Developing empirically supported theories of change for housing investment and health

The assumption that improving housing conditions can lead to improved health may seem a self-evident hypothesis. Yet evidence from intervention studies suggests small or unclear health improvements, indicating that further thought is required to refine this hypothesis. Articulation of a theory can help avoid a black box approach to research and practice and has been advocated as especially valuable for those evaluating complex social interventions like housing. This paper presents a preliminary theory of housing improvement and health based on a systematic review conducted by the authors. Following extraction of health outcomes, data on all socio-economic impacts were extracted by two independent reviewers from both qualitative and quantitative studies. Health and socio-economic outcome data from the better quality studies (n = 23/34) were mapped onto a one page logic models by two independent reviewers and a final model reflecting reviewer agreement was prepared. Where there was supporting evidence of links between outcomes these were indicated in the model. Two models of specific improvements (warmth and energy efficiency; and housing led renewal), and a final overall model were prepared. The models provide a visual map of the best available evidence on the health and socio-economic impacts of housing improvement. The use of a logic model design helps to elucidate the possible pathways between housing improvement and health and as such might be described as an empirically based theory. Changes in housing factors were linked to changes in socio-economic determinants of health. This points to the potential for longer term health impacts which could not be detected within the lifespan of the evaluations. The developed theories are limited by the available data and need to be tested and refined. However, in addition to providing one page summaries for evidence users, the theory may usefully inform future research on housing and health

The CPT theorem

We provide a rigorous proof of the CPT theorem within the framework of 'Lagrangian' quantum field theory. This is in contrast to the usual rigorous proofs in purely axiomatic frameworks, and non-rigorous proof-sketches within the Lagrangian framework.Comment: 28 pages excluding appendices and references; 36 pages in tota

External validity in healthy public policy: application of the RE-AIM tool to the field of housing improvement

<b>Background</b><p></p> Researchers and publishers have called for improved reporting of external validity items and for testing of existing tools designed to assess reporting of items relevant to external validity. Few tools are available and most of this work has been done within the field of health promotion.<p></p> <b>Methods</b><p></p> We tested a tool assessing reporting of external validity items which was developed by Green & Glasgow on 39 studies assessing the health impacts of housing improvement. The tool was adapted to the topic area and criteria were developed to define the level of reporting, e.g. “some extent”. Each study was assessed by two reviewers.<p></p> <b>Results</b><p></p> The tool was applicable to the studies but some items required considerable editing to facilitate agreement between the two reviewers. Levels of reporting of the 17 external validity items were low (mean 6). The most commonly reported items related to outcomes. Details of the intervention were poorly reported. Study characteristics were not associated with variation in reporting.<p></p> <b>Conclusions</b><p></p> The Green & Glasgow tool was useful to assess reporting of external validity items but required tailoring to the topic area. In some public health evaluations the hypothesised impact is dependent on the intervention effecting change, e.g. improving socio-economic conditions. In such studies data confirming the function of the intervention may be as important as details of the components and implementation of the intervention

Potential impact of AUSFTA on Australia's blood supply

• Australia is largely self-sufficient in its supply of safe, fresh blood products because of the goodwill of non-remunerated, volunteer donors, plus rigorous testing and processing standards. • CSL Limited is the sole provider of plasma fractionatio

In labor or in limbo? : The experiences of women undergoing induction of labor in hospital: findings of a qualitative study

This is the peer reviewed version of the following article: Annabel Jay, Hilary Thomas, and Fiona Brooks, ‘In labor or in limbo? The experiences of women undergoing induction in labor in hospital: Findings of a qualitative study’, Birth: Issues in Perinatal Care, September 2017. Under embargo. Embargo end date: 17 September 2018. This article has been published in final form at DOI: 10.1111/birt.12310. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Background: Induction of labor currently accounts for around 25% of all births in high-resource countries, yet despite much research into medical aspects, little is known about how women experience this process. This study aimed to explore in depth the induction experience of primiparous women. Methods: A qualitative study was undertaken, using a sample of 21 first-time mothers from a maternity unit in the south of England. Semi-structured interviews were conducted in women's homes between 3 and 6 weeks postnatally. Data were recorded, transcribed, and analyzed thematically. Results: Women awaiting induction on the prenatal ward appeared to occupy a liminal state between pregnancy and labor. Differences were noted between women's and midwives’ notions of what constituted “being in labor” and the ward lacked the flexibility to provide individualized care for women in early labor. Unexpected delays in the induction process were common and were a source of anxiety, as was separation from partners at night. Women were not always clear about their plan of care, which added to their anxiety. Conclusions: Conceptualizing induction as a liminal state may enhance understanding of women's feelings and promote a more woman-centered approach to care. Thorough preparation for induction, including an explanation of possible delays is fundamental to enabling women to form realistic expectations. Care providers need to consider whether women undergoing induction are receiving adequate support, analgesia, and comfort aids conducive to the promotion of physiological labor and the reduction of anxiety.Peer reviewedFinal Accepted Versio

Assessing Medicare Beneficiaries’ Strength‐of‐Preference Scores for Health Care Options: How Engaging Does the Elicitation Technique Need to Be?

The objective was to determine if participants’ strength‐of‐preference scores for elective health care interventions at the end‐of‐life (EOL) elicited using a non‐engaging technique are affected by their prior use of an engaging elicitation technique

Compulsory separation of women prisoners from their babies following childbirth: Uncertainty, loss and disenfranchised grief

© 2021 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL (SHIL).There is growing evidence to show increased mental ill health in women compulsorily separated from their babies at birth (Cantwell et al., MBRRACE‐UK, 2018:56). For imprisoned women, the risk of self‐harm and suicide may be exacerbated. This article draws on in‐depth interviews with a sample of 28 imprisoned pregnant women/new mothers, 10 prison staff and observations to discuss the experience of separation from or anticipation of separation of women from their babies. Oakley (Signs, 4:607–631, 1980) reflected on the transition to motherhood with reference to the sociology of loss of identity. Women who have been compulsorily separated from their babies experience subjugated loss out of place with societal norms. The experiences of compulsory separation, in relation to concepts of disenfranchised grief, resonate with Lovell's (Social Science & Medicine, 17:755–761, 1983) research into the altered identities of mothers when loss occurs through late miscarriage or stillbirth. Additionally, this type of complex loss also denies a woman her identity as a ‘mother’. This article offers a fresh sociological perspective on the ways loss and grief are experienced by women facing separation from their babies in prison, drawing on concepts of uncertainty, loss and disenfranchised grief.Peer reviewedFinal Published versio

Experiences of midwifery care in English prisons

© 2022 The Authors. Birth published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution License. https://creativecommons.org/licenses/by/4.0/Background: In the United Kingdom (UK), all prisoners must receive healthcare equivalent to that available in the community. However, evidence suggests that equality in healthcare provision for perinatal women in UK prisons is not always achieved. The aim of this research was to examine pregnant women prisoners' and custody staffs' experiences and perceptions of midwifery care in English prisons. Methods: A qualitative approach based on institutional ethnography was used to research women's experiences in three English prisons over a period of 10 months. In total, 28 women participated in audio‐recorded, semi‐structured interviews. Ten staff members were interviewed, including six prison service staff and four health care personnel. Ten months of prison fieldwork enabled observations of everyday prison life. NVivo was used for data organization with an inductive thematic analysis method. Results: Women's experiences included: disempowerment due to limited choice; fear of birthing alone; and a lack of information about rights, with a sense of not receiving entitlements. Some women reported favorably on the continuity of midwifery care provided. There was confusion around the statutory role of UK midwifery. Discussion: Experiences of perinatal prisoners contrast starkly with best midwifery practice—women are unable to choose their care provider, their birth companions, or their place of birth. In addition, a reliance upon “good behavior” in return for appropriate treatment may be detrimental to the health, safety, and well‐being of the pregnant woman and her unborn baby. Conclusion: Prison is an adverse environment for a pregnant woman. This study provides key insights into imprisoned women's experiences of midwifery care in England and shows that midwives play an essential role in ensuring that perinatal prisoners receive safe, high‐quality, respectful care.Peer reviewe

Duration of untreated psychosis and social function: 1-year follow-up study of first-episode schizophrenia.

BACKGROUND: In first-episode schizophrenia, longer duration of untreated psychosis (DUP) predicts poorer outcomes. AIMS: To address whether the relationship between DUP and outcome is a direct causal one or the result of association between symptoms and/or cognitive functioning and social functioning at the same time point. METHOD: Symptoms, social function and cognitive function were assessed in 98 patients with first-episode schizphrenia at presentation and 1 year later. RESULTS: There was no significant clinical difference between participants with short and long DUP at presentation. Linear regression analyses revealed that longer DUP significantly predicted more severe positive and negative symptoms and poorer social function at 1 year, independent of scores at presentation. Path analyses revealed independent direct relationships between DUP and social function, core negative symptoms and positive symptoms. There was no significant association between DUP and cognition. CONCLUSIONS: Longer DUP predicts poor social function independently of symptoms. The findings underline the importance of taking account of the phenomenological overlap between measures of negative symptoms and social function when investigating the effects of DUP