TRANSIT Working Paper # 7

A previous version of this paper has been part of TRANSIT Deliverable 3.3 (July 2016), the second prototype of TSI theory.[Abstract] This working paper presents a set of propositions about the agency and dynamics of transformative social innovation (TSI) that have been developed as part of an EU-funded research project entitled “TRANsformative Social Innovation Theory” (TRANSIT; 2014-2017). These TSI propositions represent first steps towards the development of a new theory of TSI, taking the form of proto-explanations of the agency and dynamics of TSI, based on the bringing together of our empirical observations on TSI and the project's theoretical reviews and theoretical framings. Ideally this working paper should be read in conjunction with the working paper entitled “A framework for transformative social innovation” (Haxeltine et al 2016) which presents in skeletal terms the theoretical and conceptual framing of TSI developed in the TRANSIT project. This TSI framework builds on sustainability transition studies, social innovation research, social psychology studies of empowerment and other several other areas of social theory to deliver a bespoke theoretical and conceptual framework that is grounded in a relational ontology and which is being employed as a platform for the development of a middle-range theory of TSI. Next we provide a very brief overview of some key elements of the framework, in particular how we conceptualise social innovation, transformative change, and transformative social innovation. Propositions were developed for each of four relational dimensions implied by the TSI framework with also a brief statement of the topic addressed by each of the twelve propositions.This article is based on research carried out as part of the Transformative Social Innovation Theory (“TRANSIT”) project, which is funded by the European Union's Seventh Framework Programme (FP7) under grant agreement 61316

The Critical Turning Points Database : Concept, Methodology and Dataset of an International Transformative Social Innovation Comparison (TRANSIT Working Paper # 10, July 12th 2017)

[Abstract] This working paper presents the TRANSIT open-access online database on Critical Turning Points (CTP) in Transformative Social Innovation. It specifies the contents of the database, comprising qualitative accounts of more than 450 ‘critical’ episodes in the evolution of social innovation initiatives in 27 different countries. Providing the theoretical-methodological context to these data, the paper also describes the theoretical background of the CTP concept and the methodology though which the CTP accounts have been reconstructed through interviews with members of SI initiatives. The paper concludes with reflections on the open access CTP database as a knowledge infrastructure, discussing its significance in terms of mapping, dissemination and framing of social innovation.This project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no 61316

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

A First Prototype of TSI Theory: TRANSIT WP3 Deliverable D3.2

Version 1.1[Abstract] The purpose of this deliverable (D3.2) of the TRANSIT research project is to report on the development of a ‘first prototype’ of a middle-range theory of transformative social innovation. The ‘prototype’ is presented here in the form a framework for Transformative Social Innovation, which at this point (in the research process) consists of a theoretically-grounded conceptual framework for TSI together with a set of propositions about the dynamics of TSI, that have been developed based on the findings of the first phase of empirical research in the project.This project has received funding from the European Union’s Seventh Framework Programme for research, Grant agreement n. 61316