19,753 research outputs found

    The effect direction plot: visual display of non-standardised effects across multiple outcome domains

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    Visual display of reported impacts is a valuable aid to both reviewers and readers of systematic reviews. Forest plots are routinely prepared to report standardised effect sizes, but where standardised effect sizes are not available for all included studies a forest plot may misrepresent the available evidence. Tabulated data summaries to accompany the narrative synthesis can be lengthy and inaccessible. Moreover, the link between the data and the synthesis conclusions may be opaque. This paper details the preparation of visual summaries of effect direction for multiple outcomes across 29 quantitative studies of the health impacts of housing improvement. A one page summary of reported health outcomes was prepared to accompany a 10 000-word narrative synthesis. The one page summary included details of study design, internal validity, sample size, time of follow-up, as well as changes in intermediate outcomes, for example, housing condition. This approach to visually summarising complex data can aid the reviewer in cross-study analysis and improve accessibility and transparency of the narrative synthesis where standardised effect sizes are not available

    Good Housing Good Health? A review and recommendations for housing and health practitioners.

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    NASA/FAA general aviation crash dynamics program

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    The program involves controlled full scale crash testing, nonlinear structural analyses to predict large deflection elastoplastic response, and load attenuating concepts for use in improved seat and subfloor structure. Both analytical and experimental methods are used to develop expertise in these areas. Analyses include simplified procedures for estimating energy dissipating capabilities and comprehensive computerized procedures for predicting airframe response. These analyses are developed to provide designers with methods for predicting accelerations, loads, and displacements on collapsing structure. Tests on typical full scale aircraft and on full and subscale structural components are performed to verify the analyses and to demonstrate load attenuating concepts. A special apparatus was built to test emergency locator transmitters when attached to representative aircraft structure. The apparatus is shown to provide a good simulation of the longitudinal crash pulse observed in full scale aircraft crash tests

    Incentives for breastfeeding and for smoking cessation in pregnancy: An exploration of types and meanings

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    Financial or tangible incentives are a strategy for improving health behaviours. The mechanisms of action of incentives are complex and debated. Using a multidisciplinary integrated mixed methods study, with service-user collaboration throughout, we developed a typology of incentives and their meanings for initiating and sustaining smoking cessation in pregnancy and breastfeeding. The ultimate aim was to inform incentive intervention design by providing insights into incentive acceptability and mechanisms of action. Systematic evidence syntheses of incentive intervention studies for smoking cessation in pregnancy or breastfeeding identified incentive characteristics, which were developed into initial categories. Little published qualitative data on user perspectives and acceptability was available. Qualitative interviews and focus groups conducted in three UK regions with a diverse socio-demographic sample of 88 women and significant others from the target population, 53 service providers, 24 experts/decision makers, and conference attendees identified new potential incentives and providers, with and without experience of incentives. Identified incentives (published and emergent) were classified into eight categories: cash and shopping vouchers, maternal wellbeing, baby and pregnancy-related, behaviour-related, health-related, general utility, awards and certificates, and experiences. A typology was refined iteratively through concurrent data collection and thematic analysis to explore participants' understandings of ‘incentives’ and to compare and contrast meanings across types. Our typology can be understood in three dimensions: the degree of restriction, the extent to which each is hedonic and/or utilitarian, and whether each has solely monetary value versus monetary with added social value. The layers of autonomy, meanings and the social value of incentive types influence their acceptability and interact with structural, social, and personal factors. Dimensions of incentive meaning that go beyond the simple incentive description should inform incentive programme design and are likely to influence outcomes

    Survey of NASA research on crash dynamics

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    Ten years of structural crash dynamics research activities conducted on general aviation aircraft by the National Aeronautics and Space Administration (NASA) are described. Thirty-two full-scale crash tests were performed at Langley Research Center, and pertinent data on airframe and seat behavior were obtained. Concurrent with the experimental program, analytical methods were developed to help predict structural behavior during impact. The effects of flight parameters at impact on cabin deceleration pulses at the seat/occupant interface, experimental and analytical correlation of data on load-limiting subfloor and seat configurations, airplane section test results for computer modeling validation, and data from emergency-locator-transmitter (ELT) investigations to determine probable cause of false alarms and nonactivations are assessed. Computer programs which provide designers with analytical methods for predicting accelerations, velocities, and displacements of collapsing structures are also discussed

    Perspectives on financial incentives to health service providers for increasing breast feeding and smoking quit rates during pregnancy: a mixed methods study

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    Objective: To explore the acceptability, mechanisms and consequences of provider incentives for smoking cessation and breast feeding as part of the Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS) study. Design: Cross-sectional survey and qualitative interviews. Setting: Scotland and North West England. Participants: Early years professionals: 497 survey respondents included 156 doctors; 197 health visitors/maternity staff; 144 other health staff. Qualitative interviews or focus groups were conducted with 68 pregnant/postnatal women/family members; 32 service providers; 22 experts/decision-makers; 63 conference attendees. Methods: Early years professionals were surveyed via email about the acceptability of payments to local health services for reaching smoking cessation in pregnancy and breastfeeding targets. Agreement was measured on a 5-point scale using multivariable ordered logit models. A framework approach was used to analyse free-text survey responses and qualitative data. Results: Health professional net agreement for provider incentives for smoking cessation targets was 52.9% (263/497); net disagreement was 28.6% (142/497). Health visitors/maternity staff were more likely than doctors to agree: OR 2.35 (95% CI 1.51 to 3.64; p<0.001). Net agreement for provider incentives for breastfeeding targets was 44.1% (219/497) and net disagreement was 38.6% (192/497). Agreement was more likely for women (compared with men): OR 1.81 (1.09 to 3.00; p=0.023) and health visitors/maternity staff (compared with doctors): OR 2.54 (95% CI 1.65 to 3.91; p<0.001). Key emergent themes were 'moral tensions around acceptability', 'need for incentives', 'goals', 'collective or divisive action' and 'monitoring and proof'. While provider incentives can focus action and resources, tensions around the impact on relationships raised concerns. Pressure, burden of proof, gaming, box-ticking bureaucracies and health inequalities were counterbalances to potential benefits. Conclusions: Provider incentives are favoured by non-medical staff. Solutions which increase trust and collaboration towards shared goals, without negatively impacting on relationships or increasing bureaucracy are required
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