Reviews

Regions. ERA 1998: 21st CENTURY REGIONS. London: Economic & regional analysis, 23. Buckingham Gate, London SW1E 6LB, £30 + £1 p&p paper.

Environmental management standards. Krut, R. and Gleckman, H. 1998: ISO 14001: A MISSED OPPORTUNITY FOR SUSTAINABLE GLOBAL INDUSTRIAL DEVELOPMENT. London: Earthscan Publications Ltd, £14.95 paper.

Environmental jobs. Hale, M. and Lachowicz, M. 1998: THE ENVIRONMENT, EMPLOYMENT AND SUSTAINABLE DEVELOPMENT. London: Routledge, £17.99 paper.

Sustainability and regeneration. Carley, M. and Kirk, K. 1998: SUSTAINABLE BY 2020? A STRATEGIC APPROACH TO URBAN REGENERATION FOR BRITAIN'S CITIES. Bristol: The Policy Press, £11.95 paper.

Gambling. Frey, J.H. (ed) 1998: GAMBLING: SOCIOECONOMIC IMPACTS AND PUBLIC POLICY. The Annals of the American Academy of Political and Social Science. London: Sage Publications, £14.99 paper.

Informal employment. Williams, C. C. and Windebank, J. 1998: INFORMAL EMPLOYMENT IN THE ADVANCED ECONOMIES: IMPLICATIONS FOR WORK AND WELFARE. London: Routledge, £15.99 paper.

TECS. Jones, M. 1999: NEW INSTITUTIONAL SPACES: TECS AND THE REMAKING OF ECONOMIC GOVERNANCE. London: Regional Studies Association, £27.50 paper.

The New Regional Agenda. Dungey, J. and Newman, I. 1999: THE NEW REGIONAL AGENDA. London: Local Government Information Unit, £15.00 paper.

Mutual aid and self-help. Burne, Danny and Taylor, Marilyn, 1998: MUTUAL AID AND SELF-HELP: COPING STRATEGIES FOR EXCLUDED COMMUNITIES. Bristol: The Policy Press, £10.95.     

Cost-effectiveness of percutaneous patent foramen ovale closure as secondary stroke prevention

Objective: Compared to medical therapy alone, percutaneous closure of patent foramen ovale (PFO) further reduces risk of recurrent ischemic strokes in carefully selected young to middle-aged patients with a recent cryptogenic ischemic stroke. The objective of this study was to evaluate the cost-effectiveness of this therapy in the context of the United Kingdom (UK) healthcare system.

Methods: A Markov cohort model consisting of four health states (Stable after index stroke, Post-Minor Recurrent Stroke, Post-Moderate Recurrent Stroke, and Death) was developed to simulate the economic outcomes of device-based PFO closure compared to medical therapy. Recurrent stroke event rates were extracted from a randomized clinical trial (RESPECT) with a median of 5.9-year follow-up. Health utilities and costs were obtained from published sources. One-way and probabilistic sensitivity analyses (PSA) were performed to assess robustness. The model was discounted at 3.5% and reported in 2016 Pounds Sterling.

Results: Compared with medical therapy alone and using a willingness-to-pay (WTP) threshold of £20,000, PFO closure reached cost-effectiveness at 4.2 years. Cost-effectiveness ratios (ICERs) at 4, 10, and 20 years were ?20,951, ?6,887, and ?2,158, respectively. PFO closure was cost-effective for 89% of PSA iterations at year 10. Sensitivity analyses showed that the model was robust.

Conclusions: Considering the UK healthcare system perspective, percutaneous PFO closure in cryptogenic ischemic stroke patients is a cost-effective stroke prevention strategy compared to medical therapy alone. Its cost-effectiveness was driven by substantial reduction in recurrent strokes and patients’ improved health-related quality-of-life.     

Reviews

Regenerating town centres. Evans, R. 1997: REGENERATING TOWN CENTRES. Manchester: Manchester University Press, £30.00 cased.

Privatised utilities. Marvin, S., Graham, S. and Guy, S. 1996: PRIVATISED UTILITIES AND REGIONAL MANAGEMENT. Harlow: SEEDS (South East Economic Development Strategy), £25.00 plus £3.50 postage and packing.

Women returners. Chisholm, L. (ed) 1997: GETTING IN, CLIMBING UP AND BREAKING THROUGH. London: The Policy Press, £15.25 paper.

Regionalism. John, P. and Whitehead, A. (eds) 1997: POLICY AND POLITICS VOL 25 NO. 1 SPECIAL ISSUE. REGIONALISM IN ENGLAND: CURRENT TRENDS AND FUTURE PROSPECTS. Policy Press.

Socially regulated labour markets. Peck, J. 1996: WORK-PLACE. THE SOCIAL REGULATION OF LABOUR MARKETS. New York and London: The Guilford Press, £16.99 paper £35.00 cased.

Private delivery — public goods. Arnold-Forster, J., Lee, M. and McLeod, J. 1997: HAND IN GLOVE: PRIVATE SECTOR DELIVERING PUBLIC GOODS. London: Fabian Society, supported by Generale des Eaux, £15.00 paper.

Bio-tech. Milhell, D., Kingham, D. and Stott, M. 1997: THE DEVELOPMENT OF THE BIOTECHNOLOGY SECTOR IN OXFORDSHIRE: IMPLICATIONS FOR PUBLIC POLICY. Oxford: Oxford Innovation Limited, £5.00 paper.     

Screening the impacts of municipal service policy changes

The planning of municipal service delivery systems requires accurate forecasts of demand, and particularly of the effects the quality of service delivery has on demand. A metholology for this problem should meet three criteria, if it is to be useful for municipal planning: it must be low-cost and use generally available data; it must be based on user behavior, so that the effects of policy changes can be correctly attributed; and it must allow testing of the transferability of the results, since this is required for general forecasting use. This paper develops such a methodology, based on econometric analysis of data from a number of service areas within a number of regions, forming a double cross-section. Empirical tests of the methodology were performed for two local government services where the effect of service quality on demand is important: sewer and highway construction, which have been hypothesized to affect the patterns of development within regions; and solid waste collection, where the level of service provided affects how much waste enters the collection system and how much is littered, burned or recycled. The two case studies and other analyses suggest that the methodology is a useful tool for testing whether policy changes have an effect on the demand for service, but not for accurate demand forecasting. Thus, these simple models are relevant for the role of screening the effect of policy changes, but more detailed and localized approaches are necessary for system design.     

Learning to labour: an evaluation of internships and employability in the ICT sector

The employability of graduates is often reduced to lists of de‐contextualised skills that graduates may or may not have and which may or may not translate to prized graduate positions. Recently, internships have become the way in which graduates acquire and demonstrate work‐readiness to potential employers. This article examines a particular type of internship in the ICT sector, namely placements incorporated in degree education. The findings suggest that while internships can enhance employability and indeed be a mechanism for accessing permanent jobs, more often, instead of ‘learning to labour’, interns are expected to be productive workers. A mini labour market operates at the undergraduate level that advantages those already possessed of the required soft skills. The emphasis on soft skills signals a shift in the nature of ICT work with attendant implications for education of workers in this sector, revealed by anchoring employability to particular labour process(es).