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Evaluation of a complex intervention for prisoners with common mental health problems, near to and after release: the Engager randomised controlled trial
- Richard Byng, Tim Kirkpatrick, Charlotte Lennox, Fiona C. Warren, Rob Anderson, Sarah Louise Brand, Lynne Callaghan, Lauren Carroll, Graham Durcan, Laura Gill, Sara Goodier, Jonathan Graham, Rebecca Greer, Mark Haddad, Tirril Harris, William Henley, Rachael Hunter, Sarah Leonard, Mike Maguire, Susan Michie, Christabel Owens, Mark Pearson, Cath Quinn, Sarah Rybczynska-Bunt, Caroline Stevenson, Amy Stewart, Alex Stirzaker, Roxanne Todd, Florian Walter, Lauren Weston, Nat Wright, Rod S. Taylor, Jenny Shaw
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- Journal:
- The British Journal of Psychiatry / Volume 222 / Issue 1 / January 2023
- Published online by Cambridge University Press:
- 18 August 2022, pp. 18-26
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- January 2023
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Background
Many male prisoners have significant mental health problems, including anxiety and depression. High proportions struggle with homelessness and substance misuse.
AimsThis study aims to evaluate whether the Engager intervention improves mental health outcomes following release.
MethodThe design is a parallel randomised superiority trial that was conducted in the North West and South West of England (ISRCTN11707331). Men serving a prison sentence of 2 years or less were individually allocated 1:1 to either the intervention (Engager plus usual care) or usual care alone. Engager included psychological and practical support in prison, on release and for 3–5 months in the community. The primary outcome was the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), 6 months after release. Primary analysis compared groups based on intention-to-treat (ITT).
ResultsIn total, 280 men were randomised out of the 396 who were potentially eligible and agreed to participate; 105 did not meet the mental health inclusion criteria. There was no mean difference in the ITT complete case analysis between groups (92 in each arm) for change in the CORE-OM score (1.1, 95% CI –1.1 to 3.2, P = 0.325) or secondary analyses. There were no consistent clinically significant between-group differences for secondary outcomes. Full delivery was not achieved, with 77% (108/140) receiving community-based contact.
ConclusionsEngager is the first trial of a collaborative care intervention adapted for prison leavers. The intervention was not shown to be effective using standard outcome measures. Further testing of different support strategies for prison with mental health problems is needed.
Frequency and clinical correlates of bipolar features in acute coronary syndrome patients
- S. Pini, M. Abelli, C. Gesi, L. Lari, A. Cardini, L. Di Paolo, F. Felice, R. Di Stefano, G. Mazzotta, C. Oligeri, F.M. Bovenzi, L. Borelli, D. Bertoli, P. Michi, A. Muccignat, J. Micchi, A. Balbarini
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- Journal:
- European Psychiatry / Volume 29 / Issue 4 / May 2014
- Published online by Cambridge University Press:
- 15 April 2020, pp. 253-258
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Background:
Depression and acute coronary syndrome (ACS) are both extremely prevalent diseases. Studies aimed at evaluating whether depression is an independent risk factor for cardiac events provided no definitive results. In most of these studies, depression has been broadly defined with no differentiation between unipolar (MDD) versus bipolar forms (BD). The aim of this study was to evaluate the frequency of DSM-IV BD (bipolar I and bipolar II subtypes, cyclothymia), as well as temperamental or isolated bipolar features in a sample of 171 patients hospitalized for ACS. We also explored whether these psychopathological conditions were associated with some clinical characteristics of ACS.
Methods:Patients with ACS admitted to three neighboring Cardiac Intensive Care Units (CICUs) in a 12-month continuative period of time were eligible for inclusion if they met the criteria for either acute myocardial infarct with or without ST-segment elevation or unstable angina, verified by standard ACS criteria. All patients underwent standardized cardiological and psychopathological evaluations.
Results:Of the 171 ACS patients enrolled, 37 patients (21.7%) were found to have a DSM-IV mood disorder. Of these, 20 (11.7%) had bipolar type I or type II or cyclothymia, while 17 (10%) were the cases of MDD. Rapid mood switches ranged from 11% of ACS patients with no mood disorders, to 47% of those with MDD to 55% of those with BD. Linear regression analysis showed that a diagnosis of BD (p = .023), but not that of MDD (p = .721), was associated with a significant younger age at the index episode of ACS. A history of previous coronary events was more frequent in ACS patients with BD than in those with MDD.
Conclusions:Our data indicate that bipolar features and diagnosis are frequent in ACS patients. Bipolar disorder has a negative impact on cardiac symptomatology. Further research in this area is warranted.
Using animal-mounted sensor technology and machine learning to predict time-to-calving in beef and dairy cows
- G. A. Miller, M. Mitchell, Z. E. Barker, K. Giebel, E. A. Codling, J. R. Amory, C. Michie, C. Davison, C. Tachtatzis, I. Andonovic, C.-A. Duthie
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Worldwide, there is a trend towards increased herd sizes, and the animal-to-stockman ratio is increasing within the beef and dairy sectors; thus, the time available to monitoring individual animals is reducing. The behaviour of cows is known to change in the hours prior to parturition, for example, less time ruminating and eating and increased activity level and tail-raise events. These behaviours can be monitored non-invasively using animal-mounted sensors. Thus, behavioural traits are ideal variables for the prediction of calving. This study explored the potential of two sensor technologies for their capabilities in predicting when calf expulsion should be expected. Two trials were conducted at separate locations: (i) beef cows (n = 144) and (ii) dairy cows (n = 110). Two sensors were deployed on each cow: (1) Afimilk Silent Herdsman (SHM) collars monitoring time spent ruminating (RUM), eating (EAT) and the relative activity level (ACT) of the cow, and (2) tail-mounted Axivity accelerometers to detect tail-raise events (TAIL). The exact time the calf was expelled from the cow was determined by viewing closed-circuit television camera footage. Machine learning random forest algorithms were developed to predict when calf expulsion should be expected using single-sensor variables and by integrating multiple-sensor data-streams. The performance of the models was tested using the Matthew’s correlation coefficient (MCC), the area under the curve, and the sensitivity and specificity of predictions. The TAIL model was slightly better at predicting calving within a 5-h window for beef cows (MCC = 0.31) than for dairy cows (MCC = 0.29). The TAIL + RUM + EAT models were equally as good at predicting calving within a 5-h window for beef and dairy cows (MCC = 0.32 for both models). Combining data-streams from SHM and tail sensors did not substantially improve model performance over tail sensors alone; therefore, hour-by-hour algorithms for the prediction of time of calf expulsion were developed using tail sensor data. Optimal classification occurred at 2 h prior to calving for both beef (MCC = 0.29) and dairy cows (MCC = 0.25). This study showed that tail sensors alone are adequate for the prediction of parturition and that the optimal time for prediction is 2 h before expulsion of the calf.
Postmortem observations on rumen wall histology and gene expression and ruminal and caecal content of beef cattle fattened on barley-based rations
- N. N. Jonsson, H. J. Ferguson, H. H. C. Koh-Tan, C. A. McCartney, R. C. Cernat, E. M. Strachan, W. Thomson, T. J. Snelling, C. D. Harvey, I. Andonovic, C. Michie, R. J. Wallace
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Sub-acute ruminal acidosis (SARA) can reduce the production efficiency and impair the welfare of cattle, potentially in all production systems. The aim of this study was to characterise measurable postmortem observations from divergently managed intensive beef finishing farms with high rates of concentrate feeding. At the time of slaughter, we obtained samples from 19 to 20 animals on each of 6 beef finishing units (119 animals in total) with diverse feeding practices, which had been subjectively classified as being high risk (three farms) or low risk (three farms) for SARA on the basis of the proportions of barley, silage and straw in the ration. We measured the concentrations of histamine, lipopolysaccharide (LPS), lactate and other short-chain fatty acids (SCFAs) in ruminal fluid, LPS and SCFA in caecal fluid. We also took samples of the ventral blind sac of the rumen for histopathology, immunohistopathology and gene expression. Subjective assessments were made of the presence of lesions on the ruminal wall, the colour of the lining of the ruminal wall and the shape of the ruminal papillae. Almost all variables differed significantly and substantially among farms. Very few pathological changes were detected in any of the rumens examined. The animals on the high-risk diets had lower concentrations of SCFA and higher concentrations of lactate and LPS in the ruminal fluid. Higher LPS concentrations were found in the caecum than the rumen but were not related to the risk status of the farm. The diameters of the stratum granulosum, stratum corneum and of the vasculature of the papillae, and the expression of the gene TLR4 in the ruminal epithelium were all increased on the high-risk farms. The expression of IFN-γ and IL-1β and the counts of cluster of differentiation 3 positive and major histocompatibility complex class two positive cells were lower on the high-risk farms. High among-farm variation and the unbalanced design inherent in this type of study in the field prevented confident assignment of variation in the dependent variables to individual dietary components; however, the CP percentage of the total mixed ration DM was the factor that was most consistently associated with the variables of interest. Despite the strong effect of farm on the measured variables, there was wide inter-animal variation.
Acts of control in schizophrenia: dissociating the components of inhibition
- J. C. BADCOCK, P. T. MICHIE, L. JOHNSON, J. COMBRINCK
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- Psychological Medicine / Volume 32 / Issue 2 / February 2002
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- 08 April 2017, pp. 287-297
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Background. Inhibitory deficits have been frequently reported in schizophrenia. Such deficits are usually associated with activities of prefrontal cortex and related networks. An understanding of intentional inhibitory control requires knowledge of how actions are planned and initiated and the components involved in stopping these actions.
Methods. Patients with schizophrenia, a psychosis comparison group and a healthy control group participated in a visual choice reaction time (go) task and attempted to inhibit their responses to the go task when an auditory ‘stop’ signal was heard.
Results. Schizophrenia patients demonstrated significantly slower response execution but the estimated speed of inhibition was not significantly different from that of healthy controls. Both patient groups were impaired in their ability to inhibit a response across a range of stop-signal delays. The poorer performance of schizophrenia patients only was related to a difficulty in reliably triggering the inhibitory response.
Conclusions. Impaired response inhibition is not unique to schizophrenia. However, the nature of their problem is markedly different from that of other psychopathological groups. Possible neural mechanisms underpinning difficulties in triggering inhibitory responses and in the voluntary initiation of actions in schizophrenia are considered.
2 - Financiers and Merchants: 1856–1870
- Ranald C. Michie
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- Guilty Money
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- 05 December 2014, pp 37-76
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Summary
By the mid-1850s the City of London had established itself as the most important financial centre in the world, though it continued to face rivalry from Amsterdam and, especially, Paris. It also remained a very important commercial centre, being the world's largest port, benefiting from Britain's dominant position in international trade. Domestically, the railways and the telegraph permitted those in London to receive and transmit news and orders to and from all parts of the kingdom, facilitating the integration of markets to a degree never before attained. Generally, fundamental forces were working to enhance the importance of the City in the country's external and internal commercial, financial and business affairs. Banking, for example, was increasingly conducted through branches directed from London head offices. Tangible evidence of the impact made by London on the entire British population, rather than those living within its vicinity or the small aristocratic elite who were regular visitors, was the Great Exhibition of 1851. This received a huge number of visitors from across the country, as well as generating vast publicity. Local enterprise and local business did continue to flourish, as with the continuing importance of locally-run banks and stock exchanges, but they were increasingly responsive to a lead from London. In terms of culture this could have a number of repercussions. On the one hand it might generate an admiration for the City as the most powerful and successful commercial and financial centre in the world. On the other hand the growing influence of the City over the nation's well being might stimulate resentment because the loss of local autonomy. Both reactions were possible and so it is important to determine which came to dominate. Conversely, it is possible that neither of these fundamental changes in the City's international and domestic role were responsible for its place in contemporary culture. Instead, it could be events that determined attitudes. In particular, this period saw the spread of joint stock enterprise away from the likes of railways into other types of business, such as mining and manufacturing, in response to the passing of the Limited Liability Acts.
Works Cited
- Ranald C. Michie
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- Guilty Money
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- 05 December 2014, pp 263-274
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Guilty Money
- The City of London in Victorian and Edwardian Culture, 1815–1914
- Ranald C. Michie
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This is an engaging socio-cultural study of the place occupied by the City of London within British cultural life during the Victorian and Edwardian periods. Michie interrogates the dialectic nature of two traditional views of the City as a global financial centre: London as a theatre of corruption, fraud and scandal; and as a place of unbridled success and power for the ambitious elite.
Rather than rely on the opinion of orthodox figures contemporaneous to the period under examination, Michie recognises the novel as a pertinent source of socio-economic representation. By comparing both literary and popular novels at different times, this work illustrates how the evidence for cultural shifts can rest upon the generality of the population. Marrying literary and economic analysis, Guilty Money foregrounds the limitless possibilities of the novel as a work of historical documentation.
Index
- Ranald C. Michie
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- Guilty Money
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- 05 December 2014, pp 275-278
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Introduction
- Ranald C. Michie
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- 05 December 2014, pp 1-12
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Summary
The City of London has been one of the leading financial centres in the world for over 300 years, playing an essential role in the mobilization and distribution of credit and capital. Over that time the business conducted within its confines has generated vast wealth for the British people and provided an essential service for successive British governments through the ability to borrow and tax. For those reasons alone it might be assumed that the City would be regarded as the brightest jewel in the British crown, treasured by all because of the riches it generated. Such a view, though, runs contrary to both the culture of envy, created by the sight of the large fortunes generated in the City, and a fundamental mistrust of money that was made through manipulating money itself rather than productive toil. As the inaugural issue of a magazine devoted to wealth observed in 2008, ‘There is a widespread belief in a distinction between the deserving and the undeserving rich. And it goes far beyond the ancient debate over egalitarianism or socialism. Even for those who are happy to accept capitalism, and the idea that some will be richer than others, there is still a sense that some of the wealthy do not deserve their status’. Among those perceived as the least deserving were bankers who, in the words of a respected BBC journalist in 2008, ‘Were making obscene fortunes for themselves by gambling with other people's money’. This meant that the City of London, as a financial centre, had major barriers to overcome if it was to achieve a favourable status within British society. Compounding this problem of gaining acceptance was the fact that much of the business undertaken in the City was of an international nature and was conducted by people who were seen to be foreign, either because of race or religion. This gave them the status of outsiders, erecting another barrier between those in the City and the rest of society.
7 - Wealth and Power: 1910–1914
- Ranald C. Michie
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- Guilty Money
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- 05 December 2014, pp 191-228
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Summary
In the years before the First World War the City of London reached its peak of global influence. Located in this one small district of the metropolis of London were some of the most important commercial markets in the world, with the most influential financial institutions in the shape of the Bank of England, Lloyds and the London Stock Exchange, and many of the world's largest banking and insurance companies. In addition, it was from the City of London that international trade, finance and shipping was organized, facilitating the global distribution of money and merchandise. However, most of these varied activities, though widely recognized and admired, only dimly impinged upon the public imagination, being conducted in a dull and routine manner and of a highly technical nature. In contrast, it was events on the Stock Exchange that continued to absorb most public interest, with the rise and fall of prices being attributed to the manipulation of insiders, especially in mining and oil companies. The fortunes of individual companies also attracted attention, especially newly promoted ones, as any sudden bankruptcy, bringing ruin to investors, could be laid at the feet of a financial genius or scheming fraudster. Thus, along with the brokers and jobbers who daily bought and sold shares, it was company promoters and their constant stream of offerings that helped identify the City of London in the public mind. The period also witnessed both a speculative mania, centring on rubber plantation companies, and a run on the Birkbeck Bank in 1910 followed by its collapse in 1911. There was even a scandal in 1912 over accusations of insider trading, involving prominent members of the Liberal government, Sir Herbert Samuel and Sir Rufus Isaacs, and the chairman of the Marconi Company, Godfrey Isaacs, who was the brother of Sir Rufus. Above all, the public were especially fascinated by the personification of the City in the shape of certain flamboyant and newsworthy financiers that appeared to thrive in its precincts, with again many of the most prominent being Jewish or foreign or both, such as Barney Barnato, Ernest Cassel, and Saemy Japhet. This raises the question of which was more important in determining the place of the City in British culture.
Frontmatter
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- 05 December 2014, pp i-vi
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5 - Gold and Greed: 1895–1900
- Ranald C. Michie
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- 05 December 2014, pp 131-162
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A speculative bubble had been building up in London throughout the early 1890s. The dramatic reduction in external investment opportunities, with the crises in Australia, Argentina and the USA, had driven down British interest rates. This had fuelled a boom in house building and railway construction, as well as the conversion of established businesses into the joint stock form so that their shares could be sold to the public. Allied to the absence of borrowing by the British government the result was a period of low returns for investors and an increased willingness to look for new opportunities. Into this vacuum came the gold discoveries in South Africa and western Australia. Of all the metals in existence gold possessed a quality that no other had. This was its fixed price under the Gold Standard. Numerous currencies including the pound sterling had their value determined by a specific amount of gold for which they could be exchanged. Furthermore, the Bank of England was obliged to buy all gold offered to it at a fixed price. Thus, if gold could be found, mined, refined and then shipped to London it could be sold at a price known in advance. Given the discovery of new and large gold deposits in areas that were becoming accessible because of the railway, it appeared but a simple task of connecting supply and demand and profiting from the difference in price. Presented with such an opportunity investors quickly came to believe that every potential gold discovery offered a path to incalculable wealth. Gold mining appeared to possess the certainty of return that came with railways, because of their provision of a basic service, and the prospects of huge capital gain as the uncertainty of exploration gave way to the certainty of production. With gold there was no risk that the price would fall as output rose, as in the case of other metals and coal, for the demand was infinite and the price guaranteed.
1 - Capitalism and Culture: 1800–1856
- Ranald C. Michie
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- 05 December 2014, pp 13-36
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Summary
From at least the seventeenth century onwards the City of London was widely regarded as a place where a man and his money were easily parted and usually by the most villainous means imaginable. The place it occupied within contemporary culture was one that varied from amazement, because of its size and population, to distrust as a result of the activities conducted there. Such a view was driven both by the longstanding Christian antipathy towards usury, which inevitably brought any financial centre into disrepute, and the general suspicion of the middleman in any transaction, as the differential price led both buyer and seller to believe they had been cheated. In addition, there were specific events in the City of London that fuelled public hostility. The speculative boom in 1720, with the Mississippi Bubble in Paris and the South Sea Bubble in London, convinced many that there was something rotten associated with the rise and fall of stock and share prices, and the promotion of joint stock companies. Those events continued to colour popular perceptions from then on, and certainly way into the nineteenth century. At the time of another speculative boom in 1864 the British historical novelist, W. H. Ainsworth, thought it worthwhile to write a story based around John Law, the great Scottish financier whose schemes lay at the heart of the events in Paris. However, other aspects of the City's activities did experience a slow rehabilitation during the course of the eighteenth century, which was evident by the beginning of the nineteenth. Increasingly the City merchant was regarded by contemporaries as being an honourable person, having accumulated wealth through legitimate means. The business being conducted by merchants had relevance to most people, as they ranged from retailing through wholesaling to international trade, and so was accepted as necessary. If that business was then conducted in such a way as permitted the slow accumulation of a fortune, without the use of practices that appeared to cheat suppliers and customers, then the successful merchant could command the respect of their peers.
6 - Money and Mansions: 1900–1910
- Ranald C. Michie
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- Guilty Money
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- 05 December 2014, pp 163-190
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Summary
After the speculative boom of the mid-1890s, which had focused the public's attention on the City, the early twentieth century brought in a less eventful period. Though the stock market continued to rise and fall and companies continued to be promoted and to fail, there was nothing akin to the craze for gold that had gripped the nation in 1895. Instead, the City of London continued to build up its position as the most important financial and commercial centre in the world. Turner, writing in 1902, claimed that
London is the chief abode of the great god Money, whose throne, visible to all men, is in the heart of the City. From Queen Street and Guildhall to Gracechurch Street and Bishopsgate, from London Bridge to London Wall, lies a region in which the temples of the god cluster together in thick profusion. From here the greatest and the most numerous of his activities are conducted; for London, in spite of the rivalry of New York and the growing importance of Paris and Berlin as money centres, is still paramount as a headquarters of exchange and banking.
On the commercial front, Beavan, writing in 1901, saw the City as ‘…the Mart of Nations’, with Mincing Lane at its heart. This very range and extent of the City's activities defied easy generalization, beyond such statements about its role as a money market or a commodity market. Similarly, the complexity of the functions performed on behalf of global trade and finance made it difficult for the non-specialist to understand what the City actually did. Many of the familiar landmarks of the past, such as the private banks, had virtually disappeared, leaving the City inhabited by a vast mass of people and businesses carrying out tasks unintelligible to the lay person. Also, there was now little reason to visit the City, beyond St Paul's Cathedral, unless on business, for it had ceased to possess any retail activities apart from those meeting the needs of those who worked there.
3 - Damnation and Forgiveness: 1870–1885
- Ranald C. Michie
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- Guilty Money
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- 05 December 2014, pp 77-102
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Summary
From 1870 onwards the City of London was judged by contemporaries more and more on the functions it performed. This meant that its position in British culture increasingly relied upon which of these functions caught the public's imagination at any particular moment rather than the actual range and importance of the activities conducted within its boundaries. During the years after 1870 the City of London consolidated its position as the dominant financial centre in Britain. Domestically, London-based joint stock banks extended their influence throughout England and Wales by opening ever more branches and taking over provincial banks. Provincial banks followed the same route by taking over London banks and then gradually transferring the centre of their operations to the City. The result was a nationwide branch banking system in England and Wales that was capable of withstanding any financial crises or monetary disturbance. Increasingly, all the City's joint stock banks were seen to possess the stability that was once the exclusive privilege of the Bank of England. City-based joint stock banking became a highly disciplined service conducted according to strict principles and careful monitoring. The last collapse of a major British bank in the nineteenth century took place in 1878 and concerned a Scottish bank, the City of Glasgow Bank, rather than one in the City. This was highly symbolic as Scotland had long been home to best practice in banking and possessed a reputation for thrift and prudence. At the same time the railway and the telegraph, with the telephone appearing from 1879, helped to integrate British financial and commercial markets so that all looked instantly to London for prices and conditions. Again, such activities became routine as bankers, brokers and merchants throughout the country were in constant contact with each other. Finally, joint stock enterprise had passed through a learning curve, making it easier for financiers in the City to provide a realistic valuation of the businesses created. It was now evident that joint stock would not sweep all before it but it was also clear that corporate enterprise could make a real contribution in certain areas of the economy, as well as providing a safe and remunerative investment.
Conclusion
- Ranald C. Michie
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- 05 December 2014, pp 229-246
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Summary
The City of London grew, flourished and changed throughout the Victorian and Edwardian periods. It lost its residential population to other parts of London and the suburbs, and ceased to be a manufacturing centre as those activities relocated to areas where land and labour was cheaper. This did not mean that the City became an exclusively financial district by the First World War, for commercial and shipping business not only remained but experienced absolute growth, as did the vast range of ancillary services such as accountancy and law along with new ones like consulting engineers, loss adjusters and advertising agents. Though contemporaries were aware of the continuing presence of so many diverse groups and activities within the City of London, the nature of the work that most did, and the lack of contact, meant that they increasingly passed unnoticed. The result was to focus public attention on those aspects of the City that did make an impact on the public. Even here, change was taking place. Whereas in the mid-nineteenth century banking crises and insurance company collapses continued to occur, these had both become something of a rarity by the end. In each case both banking and insurance had become dominated by large and well-capitalized joint stock companies that delivered regular returns to their shareholders while safeguarding deposits and paying out on their policies. This had the effect of reducing their activities to ones that the public took for granted and so did not require comment. As a consequence, the public's awareness of the City became increasingly confined to a very narrow range of its overall activities. This awareness was continuously enhanced by growing literacy and ease of communication. It became possible to know, at a glance, the current state of the stock market or the latest speculative fad, rather than such information being confined to a small elite located in London. Anything associated with speculation on the Stock Exchange and the promotion of joint stock companies generated public interest because of the constant fluctuations in prices and the making and losing of fortunes. Inevitably, it was the most spectacular of these that attracted the greatest interest.
CONTENTS
- Ranald C. Michie
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- Guilty Money
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- 05 December 2014, pp vii-viii
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Notes
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4 - Avarice and Honesty: 1885–1895
- Ranald C. Michie
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- 05 December 2014, pp 103-130
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Summary
By the late 1880s the City was no longer seen as a place where swindlers could operate without redress, where violent fluctuations in the stock market could ruin investors overnight, or where sudden banking collapses could wipe out a person's entire savings. Though the City remained a place viewed with suspicion by many because of its connection with speculation and the world of money dealing, it did appear to have assumed an air of respectability and reliability among the population at large. However, that reputation was to be severely tested in the early 1890s in a series of financial and banking collapses at home and abroad. The most notable event that originated domestically was the collapse of the Liberator Building Society. This was a bank that had expanded rapidly through the strategy of continuously revaluing its portfolio of mortgaged property so as to justify ever more ambitious lending, and by paying generous rates of interest to small savers. Eventually the whole edifice collapsed in 1892 exposing massive fraud undertaken by its chairman, Jabez Balfour, who then fled abroad so as to escape prosecution. Important as the case of the Liberator Building Society was, in terms of the adverse publicity it created for the City, much more significant were events that took place abroad, such was the global reach of the City of London and the worldwide interests of British investors. Numbered among the most spectacular of these was the Baring Crisis of 1890. This crisis centred on the inability of borrowers in Argentina to service their debts, after a period of rapid expansion financed by selling securities in London to British investors through Barings, one of the City's largest and oldest merchant banks. Not only was Barings responsible for paying interest on these securities, as agent for the borrowers in Argentina, but it also had substantial holdings on its own account. The temporary suspension of interest payments on Argentinian debt and the near collapse of Barings bank helped to undermine confidence in all Latin American securities.