Food for thought: an ethnographic study of negotiating ill health and food insecurity in a UK foodbank.

Emergency foodbanks have become an increasingly prominent and controversial feature of austerity in Europe and the USA. In the UK, foodbanks have been called a 'public health emergency'. Despite this, there has been no UK research examining the health of foodbank users. Through an ethnographic study, this paper is the first to explore the health and health perceptions of foodbank users via a case study of Stockton-on-Tees in the North East of England, UK during a period of welfare reform and austerity. Participant observation, field notes and interviews with foodbank users and volunteers were conducted over a seventeen month period (November 2013 to March 2015) inside a Trussell Trust foodbank. Foodbank users were almost exclusively of working age, both men and women, with and without dependent children. All were on very low incomes - from welfare benefits or insecure, poorly paid employment. Many had pre-existing health problems which were exacerbated by their poverty and food insecurity. The latter meant although foodbank users were well aware of the importance and constitution of a healthy diet, they were usually unable to achieve this for financial reasons - constantly having to negotiate their food insecurity. More typically they had to access poor quality, readily available, filling, processed foods. Foodbank users are facing the everyday reality of health inequalities at a time of ongoing austerity in the UK.

Prospective pilot evaluation of the effectiveness and cost-utility of a 'health first' case management service for long-term Incapacity Benefit recipients.

BACKGROUND: In line with the NICE guidance, an NHS-commissioned case management intervention was provided for individuals receiving Incapacity Benefit payments for ≥3 years in the North East of England. The intervention aimed to improve the health of the participants. METHODS: A total of 131 participants receiving the intervention were compared over 9 months with a (non-equivalent) comparison group of 229 receiving Incapacity Benefit payments and usual care. Health was measured using EQ-5D, EQ-VAS, SF-8, HADS and the Nordic Musculoskeletal questionnaire. Socio-demographic and health behaviour data were also collected. Fixed-effects linear models with correlated errors were used to compare health changes between groups over time. A preliminary cost-utility analysis was also conducted. RESULTS: The comparison group measures of health were stable over time. Starting from comparatively poor initial levels, case-management group generic (EQ5D, EQ-VAS) and mental health (HADS-A, HADS-D and SF8-MCS) measures improved within 6 months to similar levels found in the comparison group. Musculoskeletal (Nordic 2) and health behaviours did not improve. Tentative estimates of cost-utility suggest an intervention cost in the region of £16 700-£23 500 per QALY. CONCLUSIONS: Case management interventions may improve the health of Incapacity Benefit recipients. Further research is required to help confirm these pilot findings.

'It was just nice to be able to talk to somebody': long-term incapacity benefit recipients' experiences of a case management intervention.

BACKGROUND: This paper provides important contextual and service implementation data by exploring participant experiences of a pilot case management intervention for long-term incapacity benefit (IB) recipients. METHODS: Service experiences were assessed via a postal questionnaire and semi-structured qualitative telephone interviews. Data from 77 service user questionnaires and 20 semi-structured qualitative interviews were obtained. Questionnaire data were analysed using SPSS and telephone interviews were transcribed, thematically coded and analysed using NVivo. RESULTS: Respondents were generally positive about their experience of the intervention and particularly the benefit gained from the personal support that case managers provided. However, they also made suggestions about how the service could be delivered more effectively particularly in terms of the duration of the treatments and increasing the level of face-to-face support. CONCLUSIONS: Case management approaches may offer a supportive environment in which the health needs of those in the long-term receipt of IB can be addressed.

A labour of Sisyphus? Public policy and health inequalities research from the Black and Acheson Reports to the Marmot Review.

OBJECTIVES: To explore similarities and differences in policy content and the political context of the three main English government reports on health inequalities: the Black Report (1980), the Acheson Enquiry (1998), and the Marmot Review (2010). METHODS: Thematic policy and context analysis of the Black Report (1980), the Acheson Enquiry (1998), and the Marmot Review (2010) in terms of: (i) underpinning theoretical principles; (ii) policy recommendations; (iii) the political contexts in which each was released; and (iv) their actual or potential influence on research and policy. RESULTS: There were great similarities and very few differences in terms of both the theoretical principles guiding the recommendations of these reports and the focus of the recommendations themselves. However, there were clear differences in terms of the political contexts of each report, as well as their subsequent impacts on research and policy. CONCLUSION: The paper calls into question the progress of health inequalities research, the use of evidence and of the links between research, politics and policy.

Collection of analytical data for benzodiazepines and benzophenones.

On April 1st, 1986, amendments were made to Schedule 2 to the Misuse of Drugs Act 1971 such that 33 benzodiazepines became controlled as Class C drugs in the U.K. An analytical database has been prepared to aid the detection and identification of controlled benzodiazepines. Chromatographic properties have been measured including gas chromatography (GC) retention index values, high-performance liquid chromatography (HPLC) capacity factors and thin-layer chromatography (TLC) RF x 100 values. UV spectroscopic and mass spectrometric (MS) data have also been recorded. Analytical data (GC, TLC and MS) are also presented for benzophenones which were produced by acid hydrolysis of the parent benzodiazepines.