Fathers' involvement and the impact on family mental health: evidence from Millennium Cohort Study analyses

This paper reports evidence from the Millennium Cohort Study (MCS) on the relationship between fathers' involvement and the mental well-being of mothers, fathers and children. Drawing on previous research, we use a tripartite definition of father involvement: engagement, accessibility and responsibility. After searching 14 databases and websites, we screened for applicability, coded, quality assessed and synthesised the evidence. The majority of studies focused on ‘accessibility’ in terms of family structure or on ‘responsibility’ in terms of father employment. Overall, the studies suggest that aspects of fathers' involvement can positively influence both maternal and child mental well-being; fathers' mental health was only analysed in relation to one aspect of involvement: parental or father employment was found to influence fathers' mental well-being positively. Further MCS-based research is recommended to examine the impact of fathers' involvement on their own mental well-being, as well as the broader impact of a more active or ‘modern’ fatherhood model encompassing engagement and an understanding of responsibility beyond the breadwinning role.     

Bayesian methods for the cross-design synthesis of epidemiological and toxicological evidence

Summary.  Systematic review and synthesis (meta-analysis) methods are now increasingly used in many areas of health care research. We investigate the potential usefulness of these methods for combining human and animal data in human health risk assessment of exposure to environmental chemicals. Currently, risk assessments are often based on narrative review and expert judgment, but systematic review and formal synthesis methods offer a more transparent and rigorous approach. The method is illustrated by using the example of trihalomethane exposure and its possible association with low birth weight. A systematic literature review identified 13 relevant studies (five epidemiological and eight toxicological). Study-specific dose–response slope estimates were obtained for each of the studies and synthesized by using Bayesian meta-analysis models. Sensitivity analyses of the results obtained to the assumptions made suggest that some assumptions are critical. It is concluded that systematic review methods should be used in the synthesis of evidence for environmental standard setting, that meta-analysis will often be a valuable approach in these contexts and that sensitivity analyses are an important component of the approach whether or not formal synthesis methods (such as systematic review and meta-analysis) are used.     

Who participates? Socioeconomic Factors Associated with Women's Participation in Voluntary Groups

Participation in voluntary groups is potentially an important way to create health promoting social capital. This paper investigates women's participation in voluntary groups, utilising data from a postal survey of 968 female respondents and in‐depth interviews with 30 women. Logistic regression was conducted to examine factors associated with frequency of women's group involvement. Not working full time, living in a married relationship, and having a university education were all significantly associated with regular involvement. The qualitative data further illustrated some of the ways in which these three factors were linked with women's involvement in groups. We conclude that women who were able to regularly participate were those who already enjoyed levels of social and economic privilege. Policies to promote social capital via participation might focus on identifying what types of group involvement benefit women's health, and increasing the accessibility of such groups to include diverse groups of women.     

A Bayesian approach to Markov modelling in cost-effectiveness analyses: application to taxane use in advanced breast cancer

Summary. The paper demonstrates how cost-effectiveness decision analysis may be implemented from a Bayesian perspective, using Markov chain Monte Carlo simulation methods for both the synthesis of relevant evidence input into the model and the evaluation of the model itself. The desirable aspects of a Bayesian approach for this type of analysis include the incorporation of full parameter uncertainty, the ability to perform all the analysis, including each meta-analysis, in a single coherent model and the incorporation of expert opinion either directly or regarding the relative credibility of different data sources. The method is described, and its ease of implementation demonstrated, through a practical example to evaluate the cost-effectiveness of using taxanes for the second-line treatment of advanced breast cancer compared with conventional treatment. For completeness, the results from the Markov chain Monte Carlo simulation model are compared and contrasted with those from a classical Monte Carlo simulation model.     

Duvet woman versus action man: the gendered aetiology of Chronic Fatigue Syndrome according to English newspapers

Media portrayals of conditions such as Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) demand exploration as the media is a potent source of information and meaning, and as such has the potential to inform public and professional understandings. To date, there is little systematic exploration of print media representations of CFS/ME. In this study, we address that gap by exploring the voices of CFS/ME sufferers in the English print media (1998–2015) from a constructionist feminist perspective. We found that portrayals of CFS/ME differ meaningfully, depending on gender. The psychological and emotional tended to be foregrounded where women were concerned and the scepticism surrounding CFS/ME as a “non disease” was much more evident. On some occasions this was dealt with directly, whilst on others it was “leaked in” or hinted at. This serves to delegitimise the illness in women. In contrast, the physical was usually foregrounded in the case of men suffering from the condition and their experiences were accredited greater legitimacy. We problematise these representations and discuss the potential impact upon public and professional sympathy, treatment options and long-standing, gendered constructions of illness.     

Work,welfare, and wellbeing: The impacts of welfare conditionality on people with mental health impairments in the UK

The personal, economic, and social costs of mental ill health are increasingly acknowledged by many governments and international organisations. Simultaneously, in high-income nations, the reach of welfare conditionality has extended to encompass many people with mental health impairments as part of on-going welfare reforms. This is particularly the case in the UK where, especially since the introduction of Employment and Support Allowance in 2008, the rights and responsibilities of disabled people have been subject to contestation and redefinition. Following a review of the emergent international evidence on mental health and welfare conditionality, this paper explores two specific issues. First, the impacts of the application of welfare conditionality on benefit claimants with mental health impairments. Second, the effectiveness of welfare conditionality in supporting people with experience of mental ill health into paid work. In considering these questions, this paper presents original analysis of data generated in qualitative longitudinal interviews with 207 UK social security benefit recipients with experience of a range of mental health issues. The evidence suggests that welfare conditionality is largely ineffective in moving people with mental health impairments into, or closer to, paid work. Indeed, in many cases, it triggers negative health outcomes that make future employment less likely. It is concluded that the application of conditionality for people with mental health issues is inappropriate and should cease.     

Factors affecting the organizational responses of employers to workers with injuries

The organizational responses of employers to work-related injuries is one of several significant influences on return-to-work outcomes. Thus, understanding the factors that lead to better or worse organizational responses to work injuries may ultimately help to improve success in this area. The purpose of this study was to systematically explore factors that might influence the organizational responses of employers to injured workers, based on employee perceptions. Cross-sectional survey data were collected from 2,943 subjects with work-related injuries which had occurred less than eight weeks prior to survey completion. Measured variables included pre-injury demographic and job factors, injury circumstances, and a measure of post-injury events that comprised the organizational response. Multivariate linear regression results show that age, gender, job dissatisfaction before injury, prior difficulty performing job tasks, injury severity, back injury and lost time were all associated with negative organizational responses, suggesting potential opportunities for intervention.