Who knows best? A Q methodology study to explore perspectives of professional stakeholders and community participants on health in low-income communities

Abstract Background Health inequalities in the UK have proved to be stubborn, and health gaps between best and worst-off are widening. While there is growing understanding of how the main causes of poor health are perceived among different stakeholders, similar insight is lacking regarding what solutions should be prioritised. Furthermore, we do not know the relationship between perceived causes and solutions to health inequalities, whether there is agreement between professional stakeholders and people living in low-income communities or agreement within these groups. Methods Q methodology was used to identify and describe the shared perspectives (‘subjectivities’) that exist on i) why health is worse in low-income communities (‘Causes’) and ii) the ways that health could be improved in these same communities (‘Solutions’). Purposively selected individuals (n = 53) from low-income communities (n = 25) and professional stakeholder groups (n = 28) ranked ordered sets of statements – 34 ‘Causes’ and 39 ‘Solutions’ – onto quasi-normal shaped grids according to their point of view. Factor analysis was used to identify shared points of view. ‘Causes’ and ‘Solutions’ were analysed independently, before examining correlations between perspectives on causes and perspectives on solutions. Results Analysis produced three factor solutions for both the ‘Causes’ and ‘Solutions’. Broadly summarised these accounts for ‘Causes’ are: i) ‘Unfair Society’, ii) ‘Dependent, workless and lazy’, iii) ‘Intergenerational hardships’ and for ‘Solutions’: i) ‘Empower communities’, ii) ‘Paternalism’, iii) ‘Redistribution’. No professionals defined (i.e. had a significant association with one factor only) the ‘Causes’ factor ‘Dependent, workless and lazy’ and the ‘Solutions’ factor ‘Paternalism’. No community participants defined the ‘Solutions’ factor ‘Redistribution’. The direction of correlations between the two sets of factor solutions – ‘Causes’ and ‘Solutions’ – appear to be intuitive, given the accounts identified. Conclusions Despite the plurality of views there was broad agreement across accounts about issues relating to money. This is important as it points a way forward for tackling health inequalities, highlighting areas for policy and future research to focus on

Compositional transformation and impurity-mediated optical transitions in co-evaporated Cu2AgBiI6 thin films for photovoltaic applications

Quaternary copper-silver-bismuth-iodide compounds represent a promising new class of wide-bandgap (2 eV) semiconductors for photovoltaic and photodetector applications. In this study, vapor phase co-evaporation is utilized to fabricate Cu2AgBiI6 thin films and photovoltaic devices. The findings show that the properties of vapor-deposited films are highly dependent upon processing temperature, exhibiting increased pinhole density and transforming into a mixture of quaternary, binary, and metallic phases depending on the post-deposition annealing temperature. This change in phase is accompanied by an enhancement in photoluminescence (PL) intensity and charge-carrier lifetime, along with the emergence of an additional absorption peak at high energy (≈3 eV). Generally, increased PL is a desirable property for a solar absorber material, but this change in PL is ascribed to the formation of CuI impurity domains, whose defect-mediated optical transition dominates the emission properties of the thin film. Via optical pump terahertz probe spectroscopy, it is revealed that CuI impurities hinder charge-carrier transport in Cu2AgBiI6 thin films. It is also revealed that the predominant performance limitation in Cu2AgBiI6 materials is the short electron-diffusion length. Overall, the findings pave the way for potential solutions to critical issues in copper-silver-bismuth-iodide materials and indicate strategies to develop environmentally compatible wide-bandgap semiconductors

From causes to solutions - insights from lay knowledge about health inequalities

<p>Abstract</p> <p>Background</p> <p>This paper reports on a qualitative study of lay knowledge about health inequalities and solutions to address them. Social determinants of health are responsible for a large proportion of health inequalities (unequal levels of health status) and inequities (unfair access to health services and resources) within and between countries. Despite an expanding evidence base supporting action on social determinants, understanding of the impact of these determinants is not widespread and political will appears to be lacking. A small but growing body of research has explored how ordinary people theorise health inequalities and the implications for taking action. The findings are variable, however, in terms of an emphasis on structure versus individual agency and the relationship between being 'at risk' and acceptance of social/structural explanations.</p> <p>Methods</p> <p>This paper draws on findings from a qualitative study conducted in Adelaide, South Australia, to examine these questions. The study was an integral part of mixed-methods research on the links between urban location, social capital and health. It comprised 80 in-depth interviews with residents in four locations with contrasting socio-economic status. The respondents were asked about the cause of inequalities and actions that could be taken by governments to address them.</p> <p>Results</p> <p>Although generally willing to discuss health inequalities, many study participants tended to explain the latter in terms of individual behaviours and attitudes rather than social/structural conditions. Moreover, those who identified social/structural causes tended to emphasise individualized factors when describing typical pathways to health outcomes. This pattern appeared largely independent of participants' own experience of advantage or disadvantage, and was reinforced in discussion of strategies to address health inequalities.</p> <p>Conclusions</p> <p>Despite the explicit emphasis on social/structural issues expressed in the study focus and framing of the research questions, participants did not display a high level of knowledge about the nature and causes of place-based health inequalities. By extending the scope of lay theorizing to include a focus on solutions, this study offers additional insights for public health. Specifically it suggests that a popular constituency for action on the social determinants of health is unlikely to eventuate from the current popular understandings of possible policy levers.</p

Social media for health promotion and weight management: A critical debate

© 2018 The Author(s). Background: In 2016 an estimated 1.9 billion adults world-wide were either overweight or obese. The health consequences of obesity are responsible for 2.8 million preventable deaths per year. The WHO now considers obesity as a global epidemic and recommends population-wide health promotion strategies to address this issue. Weight gain is caused by increased energy intake and physical inactivity, so treatment should focus on changes to behaviour regarding diet and physical activity. Discussion: The WHO has also recognised the importance of social resources as a valuable agent for behaviour change in health promotion. Social resources are translated at the community level as support provided by significant others such as family, partners and peers, in the form of information, material aid and encouragement. Social support has been shown to improve health and well-being, whereas social isolation has been shown to have a negative impact on health outcomes. Social support provided by peers has been shown to be a useful strategy to employ in weight management programmes. The documented increased use of ICT and social media has presented health promoters with a potentially useful medium to increase social support for weight management. Conclusion: While the use of social media for health promotion is an emerging field of investigation, preliminary research suggests that it increases participant engagement, and may provide a cost-effective tool to provide social support for individuals participating in weight management programmes. With stringent privacy protocols in place, social media may be a useful, cost-effective accompaniment to multifactorial weight management programmes. However more research is needed to identify how to make the best use of social media as health promotion tool

Advanced implementation and realization of TFDs

The design of efficient algorithms is the key to effective utilization of the properties of time-frequency distributions (TFDs) for real-life applications. This chapter presents the needed procedures, techniques, and methodologies for the effective implementation of such time-frequency (t,f) methods. This is an important chapter for those interested in practical implementations and it is the basis foundation of the (t,f) toolbox described in Chapter 17. The topic is covered in six sections with appropriate cross-referencing to the most relevant chapters. The discrete-time equivalent formulation of quadratic TFDs is first defined for the purpose of digital computation (Section 6.1). An alternative method for realization of quadratic TFDs uses the short-time Fourier transform as a basis (Section 6.2). The Gabor time-frequency representation may be expanded on a rectangular lattice, using the Fourier and Zak transforms for direct implementations (Section 6.3). The computation of other quadratic TFDs can also be done by using a spectrogram decomposition (Section 6.4). Finally, the computational procedure for implementing quadratic time-frequency methods directly is outlined, along with the required algorithms and MATLABtm code fragments (Section 6.5). The last section focuses on the design of memory-efficient algorithms to implement discrete-time TFDs to deal with the issues of memory limitations when processing large amount of data in applications such as biomedicine, telecommunications, or geophysics (Section 6.6).Scopu

Neighbourhood life and social capital: the implications for health

Social capital has been linked to health outcomes, though there are some inconsistencies in the research and the link is dependent on the measures of social capital and health used. In this paper, we argue that social capital is multifaceted and its relationship with health is complex. We explore the relationship between a number of elements of neighbourhood life and neighbourhood-based social capital, and health, using both qualitative and quantitative methods. The paper reports on a study of the Western suburbs of Adelaide and the analysis of 2400 questionnaires and 40 in-depth interviews. A partial least-square path analysis was undertaken with the questionnaire data. It considered the impact of perceptions of the physical environment, neighbourhood connections, neighbourhood trust, reciprocity, perceived safety and local civic action, and a number of demographic variables, on physical and mental health as measured by the SF-12. Of the neighbourhood-related variables, only perceived neighbourhood safety was related to physical health, with neighbourhood safety and neighbourhood connections related to mental health. Of the demographic variables, higher-income level and educational achievement were related to better physical and mental health. In addition, physical health was lower and mental health higher within older age groups. The inter-relationships between the neighbourhood variables and demographic differences in experience of neighbourhood were also examined. The thematic analysis of the interviews linked a number of social aspects of neighbourhood, the physical neighbourhood environment, perceptions of safety, civic activities and availability of local services, to health outcomes. The paper concludes that there is a need for more complex measures of social capital and that socio-economic factors are of relatively greater importance in determining health.Social capital Health inequities Neighbourhood Location Physical environment Path analysis Australia