Designing a generic, adaptive protocol resource for the measurement of health impact in cash transfer pilot and feasibility studies and trials in high-income countries

INTRODUCTION: In the context of the COVID-19 pandemic, upstream interventions that tackle social determinants of health inequalities have never been more important. Evaluations of upstream cash transfer trials have failed to capture comprehensively the impacts that such systems might have on population health through inadequate design of the interventions themselves and failure to implement consistent, thorough research measures that can be used in microsimulations to model long-term impact. In this article, we describe the process of developing a generic, adaptive protocol resource to address this issue and the challenges involved in that process. The resource is designed for use in high-income countries (HIC) but draws on examples from a UK context to illustrate means of development and deployment. The resource is capable of further adaptation for use in low- and middle-income countries (LMIC). It has particular application for trials of Universal Basic Income but can be adapted to those covering other kinds of cash transfer and welfare system changes. METHODS: We outline two types of prospective intervention based on pilots and trials currently under discussion. In developing the remainder of the resource, we establish six key principles, implement a modular approach based on types of measure and their prospective resource intensity, and source (validated where possible) measures and baseline data primarily from routine collection and large, longitudinal cohort studies. Through these measures, we seek to cover all areas of health impact identified in our theoretical model for use in pilot and feasibility studies. RESULTS: We find that, in general, self-reported measures alongside routinely collected linked respondent data may provide a feasible means of producing data capable of demonstrating comprehensive health impact. However, we also suggest that, where possible, physiological measures should be included to elucidate underlying biological effects that may not be accurately captured through self-reporting alone and can enable modelling of long-term health outcomes. In addition, accurate self-reported objective income data remains a challenge and requires further development and testing. A process of development and implementation of the resource in pilot and feasibility studies will support assessment of whether or not our proposed health outcome measures are acceptable, feasible and can be used with validity and reliability in the target population. DISCUSSION: We suggest that while Open Access evaluation instruments are available and usable to measure most constructs of interest, there remain some areas for which further development is necessary. This includes self-reported wellbeing measures that require paid licences but are used in a range of nationally important longitudinal studies instead of Open Access alternatives

On the convergence of the critical cooling timescale for the fragmentation of self-gravitating discs

We carry out simulations of gravitationally unstable discs using a Smoothed Particle Hydrodynamics (SPH) code and a grid-based hydrodynamics code, FARGO, to understand the previous non-convergent results reported by Meru & Bate (2011a). We obtain evidence that convergence with increasing resolution occurs with both SPH and FARGO and in both cases we find that the critical cooling timescale is larger than previously thought. We show that SPH has a first-order convergence rate while FARGO converges with a second-order rate. We show that the convergence of the critical cooling timescale for fragmentation depends largely on the numerical viscosity employed in both SPH and FARGO. With SPH, particle velocity dispersion may also play a role. We show that reducing the dissipation from the numerical viscosity leads to larger values of the critical cooling time at a given resolution. For SPH, we find that the effect of the dissipation due to the numerical viscosity is somewhat larger than had previously been appreciated. In particular, we show that using a quadratic term in the SPH artificial viscosity (beta_{SPH}) that is too low appears to lead to excess dissipation in gravitationally unstable discs, which may affect any results that sensitively depend on the thermodynamics, such as disc fragmentation. We show that the two codes converge to values of the critical cooling timescale, beta_{crit} > 20 (for a ratio of specific heats of gamma=5/3), and perhaps even as large as beta_{crit} \approx 30. These are approximately 3-5 times larger than has been found by most previous studies. This is equivalent to a maximum gravitational stress that a disc can withstand without fragmenting of alpha_{GI,crit} \approx 0.013-0.02, which is much smaller than the values typically used in the literature. It is therefore easier for self-gravitating discs to fragment than has been concluded from most past studies.Comment: Accepted for publication by MNRAS. 26 pages, 17 figure

Serial Killer & Childhood Trauma

The current qualitative study sought to investigate the top 10 serial killers, with the highest confirmed kills, in the United States between the 1970-90s. Unlike previous research, we have chosen to focus on multiple serial killers with the highest confirmed kills as opposed to doing a case study of only one individual with media notoriety. We worked from a constructivist paradigm approach to analyze the correlations between experience of childhood trauma, victim statistics (age, sex and ethnicity), and mode of murder. Working from a phenomenology of qualitative research method we reviewed theoretical ACEs (Adverse Childhood Experiences) scores of each killer to quantify trauma statistics. Our data was compiled from secondary sources including radford.edu, murderpedia.org, and biography.com to include a wide range of qualitative variables. We hypothesize a correlation between type of child trauma and victim statistics (to include mode of murder). From our findings, we anticipate reviewing victim statistics and categorization of murder in correlation to childhood trauma (i.e childhood sexual trauma by a female and sexually charged murders of women). We discuss possible explanations of the variables’ correlation, as supported in previous research. From our preliminary data collection, we found that a majority of the killers have experienced childhood trauma, defined as: any physical, sexual, or emotional abuse including periods of long-term neglect or witness to extreme violence. The implication is that childhood trauma is a marked precursor for possible homicidal behavior as an adult

Sexual behavior of HIV-positive adults not accessing HIV treatment in Mombasa, Kenya: Defining their prevention needs

<p>Abstract</p> <p>Background</p> <p>HIV spread continues at high rates from infected persons to their sexual partners. In 2009, an estimated 2.6 million new infections occurred globally. People living with HIV (PLHIV) receiving treatment are in contact with health workers and therefore exposed to prevention messages. By contrast, PLHIV not receiving ART often fall outside the ambit of prevention programs. There is little information on their sexual risk behaviors. This study in Mombasa Kenya therefore explored sexual behaviors of PLHIV not receiving any HIV treatment.</p> <p>Results</p> <p>Using modified targeted snowball sampling, 698 PLHIV were recruited through community health workers and HIV-positive peer counsellors. Of the 59.2% sexually-active PLHIV, 24.5% reported multiple sexual partners. Of all sexual partners, 10.2% were HIV negative, while 74.5% were of unknown HIV status. Overall, unprotected sex occurred in 52% of sexual partnerships; notably with 32% of HIV-negative partners and 54% of partners of unknown HIV status in the last 6 months. Multivariate analysis, controlling for intra-client clustering, showed non-disclosure of HIV status (AOR: 2.38, 95%CI: 1.47-3.84, p < 0.001); experiencing moderate levels of perceived stigma (AOR: 2.94, 95%CI: 1.50-5.75, p = 0.002); and believing condoms reduce sexual pleasure (AOR: 2.81, 95%CI: 1.60-4.91, p < 0.001) were independently associated with unsafe sex. Unsafe sex was also higher in those using contraceptive methods other than condoms (AOR: 5.47, 95%CI: 2.57-11.65, p < 0.001); or no method (AOR: 3.99, 95%CI: 2.06-7.75, p < 0.001), compared to condom users.</p> <p>Conclusions</p> <p>High-risk sexual behaviors are common among PLHIV not accessing treatment services, raising the risk of HIV transmission to discordant partners. This population can be identified and reached in the community. Prevention programs need to urgently bring this population into the ambit of prevention and care services. Moreover, beginning HIV treatment earlier might assist in bringing this group into contact with providers and HIV prevention services, and in reducing risk behaviors.</p

Winning the vote with a Universal Basic Income: Evidence from the 'Red Wall'

This report, backed by North of Tyne and Greater Manchester mayors and councillors across the North, suggests that a basic income could be the key to Labour’s success in regaining its former heartlands at the next election, with three quarters of ‘red wall’ voters supporting the policy. The research sought to better understand the reasons behind support for the policy, finding that the health benefits, savings to the NHS and provision of financial security are the most important factors for support of UBI. Through dialogue with strong opponents to a basic income the research found that even in among strong opponents support increased through six specific framings relating to economic crisis, evidence, relative gains, flourishing, efficiency, and security. Using these narratives, support for UBI increases even among strong opponents for more than 60 of respondents

The Heavy Element Composition of Disk Instability Planets Can Range From Sub- to Super-Nebular

Transit surveys combined with Doppler data have revealed a class of gas giant planets that are massive and highly enriched in heavy elements (e.g., HD149026b, GJ436b, and HAT-P-20b). It is tempting to consider these planets as validation of core accretion plus gas capture because it is often assumed that disk instability planets should be of nebular composition. We show in this paper, to the contrary, that gas giants that form by disk instability can have a variety of heavy element compositions, ranging from sub- to super-nebular values. High levels of enrichment can be achieved through one or multiple mechanisms, including enrichment at birth, planetesimal capture, and differentiation plus tidal stripping. As a result, the metallicity of an individual gas giant cannot be used to discriminate between gas giant formation modes.Comment: Accepted by Ap

Universal Basic Income is affordable and feasible: evidence from UK economic microsimulation modelling

Critics of Universal Basic Income (UBI) have claimed that it would be either unaffordable or inadequate. This discussion paper tests this claim by examining the distributional impacts of three UBI schemes broadly designed to provide pathways to attainment of the Minimum Income Standard (MIS). We use microsimulation of data from the Family Resources Survey to outline the static distributional impacts and costs of the schemes. Our key finding is that even the fiscally neutral starter scheme would reduce child poverty to the lowest level achieved since 1961 and achieve more than the anti-poverty interventions of the New Labour Governments from 2000. The more generous schemes would make further inroads into the UK’s high levels of poverty and inequality, but at greater cost. We conclude by assessing fiscal strategies to reduce the up-front deficit of higher schemes, providing a more positive assessment of affordability and impact than critics have assumed

Designing a generic, adaptive protocol resource for the measurement of health impact in cash transfer trials

IntroductionIn the context of the COVID-19 pandemic, upstream interventions that tackle social determinants of health inequalities have never been more important. Evaluations of upstream cash transfer trials have failed to capture comprehensively the impacts that such systems might have on population health through inadequate design of the interventions themselves and failure to implement consistent, thorough research measures that can be used in microsimulations to model long-term impact. In this article, we describe the process of developing a generic, adaptive protocol resource to address this issue and the challenges involved in that process.MethodsWe outline two types of prospective intervention based on trials currently under discussion. In developing the remainder of the resource, we establish six key principles, implement a modular approach based on types of measure and their prospective resource intensity, and source (validated where possible) measures and baseline data primarily from routine collection and large, longitudinal cohort studies. Through these measures, we seek to cover all areas of health impact identified in our theoretical model.ResultsWe find that, in general, self-reported measures alongside routinely collected linked respondent data may provide data capable of demonstrating comprehensive health impact. However, we also suggest that, where possible, physiological measures should be included to elucidate underlying biological effects that may not be accurately captured through self-reporting alone and can enable modelling of long-term health outcomes.DiscussionWe suggest that while Open Access evaluation instruments are available and usable to measure most constructs of interest, there remain some areas for which further development is necessary. This includes self-reported wellbeing measures that require paid licences but are used in a range of nationally important longitudinal studies instead of Open Access alternatives

Examining the Relationship Between Trait Energy and Fatigue and Feelings of Depression in Young Healthy Adults

Depression is usually co-morbid with fatigue. However, we are unaware of studies exploring the relationship between trait energy and fatigue and feelings of depression. Recent evidence suggests that energy and fatigue are two distinct moods. PURPOSE: To examine the association between trait mental and physical energy and fatigue and feelings of depression, within an otherwise healthy young adult cohort. METHODS: Using a cross-sectional design, healthy respondents (n=495) completed a series of self-reported surveys measuring depression, lifestyle factors (sleep, diet, physical activity), and trait mental and physical energy and fatigue. Using a step-wise regression, we controlled for demographics and lifestyle and added trait mental and physical energy and fatigue to the second model. RESULTS: When trait mental and physical energy and fatigue were added to the models, the adjusted R2 increased by 5% (R2 = .112, F(13, 457) = 4.455, p \u3c .001). In our second model, trait mental fatigue was the only significant predictor of depressive mood states (Β = .159, t (457) = 2.512, p = 0.01). CONCLUSION: Young adults, who struggle with high mental fatigue, may also be more likely to report feeling depressed suggesting that fatigue and depression are co-morbid, while low energy and depression are not. Future research should aim to identify epigenetic/genetic factors that influence mental fatigue and how those may be associated with feelings of depression

Blending of nanoscale and microscale in uniform large-area sculptured thin-film architectures

The combination of large thickness ($>3$ $\mu$m), large--area uniformity (75 mm diameter), high growth rate (up to 0.4 $\mu$m/min) in assemblies of complex--shaped nanowires on lithographically defined patterns has been achieved for the first time. The nanoscale and the microscale have thus been blended together in sculptured thin films with transverse architectures. SiO$_x$ ($x\approx 2$) nanowires were grown by electron--beam evaporation onto silicon substrates both with and without photoresist lines (1--D arrays) and checkerboard (2--D arrays) patterns. Atomic self--shadowing due to oblique--angle deposition enables the nanowires to grow continuously, to change direction abruptly, and to maintain constant cross--sectional diameter. The selective growth of nanowire assemblies on the top surfaces of both 1--D and 2--D arrays can be understood and predicted using simple geometrical shadowing equations.Comment: 17 pages, 9 figure