Research Fellow Research Articles

Strengthening Postsecondary Career and Technical Education Researchers Through Research Methods Webinars

The resurgence of interest in career and technical education (CTE) has driven demand for skilled researchers to examine policies and practices that prepare individuals for the workforce. This study disseminates the perspectives of graduate and post-doctoral CTE research fellows on the quality and impact of research methods webinars they attended during their fellowship. The webinars aimed to enhance research skills and professional development. The study used mixed methods to analyze fellows' feedback, revealing themes such as supplementation to doctoral coursework, networking with CTE scholars, acquiring new knowledge, peer engagement, and the essential role of webinars in the fellowship. After each webinar surveys were collected from fellows (n=175). A total of ten fellows provided detailed responses to the open-ended questions, leading to findings about the fellows' perceived level of quality and impacts of the webinars. The findings indicate that the webinars offered valuable supplementary knowledge beyond doctoral coursework, broadened the fellows' understanding, and enhanced their capability to conduct rigorous research. The webinars also facilitated networking with CTE scholars, sparked the development of new knowledge and potential research studies, fostered peer engagement, and were regarded as an essential component of the fellowship program in enhancing research skills and capabilities.

Optimization of workflow processes for sustainable paternal involvement: case study of an academic "daddy surgeon" in Japan.

Work-life balance is often discussed in Japan. Yet surgeons find it challenging to take paternity leave because of their demanding surgical duties and a strong sense of responsibility. One Japanese male surgeon had his first paternity experience as a research fellow in the US. When he returned to Japan, he resumed his surgical training and started a research project to become an academic surgeon. When he and his wife were expecting their second child, they discussed his paternity participation before the delivery and decided on a sustainable paternity participation plan. By coordinating his responsibilities with his co-workers, he limited his attendance at work to daytime hours only for 1month to manage paternity duties. This adjustment did not affect the number of main and assistant operations conducted that month and effective optimization of workflow processes decreased the extra workload for other team members. His experience suggests that the optimization of workflow processes can enhance personal life, including paternity participation. (150/150).

Public health, policy, and clinical interventions to improve perinatal care for migrant women and infants in high-income countries: a systematic review

Migrant women who are pregnant or postpartum and their infants are often at increased risk of poorer perinatal outcomes compared to host country populations. This review aimed to identify public health, policy, and clinical interventions to improve maternity care for migrant women and their infants in high-income countries (HICs). In this systematic review we searched EMBASE, EMCARE, MEDLINE and PsycINFO, CENTRAL, Scopus, CINAHL Plus, Web of Science, and grey literature from inception to 13th March 2024, with no language or date restrictions (PROSPERO: CRD42022380678). Interventional and observational studies assessing the effectiveness of any intervention to improve perinatal care for migrant women and their infants in HICs delivered in the pregnancy, peripartum, or postpartum period (up to one year after birth) were included. Quantitative outcomes were extracted. Qualitative studies were excluded. The main outcomes of interest were preterm birth, birthweight, and appointment attendance. Quantitative synthesis was conducted using Harvest plots and binomial exact calculations. 15,689 records were retrieved, 29 studies comprising data from 16,763,837 women were included. 22 studies (75.9%) included multiple interventions. Five interventions had strong evidence of effectiveness. Two clinical interventions: 100.0% of studies including specialist multidisciplinary teams improved one or more of the main outcomes of interest, namely preterm birth, birthweight, and appointment attendance (95% confidence interval 73.5-100.0%; p<0.001); and 90.9% of studies including specialist in-person interpreting improved one or more of the main outcomes of interest (58.7-100.0%; p=0.012). Three public health or policy interventions: 100.0% of social welfare interventions (75.3%-100.0%; p<0.001) improved one or more of the main outcomes of interest; 100.0% of maternal education interventions (71.5-100.0%. p<0.001), and 83.3% of studies assessing access to free healthcare (51.6-97.9%; p=0.039). The findings suggest that multicomponent interventions comprising multidisciplinary teams, in-person interpreting, maternal education, and social welfare support can improve perinatal outcomes for migrant women and their infants. Removing financial barriers to care may improve perinatal outcomes and be cost saving to healthcare systems. However, these findings should be interpreted with caution given that most included studies were of poor quality and that sensitivity analysis restricting to interventional studies only did not demonstrate any effect on the main outcomes of interest. KS is supported by a National Institute for Health Research (NIHR) Doctoral Fellowship (NIHR302577). HRJ is supported by an NIHR Advanced Fellowship (NIHR303183). HRJ is supported by NIHR Applied Research Collaboration (ARC) South London. MM is supported by a Medical Research Council Clinical Research Training Fellowship (Grant number MR/W01498X/1). GF is supported by a Nuffield Department of Population Health Clinical Research Fellowship. MK is an NIHR Senior Investigator (NIHR303806). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

International PCOS guideline clinical research priorities roadmap: a co-designed approach aligned with end-user priorities in a neglected women’s health condition

Polycystic ovary syndrome (PCOS) is a common endocrinopathy with significant reproductive, metabolic, and psychological complications. Consensus on PCOS clinical research priorities across end-users is fundamental and necessitates a robust co-development of a clinical research roadmap to guide international research efforts. A multistage process included: i) international surveys of women and healthcare providers to identify research priorities and unmet needs; ii) interrogation of systematic reviews conducted for the International PCOS Guideline to identify research gaps; iii) International PCOS Guideline Network consensus generated clinical research roadmap; and iv) international peer review for external validation. A codesigned survey engaging 1278 women with PCOS and 1474 healthcare providers found general concordance on research priorities. International PCOS Guideline development processes identified gaps in the literature and coproduced over 150 research priorities throughout the women's life course, affirmed in international peer review. Key themes included: 1) Optimizing PCOS diagnosis; understanding natural history across diverse populations and life stages; detecting and preventing complications, and integrating and interrogating large data assets; 2) developing evidence-based resources, exploring optimal modes for information provision and models of care; 3) exploring effective lifestyle and weight management strategies; minimising weight stigma; 4) exploring intervention effects (including treatment efficacy, safety, cost-effectiveness, and long-term follow-up) on diverse features of PCOS across subgroups; and 5) optimising preconception care and fertility treatments in PCOS. This rigorously coproduced International PCOS Guideline clinical research roadmap addresses stakeholder priorities to guide future clinical research in this common yet neglected condition. The roadmap complements the established PCOS Core Outcome Set to enhance research quality, and tackles evidence-practice gaps to improve health outcomes for women with PCOS throughout their life course. The survey, International PCOS Guideline Network and 2018 and 2023 International PCOS Guidelines were funded by the Australian National Health and Medical Research Council (NHMRC) Centres of Research excellence in PCOS (APP1078444) and in Women's Health in Reproductive life (APP1171592). Guideline partners, American Society for Reproductive Medicine (ASRM), Endocrine Society, European Society of Human Reproduction and Embryology (ESHRE), and European Society of Endocrinology (ESE), provided additional funding and assisted in guideline development. HT and AM are NHMRC Research Fellows. LM was funded by a Heart Foundation Future Leader and Veski Fellowship and CTT by the NHMRC Centres of Research excellence in Women's Health in Reproductive life. All disclosures of interest were declared before commencing GDG involvement and updated before all major milestones and are available alongside the PCOS Guideline (https://www.monash.edu/__data/assets/pdf_file/0009/3371292/Register-of-disclosures-of-interest.pdf).

Building capacity for maternal, newborn and child health research in low-income country settings: A research fellowship experience in Ethiopia.

There is a need to build research capacity to improve maternal, newborn, and child health (MNCH) in low- and middle-income countries (LMICs). To address this gap, we co-designed the HaSET (meaning 'happiness' in Amharic) MNCH Research Fellowship programme for academics and policymakers in collaboration with the Ministry of Health (MOH) and academic institutions in Ethiopia. Based on interviews and focus group discussions regarding a landscape analysis of the MNCH research environment, we developed an innovative 'learning by doing' model in which fellows identified research questions, developed proposals, obtained institutional review board (IRB) approvals, conducted research, analysed data, disseminated their findings, and developed policy briefs. Postdoctoral fellows were paired with policymakers and health professionals at the MoH to facilitate the translation of research findings into policy and programmes. Each pair received mentorship from a member of the HaSET's scientific advisory group (SAG) who had expertise in research methods, data analysis, dissemination, and translation of evidence into policy. The HaSET MNCH Research Fellowship curriculum included 10 modules covering topics from biostatistics to study operations and professional development. From March 2021 to July 2023, five postdoctoral fellows from local universities and four policymakers from the MoH and government research institutes underwent the HaSET programme, where they learned to gather high-quality evidence on priority research questions and guide the implementation of national policies and programmes. Leveraging existing data, the fellows produced 15 manuscripts and 11 policy briefs. The programme established a functional research link between the MoH, regional health bureaus, and local universities, while utilising the SAG's expertise in mentorship. This robust and comprehensive HaSET MNCH Research Fellowship produced the first cohort of dedicated fellows trained in evidence-based medicine and mentored them to become effective public health professionals. They conducted high-quality studies to inform policy decisions on MNCH interventions in Ethiopia. Given its sustainability and scalability, researchers and academic institutions can further adapt the fellowship curriculum within capacity-building programmes to educate the next generation of research leaders in LMICs.

How clinical ethics discussions can be a model for accommodating and incorporating plural values in paediatric and adult healthcare settings.

The following text is the de-identified and edited transcript of an invited presentation by Professor Clare Delany on the topic of 'How clinical ethics discussions can be a model for accommodating and incorporating plural values in paediatric and adult healthcare settings.' Professor Delany's presentation formed part of the Conference on Accommodating Plural Values in Healthcare and Healthcare Policy, which was held in Melbourne, Australia, on Monday, October 30, 2023. This conference was a key output of the Australian Research Council Discovery Project grant DP190101597, 'Religion, pluralism, and healthcare practice: A philosophical assessment'. Professor Delany's presentation was introduced by Doctor Lauren Notini, Research Fellow and Lecturer at Monash Bioethics Centre, Monash University.

Physics-Based Modeling to Elucidate Design Principles for Redox-Mediated Electrochemical Systems

Electrochemical systems are increasingly being developed and deployed as sustainable technologies that support reductions in greenhouse gas emissions across the electric power, transportation, and industrial sectors. However, the need to overcome challenges related to cost, performance, and scalability continues to motivate exploration into alternative material sets and reactor designs that offer new pathways to widespread adoption. Redox-mediated processes, which decouple electrode reactions that activate a soluble mediator from “off-electrode” reactions where the activated mediator exchanges electrons with a solid material, are of growing interest.1,2 Recent literature has illustrated the potential of this approach for increasing the charge-storage capacity of redox flow batteries,2 performing impractical electrochemical processes,3 enhancing selectivity and efficiency of electrochemical separations and recycling,1,4,5 and unlocking spatial and temporal flexibility in electrochemical operations.6 Previously, we have developed and qualitatively validated a model capable of capturing key dynamics observed in redox-mediated flow batteries.7 Grounded in first principles and contextualized by experiments, this model has the potential to rapidly assess tradeoffs and opportunities for redox-mediated systems for applications in energy storage and conversion as well as materials recovery and recycling. Here, we describe how our model can be used to gain generalizable insights into the design-space for redox-mediated electrochemical processes. By incorporating models for pressure drop in porous media with simulated electrochemical performance, we assess the trade-offs associated with capacity utilization, power output, and parasitic pumping losses. Furthermore, we demonstrate how the model can support constrained optimization to guide the design of a system of known physical parameters. Ultimately, we seek to translate these findings into universal design principles for how electrochemical protocol and solid incorporation can be tuned to develop high-performing redox-mediated systems. Acknowledgements N.J.M gratefully acknowledges the NSF Graduate Research Fellowship Program under Grant Number 2141064. Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF. References Xue et al., Green Chem. 2020, 22 (19): 6288-6309. Yan and Wang, Mat. 2018, 30 (47). Vardner et al., ChemElectroChem 2022, 9 (24). Cotty et al., ACS Sustain Chem Eng. 2023, 11(9):3975-3986. Park et al., ACS Sustain Chem Eng. 2021, 9 (24): 8214-8221. Wang et al, Joule 2021, 5 (1): 149-165. Matteucci et al., ECS Meeting Abstracts 2023, MA2023-01 (3), 765.

The development, implementation, and evaluation of a pre-rotation quiz to improve resident preparedness for an abdominal wall reconstruction surgical rotation.

Although hernia repair constitutes a significant portion of surgical training, education around more complex hernia concepts such as abdominal wall reconstruction (AWR) or paraesophageal hernia repair may be lacking. We developed and implemented a pre-rotation quiz for residents on an AWR and minimally invasive surgery service. We also investigated the staff and resident perception of resident knowledge and experience of the rotation before and after quiz implementation. The multiple-choice quiz questions were written by clinical and research fellows, validated by four staff, two fellows, and two senior residents and implemented in June 2023. Questions assessed knowledge of anatomy, operative steps, mesh materials, clinical trials, and postoperative management specific to ventral, inguinal, and paraesophageal hernia repairs. Residents were notified of the summative quiz three weeks prior and provided with reference materials specific to quiz questions. Anonymous Likert-type surveys were distributed to staff and residents between 3/2023 and 3/2024. Responses were assessed based on the overall score as well as individual domains and then compared based on whether they were completed before or after implementation of the quiz. 17 seniors and 29 juniors rotated on service and all completed the pre-rotation quiz between 7/1/2023-3/4/2024. The mean first attempt score was 72%(± 12.4%) for junior residents and 88.4%(± 9.6%) for senior residents. Staff reported overall resident knowledge improved after quiz implementation (maximum 90, mean(SD): 46.25(± 8.58) vs. 75.5(± 11.24),p = 0.05). Sixteen(45.7%) residents responded to the survey before quiz implementation and 23(50%) after. Residents only reported improved knowledge regarding current literature (maximum 5, mean(SD):3.2 ± 0.98 vs. 3.8 ± 0.78,p = 0.04). Implementing a pre-rotation quiz effectively improves staff perception of resident knowledge and preparation.

Origins of Opportunity, Part 1: The Formation of CSWE’s Minority Research Fellowship Program, 1954–1978

ABSTRACT This paper marks the 50th anniversary of the Council on Social Work Education’s (CSWE) Minority Fellowship Program (MFP), exploring its historical development. Leveraging archival CSWE materials, it chronicles pivotal events from 1954 leading to the MFP’s inception in 1973 and its early research fellowship cohorts through 1978. This historical analysis examines the advocacy, challenges, and milestones within the CSWE and broader social movements that promoted diversity and inclusion in social work education. The MFP specifically addressed the underrepresentation of minorities by developing culturally attuned researchers and practitioners. This reflective examination enriches the social work historical record and underscores the MFP’s transformative impact in creating a profession that effectively reflects and serves our racially and ethnically diverse society.

ECR Spotlight – Hosain Bagheri

ECR Spotlight is a series of interviews with early-career authors from a selection of papers published in Journal of Experimental Biology and aims to promote not only the diversity of early-career researchers (ECRs) working in experimental biology but also the huge variety of animals and physiological systems that are essential for the ‘comparative’ approach. Hosain Bagheri is an author on ‘ Detecting subtle subterranean movement via laser speckle imaging’, published in JEB. Hosain conducted the research described in this article at Georgia Tech, USA under the supervision of Dr Goldman and Dr Goodisman. Hosain is now a Postdoctoral Research Fellow in the lab of Daniel I. Goldman at Georgia Tech, investigating biological organisms through engineering and physics to deepen our understanding of biology and develop real-world applications for societal benefit.

Training it Forward: The Role of Embedded Research Fellows in the Network of Scholars Program in Nova Scotia Comment on "Early Career Outcomes of Embedded Research Fellows: An Analysis of the Health System Impact Fellowship Program".

Kasaai et al describe the career trajectories of embedded scientists trained through the Health System Impact Fellowship (HSIF), showing that 37% of 2017-2019 HSIF alumni continue as embedded researchers in health systems. These findings suggest that the HSIF program effectively supports career readiness in health services and policy research (HSPR). Similarly, the Network of Scholars (NoS) program, launched post-pandemic in Nova Scotia, mirrors these results, with alumni continuing in embedded roles and mentoring a new cohort of learners from undergraduate to postgraduate levels. NoS has incorporated competencies in quality, project management, and innovation to strengthen training for embedded scientists, aligning with the mandate of the Institute of Health Services Policy and Research. Since 2021, NoS has supported over 100 learners, contributing to over 300 rapid reviews and 100 rapid evaluations addressing top health system priorities while enhancing learner competencies and advancing Nova Scotia's Learning Health System (LHS) vision.

How to Staff When Customers Arrive in Batches

In many different settings, requests for service can arrive in near or true simultaneity with one another. This creates batches of arrivals to the underlying queueing system. In this paper, we study the staffing problem for the batch arrival queue. We show that batches place a dangerous and deceptive stress on services, requiring a high amount of resources and exhibiting a fundamentally larger tail in those demands. This uncovers a service regime in which a system with large batch arrivals may have low utilization but will still have nontrivial waiting. Methodologically, these staffing results follow from novel large batch and large batch-and-rate limits of the multiserver queueing model. In the large batch limit, we establish the first formal connection between general multiserver queues and storage processes, another family of stochastic models. By consequence, we show that the batch scaled queue length process is not asymptotically normal and that, in fact, the fluid- and diffusion-type limits coincide. Hence, the (safety) staffing of this system must be directly proportional to the batch size just to achieve a nondegenerate probability of wait. In exhibition of the existence and insights of this large batch regime, we apply our results to data on Covid-19 contact tracing in New York City. In doing so, we identify significant benefits produced by the tracing agency’s decision to staff above national recommendations, and we also demonstrate that there may have been an opportunity to further improve the operation by optimizing the arrival pattern in the public health data pipeline. This paper was accepted by Baris Ata, stochastic models and simulation. Funding: We acknowledge the generous support of the National Science Foundation (NSF) through Andrew Daw’s Graduate Research Fellowship under grant DGE-1650441, received during the initial phase of this research as part of his doctoral studies at Cornell University. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2021.03979 .

Science Academies Summer Research Fellowship Program for Students and Teachers 2025

Science Academies Summer Research Fellowship Program for Students and Teachers 2025

A scoping review of the integration of non-medical prescribing for acute common clinical conditions by community pharmacists

Abstract Introduction Non-medical prescribing enhances patient care, safety, and medication accessibility, while also maximising expertise1. Some evidence exists for a variety of factors at individual, organisational, regulatory, and policy levels impacting the implementation of PP in community pharmacy2. Common clinical conditions (CCC) can be defined as ‘a broad range of self-limiting conditions that are more complex in their diagnosis and treatment than minor ailments and management that often involves the need for prescription medicines’. Aim To collate and characterise literature on the integration of non-medical prescribing for acute common clinical conditions by community pharmacists. Method This scoping review followed the Arksey and O’Malley framework. The review team comprised a doctoral student (LK), a research fellow (TJ) and a professor of pharmacy (SC), all with experience of review methodology, community pharmacy research and /or practice. Eligibility criteria, search databases and terms were defined. Medline, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature and Google Scholar were searched for full text, English language, peer reviewed original papers, randomised controlled trials, cross-sectional and cohort studies, papers reporting empirical data from primary research and review articles including systematic reviews /scoping reviews /narrative reviews from January 2006 to October 2023. The (global) focus was on services delivered by pharmacists and pharmacy team members in community pharmacy for the management of CCC, using non-medical prescribing rights. Search terms included “independent prescrib*”, “pharm* independent prescri*”, “pharm* prescrib*”, “non-medical prescri*, “non-medical prescri*”, “pharm* supplementary prescri*” and “collaborative prescrib*”. Following screening and full text review a narrative synthesis approach3 was used to address the aim which involved: preliminary synthesis through data extraction and tabulation of key study characteristics, exploration of relationships and differences across the studies and finally evaluation of the robustness of the synthesis. The Consolidated Framework for Implementation Research provided a theoretical lens to support synthesis, identifying barriers and facilitators for integration. All steps were independently checked by two review team members. Ethics approval was not required because this was a scoping review. Results From a total 1018 records identified, 10 papers remained after removal of duplicates, title /abstract screening and full text review. The majority of studies were from Canada and the aims and linked outcomes of studies focused on pharmacists’ views and experiences, evaluation of safety, effectiveness, and patient satisfaction. A range of CCCs were included with a focus on antibiotic prescribing. A wide range of barriers and facilitators to implementation were identified including “regulatory constraints” and “fiscal challenges” at a macro socio-organisational level and a plethora of dichotomous challenges within organisations including a lack of clarity on the pharmacist’s scope of practice and linked consumer confusion, staffing levels and workload, with specific mention of paperwork and access to patient records. Conclusion The small number of studies included indicates that there is a paucity of research in this area. There is a need for increased efforts to consider this topic further and identify ways to address the challenges for further widespread implementation and uptake of such services.

On the Impossibility of Convergence of Mixed Strategies with Optimal No-Regret Learning

We study the limiting behavior of the mixed strategies that result from optimal no-regret learning in a repeated game setting where the stage game is any 2 × 2 competitive game. We consider optimal no-regret algorithms that are mean-based and monotonic in their argument. We show that for any such algorithm, the limiting mixed strategies of the players cannot converge almost surely to any Nash equilibrium. This negative result is also shown to hold under a broad relaxation of these assumptions, including popular variants of Follow-the-Regularized Leader with optimism or adaptive step sizes. Finally, we provide partial evidence that the monotonicity and mean-based assumptions can be removed or relaxed. Our results identify the inherent stochasticity in players’ realizations as a critical factor underlying this divergence, and demonstrate a crucial difference in outcomes between using the opponent’s mixtures and realizations to make updates. Funding: V. Muthukumar was supported by a Simons-Berkeley Research Fellowship, NSF awards IIS-2212182 and CCF-2239151, and generous gifts from Amazon, Adobe, and Google. S. Phade acknowledges the support of the NSF [Grants CNS-1527846 and CCF-1618145] and the NSF Science &amp; Technology Center [Grant CCF-0939370 (Science of Information)]. A. Sahai acknowledges the support of the ML4Wireless center member companies and the NSF [Grants AST-144078 and ECCS-1343398].

Prevalence, risks and outcomes of frailty in people experiencing homelessness: secondary analysis of a cross-sectional survey

BackgroundFrailty describes age related lowered health resilience. People experiencing homelessness (PEH) are known to have poor health, with potential to become frail at a younger age. Previous estimates of frailty prevalence in PEH vary (16–55%) and remain poorly understood. This research determines the prevalence of frailty in PEH in England and explores associated factors. MethodsCross-sectional analysis of interviewer-led health needs audit survey data collected from PEH in England by Homeless Link (2015 to 2022). Adults who were homeless at time of survey or in the previous 12-months were included. A frailty index (FI) was created by (1) reviewing survey variables, (2) reaching expert consensus using modified Delphi, (3) following published guidance for FI creation (4) reviewing proposed FI, compared to existing published FIs. Input from people with lived experience of homelessness informed this process. Prevalence of frailty was calculated using the FI. Findings2288/2679 PEH were included in the analysis, 93·4% aged between 18–59 years, male:female ratio 3:1, predominantly white, heterosexual and UK nationals. Prevalence of frailty was 41·5% and pre-frailty was 43·8%. A high prevalence of frailty (23·0%) and pre-frailty (51·9%) was identified in 18–24-year-olds, which increased with age. Frailty was associated with experiences of incarceration and domestic violence (both p<0·001). Healthcare utilisation was greater amongst those who were frailer. InterpretationPrevalence of frailty in PEH is higher than reported in the comparably aged, general population and younger PEH are affected by frailty at levels typically associated with older adults. This is important because current services designed to address frailty are aimed at older, housed populations. To address frailty in this younger, homeless population, nutrition and addiction support may need consideration. Study strengths include large sample size and robust methods of FI creation. A limitation is the lack of a comparison group. FundingJD was funded by a Doctoral Research Fellowship from the National Institute for Health and Care Research (NIHR), grant reference number NIHR302285. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Early employment after childbirth: A cross-sectional analysis using data from the National Maternity Survey in England

BackgroundEarly participation in paid work after childbirth may have long-lasting health and socioeconomic impacts for women and their families, yet there has been little research on women's early postpartum employment behaviours in England since the 2000s. We investigated women's employment patterns within six months of childbirth and the factors that influence them. MethodsUsing data from a population-based national maternity survey in England in 2018, employment status at six months postpartum was assessed. Descriptive analysis was used to explore employment characteristics of women in paid work. Logistic regression was used to explore sociodemographic, pregnancy- and birth-related factors associated with postpartum employment status. FindingsOf the 4313 participants included, 7·7% were in paid work within six months of childbirth. The most frequently reported motivation for being in paid work was needing the money (76%), followed by wanting to work (41%). The median time for (re)entering paid work was 17 weeks (IQR 13–26 weeks) and the median weekly hours worked was 24 (IQR 12–36 hours). The childcare option most frequently reported was the baby's grandparent(s) (47·8%), followed by spouses/partners (44·5%). Maternal age ≥35 years (compared to 30–34 years) was positively associated with being in paid work within six months of childbirth (aOR: 1·37, 95% CI 1·02–1·84), while not living with a partner (aOR 0·50, 95% CI 0·28–0·90), and having a pre-term birth (aOR 0·38, 95% CI 0·20–0·69) were negatively associated with being in paid work within six months. InterpretationThe low prevalence of women in paid employment within six months of childbirth aligns with recent downward trends. Factors associated with early postpartum employment show mixed patterns, however, which may reflect variation in financial pressures and opportunities. Our findings may assist policymakers when evaluating current and future family-based policies such as amendments to state-funded childcare and paid parental leave allowance. FundingThis research is funded by the National Institute for Health Research (NIHR) Policy Research Programme, conducted through the Policy Research Unit in Maternal and Neonatal Health and Care, PR-PRU-1217-21202. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. GF is funded by a Clinical Research Fellowship awarded by the Nuffield Department of Population Health, University of Oxford.

Maternal and infant outcomes for women experiencing homelessness, prior to and during pregnancy, in England: a retrospective cohort study

BackgroundSafe, secure, healthy housing is a crucial determinant of health. The aim of this study was to determine whether women that experienced homelessness (WEH) in England prior to or during pregnancy, are at greater risk of adverse pregnancy outcomes than women that are housed. MethodsA retrospective nationwide population study was conducted using English national Hospital Episode Statistics Admitted Patient Care database. The population included one randomly selected singleton birth with a gestational age >24 weeks’ per women, in hospital, between the 1st January 2013 and 31st March 2023. WEH were identified as having at least one homeless code (“no fixed abode”, “registered with a homeless-exclusive GP practice”, “clinical diagnosis of homelessness”) at the time of birth. Logistic regression was used to estimate the odds ratios of severe maternal morbidity (SMM), preterm birth (<37 weeks’) and low birthweight (<2500 g) for WEH compared to housed women overall and those in the most deprived areas. Results were adjusted for age, ethnicity, parity, year of birth and pre-existing medical conditions. FindingsThe study population comprised 3 349 601 births from 2013–23. 3301 (0·1%) births were from WEH. Homelessness increased the risk of SMM, preterm birth and low birthweight, with fully adjusted odds ratios (aOR) of 1·28 (95% CI 1·02–1·60), 2·02 (95% CI 1·81–2·25) and 2·16 (95% CI 1·94–2·40) respectively compared to housed women. This remained significant when compared to women living in the most deprived areas: aOR 1·24 (95% CI 0·99–1·55), 1·94 (95% CI 1·62–2·34), 1·87 (95% CI 1·69–2·08) respectively. InterpretationThese results highlight the need for prioritisation in policy to improve housing prior to and during pregnancy. Quality research that investigates not just dichotomous homelessness, but the impact of frequent moves during pregnancy, housing quality and overcrowding is required, which necessitates the collection of detailed housing information through pregnancy and the postnatal period. FundingNV is funded by a clinical research fellowship from Nuffield Department of Population Health and Academy of Medical Sciences Starter Grant for Clinical Lecturers.

‘Musical Reflections’

In this short piece, I reflect on my experience in organising and convening a public engagement event after submitting my PhD Thesis. I explain how my initial motivations to put together a seminar series on the philosophy of music were centred on the idea of distributing the finding of my doctoral work. Yet, I conclude showing how the two-way relationship with a small, motivated and enthusiastic audience ended up being the inspiration for further research. Funding Acknowledgement Funding supplied via the Early Career Research Fellowship, Institute of Advanced Study, University of Warwick.

Total Quality Management (TQM) for the development of future smart and integrated cities and sustainable development

Sustainable cities have been among governments prevailing approaches for promoting and achieving goal 11 of the United Nations in urban areas. However, development of sustainable cities policies and measures of cities does not follow an organized and consistent approach for planning, designing, applying, and evaluating a comprehensive sustainable cities system. In that context, the objective of this article is to propose and present total quality management (TQM) as a tool that would aid cities in systematically developing to achieve this goal, literature review of research publications analyze. The research fellow descriptive analysis method.the results obtained in this literature review to find total quality management related to sustainable cities. It was concluded that creating a sustainable city and transportation urban requires understanding the total quality management (TQM) tools by policymakers and practitioners and urban center managers with the implementation and management of this tool. The total management for sustainable cities can assist as a viable management tool to more efficient use of resources in order to develop sustainable cities and achieve sustainability and sustainable transportation.