Setting priorities for development of emerging interventions against childhood diarrhoea

An expert panel exercise was conducted to assess feasibility and potential effectiveness of 10 emerging health interventions against childhood diarrhoea. Twelve international experts were invited to take part in a CHNRI priority setting process. This group used 12 different criteria relevant to successful development and implementation of the emerging interventions, nine of which were retained in the final analysis. They showed most collective optimism towards developing household or community-level water treatment, followed by sustainable, affordable latrine options; those two emerging interventions were followed by antibiotic therapy of Cryptosporidium diarrhoea, and oral or transcutaneous enteric vaccine development

Translating complex realities through technologies: lessons about participatory accountability from South Africa

Accountability is a complex issue in South Africa. The country has high levels of inequality, and marginalised groups struggle to make themselves heard by those in power. Yet the issue is further complicated by an interacting set of factors, including the legacy of apartheid, gender and religious issues, and the lack of access to those in power. Through a six-year research project, the Sustainable Livelihoods Foundation (SLF) used a range of technology-enabled participatory processes to unpack this lack of government accountability. This report focuses on four case studies, which examined the lived realities of marginalised groups and the activists that campaign on their behalf: activists against gender-based violence and for community safety; community care workers and health committee members working for public health; informal traders and the informal economy; and traditional medicine, Rastafarian bossie doktors and indigenous rights. SLF supported these groups to work together and identify the accountability issues that they felt were important, and then consider how they could raise their voice collectively to those that shape and implement policy. The process strengthened the capacity of these groups to speak out – not least through the use of different participatory technologies including digital storytelling, film making, PhotoVoice, geospatial mapping and infographics. This report reflects on the different tools used, considering the effectiveness of the outputs generated and how these tools can empower citizens and bring marginalised groups together. Lastly, the report reflects on SLF’s role as an intermediary organisation, and how this role can influence the path that marginalised groups take in their efforts to make government more responsive to their needs.DFIDUSAIDSidaOmidyar Networ

Centrifuge Modelling With Transparent Soil and Laser Aided Imaging

Transparent synthetic soils have been developed as a soil surrogate to enable internal visualization of geotechnical processes in physical models. While significant developments have been made to enhance the methodology and capabilities of transparent soil modelling, the technique is not yet exploited to its fullest potential. Tests are typically conducted at 1 g in small bench size models, which invokes concerns about the impact of scale and stress level observed in previously reported work. This paper recognized this limitation and outlines the development of improved testing methodology whereby the transparent soil and laser aided imaging technique are translated to the centrifuge environment. This has a considerable benefit such that increased stresses are provided, which better reflect the prototype condition. The paper describes the technical challenges associated with implementing this revised experimental methodology, summarizes the test equipment/systems developed, and presents initial experimental results to validate and confirm the successful implementation and scaling of transparent soil testing to the high gravity centrifuge test environment. A 0.6 m wide prototype strip foundation was tested at two scales using the principle of “modelling of models,” in which similar performance was observed. The scientific developments discussed have the potential to provide a step change in transparent soil modelling methodology, crucially providing more representative stress conditions that reflect prototype conditions, while making a broader positive contribution to physical modelling capabilities to assess complex soil–structure boundary problems

Strong cider sold in Scotland appears to be almost exclusively for dependent drinkers.

Strong cider sold in Scotland appears to be almost exclusively for dependent drinkers

Follow-up study of people who misuse alcohol: reflections on methodology.

Background Considerable challenges exist for researchers attempting to monitor longitudinally the impact of any intervention on heavy drinkers, therefore they are often excluded from surveys. A particular challenge is the loss of validity through attrition.Aim To describe issues encountered when recruiting and re-contacting difficult to reach heavy drinkers participating in a longitudinal study; and propose strategies to inform the design of future studies to minimise the effects of confounding factors.Discussion Baseline recruitment exceeded targets, but attrition at first follow-up interview was considerable. Baseline alcohol consumption was not predictive of loss to follow-up. A variety of factors affected attrition including abstinence, severe intoxication at interview, deaths, selling of telephone, change of address and incarceration.Conclusion Longitudinal studies that use personal telephones or address details in following up heavy drinkers face considerable challenges to minimise attrition. An important mitigating factor is the use of flexible and experienced interviewers.Implications for practice The anticipated and reactive strategies documented in this paper provide important lessons for costing, designing and collecting data in future studies

Follow-up study of people who misuse alcohol: reflections on methodology.

Background Considerable challenges exist for researchers attempting to monitor longitudinally the impact of any intervention on heavy drinkers, therefore they are often excluded from surveys. A particular challenge is the loss of validity through attrition.Aim To describe issues encountered when recruiting and re-contacting difficult to reach heavy drinkers participating in a longitudinal study; and propose strategies to inform the design of future studies to minimise the effects of confounding factors.Discussion Baseline recruitment exceeded targets, but attrition at first follow-up interview was considerable. Baseline alcohol consumption was not predictive of loss to follow-up. A variety of factors affected attrition including abstinence, severe intoxication at interview, deaths, selling of telephone, change of address and incarceration.Conclusion Longitudinal studies that use personal telephones or address details in following up heavy drinkers face considerable challenges to minimise attrition. An important mitigating factor is the use of flexible and experienced interviewers.Implications for practice The anticipated and reactive strategies documented in this paper provide important lessons for costing, designing and collecting data in future studies

Numerical predictions and experimental results of a dry bay fire environment.

The primary objective of the Safety and Survivability of Aircraft Initiative is to improve the safety and survivability of systems by using validated computational models to predict the hazard posed by a fire. To meet this need, computational model predictions and experimental data have been obtained to provide insight into the thermal environment inside an aircraft dry bay. The calculations were performed using the Vulcan fire code, and the experiments were completed using a specially designed full-scale fixture. The focus of this report is to present comparisons of the Vulcan results with experimental data for a selected test scenario and to assess the capability of the Vulcan fire field model to accurately predict dry bay fire scenarios. Also included is an assessment of the sensitivity of the fire model predictions to boundary condition distribution and grid resolution. To facilitate the comparison with experimental results, a brief description of the dry bay fire test fixture and a detailed specification of the geometry and boundary conditions are included. Overall, the Vulcan fire field model has shown the capability to predict the thermal hazard posed by a sustained pool fire within a dry bay compartment of an aircraft; although, more extensive experimental data and rigorous comparison are required for model validation

An exploration of the lived experiences of people with alcohol related harm in Scotland

Background; Alcohol consumption has posed well documented problems for Scottish society, in terms of morbidity, mortality and wider societal costs. Objectives; To investigate the lived experiences and drinking behaviours of people with alcohol-related harm in Scotland, against a backdrop of recent economic downturn, falling incomes, welfare reform and changes to state benefits. Methods; As part of a larger Scottish study (2012-2014) of 639 individuals attending hospital or admitted, relating to an alcohol problem, 20 participants completed semi-structured interviews about their drinking and purchasing habits which were subjected to thematic analysis. Conclusions; Key themes elucidated participants' everyday drink-related behaviours within their local environment including drinking triggers, sourcing alcohol, resourcing alcohol purchase and views relating to substitution. The majority of participants had experienced reduced income, and adapted their alcohol purchasing behaviours accordingly, including 'trading down' to cheaper alcohol. A reduction in food purchasing and heating was a common outcome, as was falling into, or increasing current, debt. More attention should be paid to the prevalence and accessibility of alcohol within local communities. Ultimately, as long as there is highly visible and easily accessible cheap alcohol, heavy drinkers may struggle to undertake positive steps to reduce their damaging consumption levels.div_PaSAnderson, P., & Baumberg, B. (2006). Alcohol in Europe. A public health perspective: London: Institute of Alcohol Studies; 2006. Beeston, C., McAdams, R., Craig, N., Gordon, R., Graham, L., MacPherson, M., McAuley, A., McCartney, G., Robinson, M., Shipton, D., & Van Heelsum, A. (2016). Monitoring and Evaluating Scotland's Alcohol Strategy. Final Report. Edinburgh: NHS Health Scotland. Black, H., Gill, J., & Chick, J. (2011). The price of a drink: levels of consumption and price paid per unit of alcohol by Edinburgh's ill drinkers with a comparison to wider alcohol sales in Scotland. Addiction, 106(4), 729-736. BMA (2012). Reducing the affordability of alcohol. A briefing from the BMA Board of Science: British Medical Association, London: BMA; 2012. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. Cohn, S. (2016). Reconceptualising public acceptability: A study of the ways people respond to policies aimed to reduce alcohol consumption. Health, 20, 203-219. Cook, P., Phillips-Howard, P., Morleo, M., Harkins, C., Briant, L., & Bellis, M. (2011). The Big Drink Debate: perceptions of the impact of price on alcohol consumption form a large scale cross-sectional convenience survey in north west England. BMC Public Health, 11, 664. doi: 10.1186/1471-2458-11-664. 21 Duffy, J., & Snowdon, C. (2012). The minimal evidence for minimum pricing: London: ASI (Research) Ltd. Forsyth, A.J.M., Ellaway, A., & Davidson, N. (2014). How might the Alcohol Minimum Unit Pricing (MUP) impact upon local off-sales shops and the communities which they serve? Alcohol and Alcoholism, 49(1), 96-102. Foster, J., & Ferguson, C. (2012). Home drinking in the UK: trends and causes. Alcohol and Alcoholism, 47(3), 355-358. Gill, J., Chick, J., Black, H., Rees, C., O'May, F., Rush, R., & McPake, B.A. (2015). Alcohol purchasing by ill heavy drinkers; cheap alcohol is no single commodity. Public Health, 129(12), 1571-1578. Gmel, G., Holmes, J. & Studer, J. (2016). Are alcohol outlet densities strongly associated with alcohol-related outcomes? A critical review of recent evidence. Drug and Alcohol Review, 35, 40-54. HM Government (2012). Welfare Reform Act 2012. Retrieved from http://services.parliament.uk/bills/2010-11/welfarereform.html (last accessed 14 January 2016) ISD (2015). Alcohol-related Hospital Statistics Scotland 2014/15. Edinburgh: Information and Statistics Division. Retrieved from http://www.isdscotland.org/Health-Topics/Drugs-and- 22 Alcohol-Misuse/Publications/2015-10-13/2015-10-13-ARHS2014-15-Report.pdf (last accessed 14 January 2016) Ludbrook, A., Petrie, D., McKenzie, L., & Farrar, S. (2012). Tackling alcohol misuse purchasing patterns affected by minimum pricing for alcohol. Applied Health Economics and Health Policy, 10(1), 51-63. MacNaughton, P., & Gillan, E. (2011). Re-thinking alcohol licensing. Edinburgh: Alcohol Focus Scotland/Scottish Health Action on Alcohol Problems. Makela, P., Herttua, K., & Martikainen, P. (2015). The socioeconomic differences in alcohol-related harm and the effects of alcohol prices on them: a summary of evidence from Finland. Alcohol and Alcoholism, 50(6), 661-669. Nakamura, R., Suhrcke, M., Pechey, R., Morciano, M., Roland, M., & Marteau, T.M. (2014a). Impact on alcohol purchasing of a ban on multi-buy promotions: a quasi-experimental evaluation comparing Scotland with England and Wales. Addiction 109(4): 558-567. Nakamura, R., Pechey, R., Suhrcke, M., Jebb, S., & Marteau, T. (2014b). Sales impact of displaying alcoholic and no-alcoholic beverages in end-of-aisle locations: an observational study. Social Science & Medicine 108: 68-73. ONS (2014). Office for National Statistics. Statistical Bulletin: Alcohol-related deaths in the United Kingdom, registered in 2012. Retrieved from http://www.ons.gov.uk/ons/dcp171778_353201.pdf (last accessed 14 January 2016). 23 O'May, F., Black, H., Gill, J., Rees, C., Chick, J., & McPake, B. (2016) Dependent drinkers' perspectives on minimum unit pricing for alcohol in Scotland: a qualitative interview study. SAGEOpen, DOI: 10.1177/2158244016657141. O'May F, Whittaker A, Black H and Gill J. (2016) The families and friends of heavy drinkers; caught in the cross fire of policy change? Drug and Alcohol Review 2016 Apr 13. doi: 10.1111/dar.12403. Orford, J., Velleman, R., Copello, A., Templeton, L. & Ibanga, A. (2010). The experiences of affected family members: a summary of two decades of qualitative research. Drug Education Prevention and Policy, 17, 44-62. Orford, J., Velleman, R., Natera, G., Templeton, L. & Coppello, A. (2013). Addiction in the family is a major but neglected contributor to the global burden of adult ill-health. Social Science & Medicine, 78, 70-77. Rice, P. (2014). Why do the health professions want minimum unit price in Scotland? In Proceedings of Scotland the Brave! - Alcohol Policy in Scotland, 5 September, 2014, Brussels. Retrieved from http://www.shaap.org.uk/images/mup-event-summary.pdf (last accessed 14 January 2016). Richardson, E.A., Hill, S.E., Mitchell,R., Pearce, J., & Shortt, N.K. (2015). Is local alcohol outlet density related to alcohol-related morbidity and mortality in Scottish cities? Health & Place, 33, 172-180. 24 Riessman, C. (1993). Narrative Analysis. London: Sage. Robinson, M., Geue, C., Lewsey, J., Mackay, D., McCartney, G., Curnock, E., Beeston, C. (2013). Monitoring and Evaluating Scotland's Alcohol Strategy: The impact of the Alcohol Act on off-trade alcohol sales in Scotland: Edinburgh: NHS Health Scotland. Robinson, M., Beeston, C., McCartney, G., Craig, N. (2015). Monitoring and Evaluating Scotland's Alcohol Strategy: Annual update of alcohol sales and price band analyses. Edinburgh: NHS Health Scotland. Scottish Government (2009). Changing Scotland's relationship with alcohol: a framework for action: Edinburgh: Health and Social Care Directorate. Scottish Government (2012). Introduction to SIMD. Edinburgh: Scottish Government. Retrieved from http://simd.scotland.gov.uk/publication-2012/ (last accessed 14 January 2016). Scottish Government (2015a). Minimum unit pricing. Retrieved from http://www.scotland.gov.uk/Topics/Health/Services/Alcohol/minimum-pricing (last accessed 12 January 2016(. Scottish Government (2015b). Scottish Liquor Licensing Statistics 2014-2015. Retrieved from http://www.gov.scot/Topics/Statistics/Browse/Crime-Justice/PubLiquor (last accessed 14 January 2016). 25 Scottish Parliament (2005). Licensing (Scotland) Act 2005. Edinburgh: Scottish Parliament. Scottish Parliament (2010). Alcohol etc. (Scotland) Act 2010. Edinburgh: Scottish Parliament. Scottish Parliament (2012). Alcohol (Minimum Pricing) (Scotland) Act. Edinburgh: Scottish Parliament. Scottish Parliament (2015). Welfare Reform Committee 1st Report, 2015 (Session 4): The Cumulative Impact of Welfare Reform on Households in Scotland. Edinburgh: Scottish Parliament. Sheron, N. (2014). Alcohol and Liver Disease in Europe. In Proceedings of Scotland the Brave! - Alcohol Policy in Scotland, 5 September, 2014, Brussels. Retrieved from http://www.shaap.org.uk/images/mup-event-summary.pdf (last accessed 14 January 2016). Shipton, D., & Whyte, B. (2011). Mental Health in Focus: a profile of mental health and wellbeing in Greater Glasgow & Clyde. Glasgow: Glasgow Centre for Population Health. Retrieved from http://www.gcph.co.uk/assets/0000/2748/Mental_Health_in_Focus_15_11_11.pdf (last accessed 14 January 2016).pub4623pu

An exploration of the lived experiences of people with alcohol-related harm in Scotland

Background: Alcohol consumption has posed well-documented problems for Scottish society in terms of morbidity, mortality, and wider societal costs. Objectives: To investigate the lived experiences and drinking behaviors of people with alcohol-related harm in Scotland against a backdrop of recent economic downturn, falling incomes, welfare reform, and changes to state benefits. Methods: As part of a larger Scottish study (2012–2014) of 639 individuals attending hospital or admitted, relating to an alcohol problem, 20 participants completed semistructured interviews about their drinking and purchasing habits that were subjected to thematic analysis. Conclusions: Key themes elucidated participants’ everyday drink-related behaviors within their local environment including drinking triggers, sourcing alcohol, resourcing alcohol purchase, and views relating to substitution. The majority of participants had experienced reduced income and adapted their alcohol-purchasing behaviors accordingly, including “trading down” to cheaper alcohol. A reduction in food purchasing and heating was a common outcome, as was falling into, or increasing current, debt. More attention should be paid to the prevalence and accessibility of alcohol within local communities. Ultimately, as long as there is highly visible and easily accessible cheap alcohol, heavy drinkers may struggle to undertake positive steps to reduce their damaging consumption levels