Incentives for breastfeeding and for smoking cessation in pregnancy: An exploration of types and meanings

Financial or tangible incentives are a strategy for improving health behaviours. The mechanisms of action of incentives are complex and debated. Using a multidisciplinary integrated mixed methods study, with service-user collaboration throughout, we developed a typology of incentives and their meanings for initiating and sustaining smoking cessation in pregnancy and breastfeeding. The ultimate aim was to inform incentive intervention design by providing insights into incentive acceptability and mechanisms of action. Systematic evidence syntheses of incentive intervention studies for smoking cessation in pregnancy or breastfeeding identified incentive characteristics, which were developed into initial categories. Little published qualitative data on user perspectives and acceptability was available. Qualitative interviews and focus groups conducted in three UK regions with a diverse socio-demographic sample of 88 women and significant others from the target population, 53 service providers, 24 experts/decision makers, and conference attendees identified new potential incentives and providers, with and without experience of incentives. Identified incentives (published and emergent) were classified into eight categories: cash and shopping vouchers, maternal wellbeing, baby and pregnancy-related, behaviour-related, health-related, general utility, awards and certificates, and experiences. A typology was refined iteratively through concurrent data collection and thematic analysis to explore participants' understandings of ‘incentives’ and to compare and contrast meanings across types. Our typology can be understood in three dimensions: the degree of restriction, the extent to which each is hedonic and/or utilitarian, and whether each has solely monetary value versus monetary with added social value. The layers of autonomy, meanings and the social value of incentive types influence their acceptability and interact with structural, social, and personal factors. Dimensions of incentive meaning that go beyond the simple incentive description should inform incentive programme design and are likely to influence outcomes

The Korean War and the Post-war Prisoner of War Regime, 1945–1956

This paper examines the framework for the treatment of prisoners of war that emerged after 1945. It focuses on one of the key elements of the post-war prisoner of war (POW) regime, the role of neutral bodies – state authorities acting as ‘protecting powers’ or humanitarian agencies such as the International Committee of the Red Cross – in supervising the implementation of the 1949 POW convention. It examines the importance of neutral supervision for the POW regime, and shows how the events of the Korean War affected the willingness of states to comply with their obligations under the new convention

Perspectives on financial incentives to health service providers for increasing breast feeding and smoking quit rates during pregnancy: a mixed methods study

Objective: To explore the acceptability, mechanisms and consequences of provider incentives for smoking cessation and breast feeding as part of the Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS) study. Design: Cross-sectional survey and qualitative interviews. Setting: Scotland and North West England. Participants: Early years professionals: 497 survey respondents included 156 doctors; 197 health visitors/maternity staff; 144 other health staff. Qualitative interviews or focus groups were conducted with 68 pregnant/postnatal women/family members; 32 service providers; 22 experts/decision-makers; 63 conference attendees. Methods: Early years professionals were surveyed via email about the acceptability of payments to local health services for reaching smoking cessation in pregnancy and breastfeeding targets. Agreement was measured on a 5-point scale using multivariable ordered logit models. A framework approach was used to analyse free-text survey responses and qualitative data. Results: Health professional net agreement for provider incentives for smoking cessation targets was 52.9% (263/497); net disagreement was 28.6% (142/497). Health visitors/maternity staff were more likely than doctors to agree: OR 2.35 (95% CI 1.51 to 3.64; p<0.001). Net agreement for provider incentives for breastfeeding targets was 44.1% (219/497) and net disagreement was 38.6% (192/497). Agreement was more likely for women (compared with men): OR 1.81 (1.09 to 3.00; p=0.023) and health visitors/maternity staff (compared with doctors): OR 2.54 (95% CI 1.65 to 3.91; p<0.001). Key emergent themes were 'moral tensions around acceptability', 'need for incentives', 'goals', 'collective or divisive action' and 'monitoring and proof'. While provider incentives can focus action and resources, tensions around the impact on relationships raised concerns. Pressure, burden of proof, gaming, box-ticking bureaucracies and health inequalities were counterbalances to potential benefits. Conclusions: Provider incentives are favoured by non-medical staff. Solutions which increase trust and collaboration towards shared goals, without negatively impacting on relationships or increasing bureaucracy are required

trans-Bis{1,2-bis­[bis­(2-methoxy­ethyl)phosphino]ethane}dichloridoiron(II)

The Fe atom in the title compound, [FeCl2(C14H32O4P2)2], has a distorted octa­hedral coordination with four P atoms in equatorial positions and two Cl atoms in apical positions

Bis{1,2-bis­[bis­(3-hydroxy­prop­yl)phosphino]ethane}dichloridoiron(II)

In the title compound, [FeCl2(C14H32O4P2)2], the FeII atom (site symmetry ) adopts a distorted trans-FeCl2P4 octa­hedral geometry with two P,P′-bidentate ligands in the equatorial positions and two chloride ions in the axial positions. In the crystal, mol­ecules are linked by O—H⋯O and O—H⋯Cl hydrogen bonds, generating a three-dimensional network

Dielectric anisotropy of nematic liquid crystals loaded with carbon nanotubes in microwave range

Liquid crystals are attractive materials for microwave applications as tunable dielectrics owing to low losses and high anisotropy of dielectric properties. The possibility of further enhancing their dielectric anisotropy is studied by loading with highly polarisable and anisotropic rods–carbon nanotubes at various concentrations. The studies are performed using two different methods, one in the range 1–4 GHz and the other at 30 GHz. More than two times increase of microwave dielectric anisotropy in liquid crystals is reported when loaded with 0.01%wt of carbon nanotubes, which is a metastable suspension and 28% increase in an equilibrated suspension. The stability of the LC-CNT composites is discussed

Manatee Occurrence in the Northern Gulf of Mexico, West of Florida

Reports of West Indian manatees (Trichechus manatus) in the US Gulf of Mexico west of Florida have increased during the last decade. We reviewed all available manatee sighting, capture, and carcass records (n = 377) from Alabama, Louisiana, Mississippi, and Texas since the early 1900s; only 40 of these were previously published. Manatees were reported most often in estuarine habitats, usually either near a freshwater source or natural or industrial warm-water springs/runoffs during winter months. The recent increase in manatee records may be due to a combination of increased public awareness and dispersal of manatees, most likely seasonal migrants from Florida. We caution that the presence of artificial warm-water sources outside of the manatee’s traditional range may attract an increasing number of manatees and could increase the incidence of cold-related mortality in this region

Characterization of carbon nanotube–thermotropic nematic liquid crystal composites

Dispersions of carbon nanotubes (CNTs) in liquid crystals (LCs) have attracted attention due to their unique properties and possible applications in photonics and electronics. However, these are hard to stabilize, and the loading level in the equilibrium state in LC hosts is small. A practical way to monitor the quality and CNT incorporation in such equilibrium dispersions is required. Here, we compare different methods for characterising equilibrium CNT–LC composite materials