquely open social order in which individuals can progress entirely through their own merit. The continuing influx of immigrants seeking precisely those freedoms, prosperity and social mobility then only serves to reinforce the conviction – visible across the entire US political class, but particularly well-embedded in the belief systems of American conservatives – that the United States remains “the shining city on the hill” which all other countries and peoples seek to emulate.
The reality behind such claims is much more complicated than their advocates imply: but in one regard at least the claim for American superiority has, until recently, had enormous force. For over the postwar period as a whole, living standards in the United States have been significantly higher than those enjoyed by the mass and generality of people living in other major industrial economies – not to mention higher than the living standards of those unfortunate enough to be marooned either in former communist countries or in the underdeveloped world.