Evaluability Assessment: A Systematic Approach to Deciding Whether and How to Evaluate Programmes and Policies

Evaluability assessment (EA) is a systematic approach to planning evaluation projects. It involves structured engagement by researchers with stakeholders to clarify intervention goals and how they are expected to be achieved, the development and evaluation of a logic model or theory of change, and provision of advice on whether or not an evaluation can be carried out at reasonable cost, and what methods should be used. To date, EA has been relatively little used in the UK, but it has begun to attract attention as a way of balancing the growing demand for evaluation with the limited resource available. As well as providing a sound basis for making decisions about whether and how to evaluate before resources are committed, EA can improve the translation of research into practice by ensuring that policy-makers and practitioners are involved from the beginning in developing and appraising evaluation options. Two EAs have recently been conducted in Scotland, which provide a model that can be applied to a wide range of interventions, programmes and policies at national, regional and local levels. What Works Scotland is keen to work with Community Planning Partnerships (CPPs) to identify opportunities for EA

Translational perspectives on perfusion-diffusion mismatch in ischemic stroke

Magnetic resonance imaging has tremendous potential to illuminate ischemic stroke pathophysiology and guide rational treatment decisions. Clinical applications to date have been largely limited to trials. However, recent analyses of the major clinical studies have led to refinements in selection criteria and improved understanding of the potential implications for the risk vs. benefit of thrombolytic therapy. In parallel, preclinical studies have provided complementary information on the evolution of stroke that is difficult to obtain in humans due to the requirement for continuous or repeated imaging and pathological verification. We review the clinical and preclinical advances that have led to perfusion–diffusion mismatch being applied in phase 3 randomized trials and, potentially, future routine clinical practice

Tell Nebi Mend: Trench VIII

Tell Nebi Mend is most famously known at the site of the battle between the Egyptians and the Hittites at Qadesh. However, its history goes back much further than this. Research at the site since the 1920s has uncovered a depth of occupation so far unrivalled in archaeological excavations in Western Syria. Thus the site is of great importance with regards to investigating the Orontes Valley and its relationship to surrounding regions, in particular during the Late Chalcolithic and Early Bronze Age phases, the majority of the evidence of which has been uncovered in Trench VIII, dug under the direction of Peter Parr. Excavated in the 1980s, the results of the investigation at Tell Nebi Mend were never fully published. With very little other archaeology undertaken with a focus on this period, and without any other excavations demonstrating the depth of stratigraphy exhibited at Tell Nebi Mend, the publication of Trench VIII is of pressing importance as an excavation in itself and as a reference for future work in the region. As such, my work will concentrate on fully writing up the stratigraphy of Trench VIII, from the Late Chalcolithic reoccupation of the site through to the suggested transition to the Early Bronze phases. Furthermore, I will be studying the ceramics from these phases in order to consolidate the phasing from the site and in order to provide a regional comparison of the ceramics from Tell Nebi Mend with its immediate area and with settlements further away. This is intended to further 'place' Tell Nebi Mend within the region and to investigate the various cultural and technological influences on ceramics during the Late Chalcolithic-Early Bronze phases. Hopefully this research will not only contribute to the final publication of the Trench VIII material from Tell Nebi Mend, but will also engage with a growing interest in the formerly somewhat under-studied Orontes Valley and its position in Western Syria

Assessing reporting of narrative synthesis of quantitative data in public health systematic reviews

No abstract available

The efect of school summer holidays on inequalities in children and young people’s mental health and cognitive ability in the UK using data from the millennium cohort study

Background: Summer learning loss has been the subject of longstanding concern among researchers, the public and policy makers. The aim of the current research was to investigate inequality changes in children’s mental health and cognitive ability across the summer holidays. Methods: We conducted linear and logistic regression analysis of mental health (borderline-abnormal total difculty and prosocial scores on the strengths and difculties questionnaire (SDQ)) and verbal cognitive ability (reading, verbal reasoning or vocabulary) at ages 7, 11 and 14, comparing UK Millennium Cohort Study members who were interviewed before and after the school summer holidays. Inequalities were assessed by including interaction terms in the outcome models between a discrete binary variable with values representing time periods and maternal academic qualifcations. Coefcients of the interaction terms were interpreted as changes from the pre- to post-holiday period in the extent of inequality in the outcome between participants whose mothers had high or low educational qualifcations. Separate models were ftted for each age group and outcome. We used inverse probability weights to allow for diferences in the characteristics of cohort members assessed before and after the summer holidays. Results: Mental health (borderline/abnormal SDQ total and prosocial scores) at ages 7 and 14 worsened and verbal cognitive ability scores at age 7 were lower among those surveyed after the summer holidays. Mental health inequalities were larger after the holidays at age 7 ([OR=1.4; 95%CI (0.6, 3.2) and 14: [OR=1.5; 95%CI (0.7, 3.2)], but changed little at age 11 (OR=0.9; 95%CI (0.4, 2.6)]. There were diferences in pro-social behaviours among those surveyed before/after the school holidays at age 14 [OR=1.2; 95%CI (0.5, 3.5)] but not at age 7 or 11. There was little change in inequalities in verbal cognitive ability scores over the school holidays [Age 7: b=1.3; 95%CI (−3.3, 6.0); Age 11: b=−0.7; 95%CI (−4.3, 2.8); Age 14: b=−0.3; 95%CI (−1.0, 0.4)]. Conclusion: We found inequalities in mental health and cognitive ability according to maternal education, and some evidence or worsening mental health and mental health inequalities across school summer holidays. We found little evidence of widening inequalities in verbal cognitive ability. Widespread school closures during the COVID-1

TIDieR-PHP: a reporting guideline for population health and policy interventions

We lack guidance on how to describe population health and policy (PHP) interventions in reports of evaluation studies. PHP interventions are legal, fiscal, structural, organisational, environmental, and policy interventions such as the regulation of unhealthy commodities, health service reorganisation, changes in welfare policy, and neighbourhood improvement schemes. Many PHP interventions have characteristics that are important for their implementation and success but are not adequately captured in the original Template for Intervention Description and Replication (TIDieR) checklist. This article describes the development of a revised reporting template for PHP interventions (TIDieR-PHP) and presents the checklist with examples for each ite

Influenza virus infection in a compromised immune system

Severe influenza virus infection, including human infection with highly pathogenic H5N1 viruses is characterised by massive pulmonary inflammation, immunopathology and excessive cytokine production, a process in which macrophages may play a vital role. The aim of this project was to investigate the hypothesis that inhibition of inflammatory responses from infected macrophages, using either alternatively activated bone marrow derived macrophages (BMDMf), or IFNg receptor deficient (IFNgR-/-) mice may ameliorate the devastating immunopathology and inflammation routinely observed in highly pathogenic influenza virus infections. Infection of alternatively activated BMDMf resulted in enhanced positivity for viral proteins, compared with classically activated, inflammatory BMDMf. However, neither subset propagated the infection indicating that while infection is abortive in both classical and alternatively activated BMDMf, the latter may prove more efficient at removing infectious virus from the site of infection due to enhanced infectivity. However, influenza virus was capable of driving expression of proinflammatory mediators such as iNOS and TNFa from classical and alternatively activated BMDMf even in the absence of IFNg signalling. IFNgR-/- BMDMf demonstrated a reduced inflammatory response to infection compared to Sv129 counterparts, suggesting a potentially impaired inflammatory response in vivo. This was investigated by infection of IFNgR-/- mice, which resulted in ameliorated disease, lower viral titres and mild immunopathology, demonstrating that inhibition of IFNg signalling limits the severity of disease. Additionally, mRNA expression for key inflammatory mediators was reduced, demonstrating that inhibition of the overwhelming inflammatory response to influenza virus infection is beneficial to the host, resulting in protection from immunopathology and improved prognosis, without impairing viral clearance

How does money influence health?

This study looks at hundreds of theories to consider how income influences health. There is a graded association between money and health – increased income equates to better health. But the reasons are debated.<p></p> Researchers have reviewed theories from 272 wide-ranging papers, most of which examined the complex interactions between people’s income and their health throughout their lives.<p></p> Key points<p></p> This research identifies four main ways money affects people’s wellbeing:<p></p> Material: Money buys goods and services that improve health. The more money families have, the better the goods they can buy.<p></p> Psychosocial: Managing on a low income is stressful. Comparing oneself to others and feeling at the bottom of the social ladder can be distressing, which can lead to biochemical changes in the body, eventually causing ill health.<p></p> Behavioural: For various reasons, people on low incomes are more likely to adopt unhealthy behaviours – smoking and drinking, for example – while those on higher incomes are more able to afford healthier lifestyles.<p></p> Reverse causation (poor health leads to low income): Health may affect income by preventing people from taking paid employment. Childhood health may also affect educational outcomes, limiting job opportunities and potential earnings

Lone parents, health, wellbeing and welfare to work:a systematic review of qualitative studies

Abstract Background Lone parents and their children experience higher than average levels of adverse health and social outcomes, much of which are explained by high rates of poverty. Many high income countries have attempted to address high poverty rates by introducing employment requirements for lone parents in receipt of welfare benefits. However, there is evidence that employment may not reduce poverty or improve the health of lone parents and their children. Methods We conducted a systematic review of qualitative studies reporting lone parents’ accounts of participation in welfare to work (WtW), to identify explanations and possible mechanisms for the impacts of WtW on health and wellbeing. Twenty one bibliographic databases were searched. Two reviewers independently screened references and assessed study quality. Studies from any high income country that met the criteria of focussing on lone parents, mandatory WtW interventions, and health or wellbeing were included. Thematic synthesis was used to investigate analytic themes between studies. Results Screening of the 4703 identified papers and quality assessment resulted in the inclusion of 16 qualitative studies of WtW in five high income countries, USA, Canada, UK, Australia, and New Zealand, covering a variety of welfare regimes. Our synthesis found that WtW requirements often conflicted with child care responsibilities. Available employment was often poorly paid and precarious. Adverse health impacts, such as increased stress, fatigue, and depression were commonly reported, though employment and appropriate training was linked to increased self-worth for some. WtW appeared to influence health through the pathways of conflict and control, analytical themes which emerged during synthesis. WtW reduced control over the nature of employment and care of children. Access to social support allowed some lone parents to manage the conflict associated with employment, and to increase control over their circumstances, with potentially beneficial health impacts. Conclusion WtW can result in increased conflict and reduced control, which may lead to negative impacts on mental health. Availability of social support may mediate the negative health impacts of WtW

KidzPass:authenticating pre-literate children

Many online services require users to authenticate themselves to prove their identity. Text-based passwords are the most widely-used authentication mechanism. Yet a number of population groups struggle with text-based passwords. One of these groups is made up of children aged 3-5. This is an important sector of society, because many of these children use the Internet at home. This was especially true during the COVID-19 pandemic.Young children can struggle with text-based passwords due to their emerging literacy and immature development. The majority of children do not learn to read fluently until age seven. At age four or five, they generally do not have the required skills to create, retain and manage alphanumeric passwords. This might well leave young children vulnerable when online or impose unrealistic demands on their care givers who support them in authenticating themselves.Here, we report on the development and evaluation of two versions of KidzPass, a graphical authentication mechanism that specifically relies on the abilities 3-5 year old children can be expected to possess. We conclude by reporting on lessons learned about designing authentication for this target user group