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Book
Reviewing the Evidence Base for De-escalation Training: A Rapid Evidence Assessment
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Year: 2019 Publisher: Santa Monica, Calif. RAND Corporation

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Abstract

Violence in the workplace is a major issue for healthcare providers. As a way to help staff manage, reduce or prevent violence from occurring, NHS Improvement asked RAND Europe to conduct an analysis of de-escalation training to support the development of this type of training within health settings. The study focused on individual skills-based training to help reduce workplace violence and assessed whether de-escalation training is effective in managing violence towards NHS staff, benefits and key methods used to provide training, key types of training and its content, and factors of success in deploying training. To answer the research questions the research team conducted a rapid evidence assessment (REA) of de-escalation training literature. Given the availability of existing reviews evaluating the efficacy of de-escalation training in healthcare settings, our approach was to perform a review of existing de-escalation training reviews and other individual skills-based approaches to aggression management within the last 10 years (2009–2019). The study found that training may help staff manage patient violence and aggression although de-escalation training may not in itself reduce the number of violent or aggressive incidents. Additionally, evidence shows de-escalation training contributes to a significant reduction in lost workdays, improved staff retention, reduced complaints, and reduced overall expenditure. Given these limitations, using comprehensive approaches to managing violence in the NHS may be more effective than de-escalation training alone. The quality of available evidence on de-escalation training is limited. Any efforts towards implementing de-escalation training would benefit from the inclusion of evaluation in their design.

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Book
Food consumption in the UK: Trends, attitudes and drivers
Authors: --- --- ---
Year: 2020 Publisher: Santa Monica, Calif. RAND Corporation

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What we eat has big implications for our health, our society and the environment. Unhealthy and nutritionally poor diets lead to ill health. The current food system and people's food practices have negative impacts on the environment, leading to greenhouse gas emissions, deforestation and biodiversity loss. Addressing these complex challenges requires changing how food is produced to ensure it is more sustainable, and, importantly, changing consumption to ensure it is healthier and more sustainable. Therefore, understanding food consumption trends, what drives them and how we can change consumption practices through interventions is crucial to inform policy. The aim of this study commissioned by the Department for Environment, Food and Rural Affairs was to provide an overview of the existing evidence in four main areas: (1) the trends related to consumer food practices and attitudes, and to the changing food environment (e.g. out-of-home sector, online retail models) in the UK; (2) the drivers of consumption (e.g. the role of information or food system actors); (3) interventions that can influence food consumption practices; and (3) the differences between groups, or 'food publics', across the trends, drivers and interventions (i.e. segmentation). Researchers conducted a rapid evidence assessment, with a focus on identification of existing evidence and evidence gaps within high-quality, primarily academic literature from the last ten years. This report provides evidence around these questions and identifies areas of uncertainty where more evidence is required and, based on this, suggests a number of priority areas for further research and action by policymakers.

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Book
What influences improvement processes in healthcare? A rapid evidence review
Authors: --- --- ---
Year: 2020 Publisher: Santa Monica, Calif. RAND Corporation

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Poor-quality healthcare has significant health-related and economic consequences for patients and the wider health system. Although many healthcare organisations are now engaging with improvement activity, the challenges associated with improving care quality remain considerable. The field of improvement research has significant potential to contribute to a better understanding of how improvements in patient care can be achieved and sustained. It is an interdisciplinary academic field, and although the literature on quality improvement is broad and diverse, it is also fragmented. Many studies look at individual improvement models, approaches and interventions, and focus on understanding what works in relation to specific improvement aims. There is less consolidated and curated evidence on learning about the process of doing improvement. A better understanding of the nature of improvement processes and influences on them could inform both ongoing and future practice, by drawing out practical insights such as those related to the challenges faced by improvers and the strategies used to overcome them. Against this context, The Healthcare Improvement Studies (THIS) Institute commissioned RAND Europe to conduct a rapid evidence review of the academic and grey literature, to draw out initial learning about what influences quality improvement processes in healthcare, and to inform potential themes to explore in future research.

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Book
Future of the Credit Information Market: Final report
Authors: --- --- --- --- --- et al.
Year: 2021 Publisher: Santa Monica, Calif. RAND Corporation

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RAND Europe was commissioned by the Financial Conduct Authority to conduct a piece of forward-looking research to understand how the credit information market might evolve in the future. Using a structured scenario methodology and stakeholder consultation, this project identified the factors influencing change and developed four plausible future scenarios that provide insights into the implications for the credit information market, the lending markets, consumers and wider society. Four plausible future scenarios were identified for 2030. Widening credit gap: Innovation in new data sources and advanced analytics has slowed, meaning credit information has not continued becoming cheaper and more consumers have little or no information held about them at the CRAs. Consumer-centric credit: Consumers are empowered to choose which data they share and with whom. Whilst lending decisions are, in general, better informed, the reliance on consumer-consented data presents challenges. Some individuals also pay a 'privacy premium'. Big data driven: CRAs have become more sophisticated in using Big Data and advanced analytics to provide insights to a diverse range of customers. However, as credit is increasingly offered on personalised terms, some higher-risk individuals face significantly higher costs and fewer options for credit. Lenders lead: Lenders have led the way in using credit information from a wider range of sources, generating greater competition. However, confusion from consumers over how their data is collected has led to an increased focus within industry on developing a code for data collection and use, including factors like ethics and transparency.

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Book
Evaluation of IPS Grow: Final report
Authors: --- --- --- ---
Year: 2021 Publisher: Santa Monica, Calif. RAND Corporation

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Individual Placement and Support (IPS) is an evidence-based model which supports people with serious mental illness into employment. In order to increase access to IPS services nationally, NHSE and Improvement has allocated funds to specific sustainability and transformation partnership (STP) areas. A proportion of funding was dedicated to IPS Grow: a national implementation support initiative that aims to speed up the time that services take to deliver high quality IPS and to ensure their sustainability. IPS Grow provides technical implementation support, workforce development support and data tools and performance standards support, through an online platform, networking and events, and support from a dedicated team. Our evaluation used a theory-based approach and a logic model to examine IPS Grow's impact on funded IPS services. We aimed to answer seven evaluation questions through a combination of methods, including telephone interviews, focus groups, case studies, online surveys and a targeted documentation review (including of reports and plans from services' IPS fidelity reviews). The study aimed to examine the uptake of support from IPS Grow by IPS services, explore the perceptions of IPS Grow by key audiences, and examine the impact that different elements of support from IPS Grow had on services, depending on their organisational features.

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Book
Enhancing deterrence and defence on NATO's northern flank: Allied perspectives on strategic options for Norway
Authors: --- --- --- --- --- et al.
Year: 2020 Publisher: Santa Monica, Calif. RAND Corporation

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As a founding member of NATO, Norway supports efforts to enhance deterrence, crisis management and regional security in the North Atlantic and High North — a region commonly understood to include territories in Scandinavia and northern Russia, as well as the surrounding waters of the Arctic Ocean, Barents Sea and North Sea. To help ensure effective delivery of these tasks and inform ongoing strategy and policy development, Norway needs insight into other NATO Allies' perspectives on strategic opportunities and challenges in the region. Researchers from RAND Europe and the RAND Corporation combined a targeted document review with expert workshops and field visits to gather and analyse evidence in support of the Norwegian Ministry of Defence's (MOD) strategy development, planning and defence policy. Researchers examined the perspectives of defence officials from Denmark, France, Germany, the UK, the US and NATO institutions and this analysis fed into a summary of findings alongside five strategic options for the MOD to consider.

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Book
Understanding perceptions of the Research Excellence Framework among UK researchers: The Real-Time REF Review
Authors: --- --- --- --- --- et al.
Year: 2021 Publisher: Santa Monica, Calif. RAND Corporation

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The Research Excellence Framework (REF) is an evaluation system for assessing the quality of research in UK higher education institutions (HEIs). Despite its importance in shaping research cultures, there is little systematic evidence about perceptions and attitudes towards the REF across the sector, and which aspects are viewed favourably or unfavourably. Research England, on behalf of the four UK higher education funding bodies, commissioned RAND Europe, together with the University of Cardiff and the University of Sheffield, to conduct a real-time evaluation of attitudes and perspectives of the sector towards REF 2021. The specific objectives of this study are to: (1) assess attitudes, perspectives and behaviours towards REF 2021 across the sector; (2) explore how REF policies and changes are embedded in the way submissions are prepared and delivered; and (3) expand and build on the findings of a pilot study conducted in 2018. By conducting the review in real time, alongside preparations for the exercise, the study aims to help accelerate the process of learning and revision post-REF 2021 and provide more clarity and perspective on the future of the REF to institutions at an early stage for the next round of assessment. The study also aims to provide an early contribution to the evidence base in anticipation of a potential reform of the REF that was requested by the UK government.

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Book
Addressing societal challenges in Norway: Key trends, future scenarios, missions and structural measures

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The Research Council of Norway (RCN), the national funding agency for research and innovation (R&I) in Norway, has identified five 'strategic areas' in its current strategy (2020-2024): health and welfare; oceans; green transition; technology and digitalisation; and cohesion and globalisation. The RCN is focussing its priorities on delivering high-impact R&I within these areas. All five areas are intrinsically linked to societal challenges, both within and outside Norway. The COVID-19 pandemic, and the impact it has had on a global scale, has served as a stark reminder that these challenges need to be urgently addressed, not least to ensure that countries — and R&I systems — are better prepared for the future and to help build resilience. RAND Europe and DAMVAD Analytics conducted a foresight study to provide evidence for the RCN's input to the 2022 revision of the Long-Term Plan for Research and Higher Education 2019-2028, which specifies the Norwegian government's ambitions, key objectives and priority areas for research and higher education. The study specifically identified a set of priority missions or targeted policy actions for the next ten years that the RCN could consider implementing in the future, and potential structural measures needed to aid the development of a resilient R&I environment in Norway. The research team adopted a mixed-methods, participatory approach to the research involving a variety of data collection tools such as trend analyses, literature reviews, stakeholder interviews, focus groups, an online survey of the public, crowdsourcing ideas and information from experts, future scenario analyses and workshops. The research team produced nine publications, all of which are available for download above.

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