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

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

Better homes, better neighbourhoods

Abstract not availabl

Assessing the health impact of local amenities: a qualitative study of contrasting experiences of local swimming pool and leisure provision in two areas of Glasgow

Study objective: To assess the health impacts of local public swimming pool and leisure provision. Design: Retrospective qualitative study using focus groups. Reports from two areas with contrasting experience of provision of a public swimming pool (opening and closure) were compared within the context of general reports about health and neighbourhood. Setting: Two deprived neighbourhoods in south Glasgow. Participants: Local adult residents of mixed ages, accessed through local community groups. Main results: In both areas the swimming pool was reported as an important amenity that was linked to health and wellbeing. However, few residents reported regular use of the pool for physical activity. Use of the pool facility for social contact was directly linked to reports of relief of stress and isolation, and improved mental health. Pool closure was one in a series of amenity closures and area decline and was used to represent other area changes. Health impacts were strongly linked to the pool closure. The pool opening was associated with local area regeneration, similar but less prominent links between swimming pool provision and health were reported. Health benefits of social contact were diffuse and linked to other local amenities as well as the new pool facility. Conclusions: Although theoretically linked to increased physical activity, the health benefits conveyed by the swimming pool may be more closely linked to the facilitation of social contact, and a supervised facility for young children. The use of qualitative work to investigate area based change provides rich contextual data to strengthen and explain the reported health impacts

Health effects of housing improvement: systematic review of intervention studies

OBJECTIVE: To review the evidence on the effects of interventions to improve housing on health. DESIGN: Systematic review of experimental and non-experimental housing intervention studies that measured quantitative health outcomes. DATA SOURCES: Studies dating from 1887, in any language or format, identified from clinical, social science, and grey literature databases, personal collections, expert consultation, and reference lists. MAIN OUTCOME MEASURES: Socioeconomic change and health, illness, and social measures. RESULTS: 18 completed primary intervention studies were identified. 11 studies were prospective, of which six had control groups. Three of the seven retrospective studies used a control group. The interventions included rehousing, refurbishment, and energy efficiency measures. Many studies showed health gains after the intervention, but the small study populations and lack of controlling for confounders limit the generalisability of these findings. CONCLUSIONS: The lack of evidence linking housing and health may be attributable to pragmatic difficulties with housing studies as well as the political climate in the United Kingdom. A holistic approach is needed that recognises the multifactorial and complex nature of poor housing and deprivation. Large scale studies that investigate the wider social context of housing interventions are required. [References: 42

Observation of a cascaded process in intracavity terahertz optical parametric oscillators based on lithium niobate

Cascaded difference frequency generation has been observed in intracavity optical parametric oscillators based on bulk lithium niobate and producing nanosecond pulses of terahertz radiation. Two idler waves are generated, namely: the primary idler wave associated with the parametric down conversion process itself; and a secondary idler wave, due to difference frequency generation. Experimental investigations of the frequency, temporal evolution, propagation direction, intensity, phase matching and oscillation threshold of the generated down-converted waves are reported. The overall generation efficiency for the terahertz radiation is enhanced, thereby overcoming the Manley-Rowe limit. Advantages of the present approach over schemes based on periodically poled lithium niobate are identified.Publisher PDFPeer reviewe

Giving urban policy its 'medical': assessing the place of health in area-based regeneration

How does regeneration affect health and how have successive urban policy evaluations sought to measure such impacts? This article draws on a systematic review of national-level evaluation documentation relating to government-funded, area-based regeneration initiatives in the UK since 1980. The review examined whether health impacts had been intended and, if so, how they had been measured. The process and difficulties of conducting the review raise significant questions about policy formulation and evaluation. Is evidence-based policy possible where evaluations are not stored centrally? In short, a model policy development as 'enlightened' or incremental is hard to sustain where a lack of systematic storage of data means that researchers, policy makers and practitioners may struggle to produce clear answers to important policy questions

Do urban regeneration programmes improve public health and reduce health inequalities? A synthesis of the evidence from UK policy and practice (1980–2004)

Objectives: To synthesise data on the impact on health and key socioeconomic determinants of health and health inequalities reported in evaluations of national UK regeneration programmes. Data Sources: Eight electronic databases were searched from 1980 to 2004 (IBSS, COPAC, HMIC, IDOX, INSIDE, Medline, Urbadisc/Accompline, Web of Knowledge). Bibliographies of located documents and relevant web sites were searched. Experts and government departmental libraries were also contacted. Review methods: Evaluations that reported achievements drawing on data from at least two target areas of a national urban regeneration programme in the UK were included. Process evaluations and evaluations reporting only business outcomes were excluded. All methods of evaluation were included. Impact data on direct health outcomes and direct measures of socioeconomic determinants of health were narratively synthesised. Results: 19 evaluations reported impacts on health or socioeconomic determinants of health; data from 10 evaluations were synthesised. Three evaluations reported health impacts; in one evaluation three of four measures of self reported health deteriorated, typically by around 4%. Two other evaluations reported overall reductions in mortality rates. Most socioeconomic outcomes assessed showed an overall improvement after regeneration investment; however, the effect size was often similar to national trends. In addition, some evaluations reported adverse impacts. Conclusion: There is little evidence of the impact of national urban regeneration investment on socioeconomic or health outcomes. Where impacts have been assessed, these are often small and positive but adverse impacts have also occurred. Impact data from future evaluations are required to inform healthy public policy; in the meantime work to exploit and synthesise "best available" data is required

Evaluation of GHA’s youth diversionary programme

To assist with funding decisions in this area and to build an evidence base, GHA commissioned an evaluation of a selection of its youth diversionary programmes in 2007

Wearing a single DNA molecule with an AFM tip

While the fundamental limit on the resolution achieved in an atomic force microscope (AFM) is clearly related to the tip radius, the fact that the tip can creep and/or wear during an experiment is often ignored. This is mainly due to the difficulty in characterizing the tip, and in particular a lack of reliable methods that can achieve this in situ. Here, we provide an in situ method to characterize the tip radius and monitor tip creep and/or wear and biomolecular sample wear in ambient dynamic AFM. This is achieved by monitoring the dynamics of the cantilever and the critical free amplitude to observe a switch from the attractive to the repulsive regime. The method is exemplified on the mechanically heterogeneous sample of single DNA molecules bound to mica mineral surfaces. Simultaneous monitoring of apparent height and width of single DNA molecules while detecting variations in the tip radius R as small as one nanometer are demonstrated. The yield stress can be readily exceeded for sharp tips (R10nm). The ability to know the AFM tip radius in situ and in real-time opens up the future for quantitative nanoscale materials properties determination at the highest possible spatial resolution.Comment: 26 pages, 6 figure