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Im vorliegenden Heft der Schriftenreihe werden die Ergebnisse von zwei Projekten vorgestellt, die sich mit futtermittelhygienischen Aspekten befassten und von Wissenschaftlern der Universität Leipzig erarbeitet wurden. Untersuchungen zur Beeinflussung der Toxinexpression von Clostridium botulinum Typ B und C unter in-vitro-Bedingungen / Untersuchungen zu Vorkommen und Verbreitung von Clostridium botulinum in Rinderbeständen des Freistaates Sachsen / Mykotoxinscreening in Blut, Galle und Milch bei gesunden und kranken Kühen

There are gaps in the UK knowledge base for understanding the implementation and evaluation of public health interventions which aim to improve the mental health and wellbeing of participants. In this thesis I examine the measurement of mental wellbeing and the implementation of health improvement interventions in a community setting and investigate the practicalities of their evaluation using a measure of mental wellbeing -- WEMWBS. Methods: Using a mixed methods approach I collected and analysed i) three cross sectional surveys of Coventry residents, ii) quasi-experimental before and after outcome evaluations of three CHIP projects, and iii) undertook semi-structured interviews with CHIP stakeholders. Data were integrated using a matrix technique. Results: A total of 8188 individuals (~40% response rate) completed valid survey questionnaires in 2010-2012, while 590 individuals (~88% response rate) completed valid before-after mental wellbeing outcome evaluations in 2011 and 2012 from three CHIP projects. Fifteen one-on-one interviews were completed. I found that health and lifestyle variables ‘sleep quality’ ‘physical activity’ and ‘fruit and vegetable consumption’ showed the strongest and most consistent patterns of association with levels of mental wellbeing measured using WEMWBS. CHIP projects demonstrated associations between the intervention and increases in mental wellbeing, some of which were both statistically significant and clinically meaningful. Some were sustained at three months. Interview findings showed that the difference between the plans and the observed implementation practices resulted in some of the projects struggling to cope with the evolving and changing needs of the programme, for example moving from outputs to outcomes, introducing mental wellbeing and changing concepts of health, and the work required to achieve partnership with the local authority). The effect on programme level outcomes and outcome measurement of these struggles was a reduction in the number and quality of valid evaluation returns from some of the projects in the programme and reduced staff capacity to deliver project objectives. The introduction of mental wellbeing as an outcome measure created a momentum of change for understanding complex health interventions and outcomes among stakeholders; it assisted those delivering the CHIP programme to understand the underlying health improvement rationale for their programme better. Through integrating quantitative datasets I provided a benchmark from which to make comparisons between population estimates of WEMWBS and observed evaluation findings. Integrating quantitative evaluation process challenges and qualitative insights from stakeholder interviews allowed for complex issues to be ‘untangled’. Interrelated mechanisms affected facilitators and barriers of programme planning, implementation, evaluation and sustainability. Integrating my quantitative and qualitative findings highlighted some clear health benefits from the projects but also highlighted a lack of congruence between the documented linear, unidirectional and unrealistic operational planning which I found in CHIP at a programme level, compared to practical implementation on the ground, which was nonlinear, complex and dynamic. Conclusion: Iterative, transitional stages of programme development could benefit implementation processes and potentially health outcomes, including mental wellbeing, in future public health practice. Further research in this area should explore the extent to which complex, collective, and adaptive operational planning can result in more successful public health improvement programmes.

Post-licensure surveillance of vaccine safety comprises of monitoring of adverse events, identification of those events that may be vaccine associated and, where necessary, controlled epidemiological studies to help assess causality. At the Health Protection Agency (HPA) in England a system for performing epidemiological studies using linked hospital episodes and immunisation data was established in the 1990s along with a new statistical approach called the self-controlled case-series (SCCS) for use on datasets which only include individuals with the adverse event of interest. In this thesis by published works I use seven publications from HPA studies addressing a variety of safety concerns to demonstrate the importance of such epidemiological studies and to form a framework which helps address the issues that need considering when doing vaccine safety studies. The seven studies are i) intussusception and oral polio vaccine, ii) measles-mumps rubella (MMR) vaccine and autism, iii) thimerosal in vaccines and neurodevelopment, iv) meningococcal group C conjugate vaccine and purpura/convulsions, v) diphtheria-tetanus-pertussis vaccines and various common and rare events, vi) pandemic influenza vaccine and Guillain-Barré syndrome, and finally vii) MMR vaccine and thrombocytopenic purpura (TP). These studies helped allay safety concerns or, in the case of MMR and TP quantify a true risk. The framework developed covers issues around defining the question, data sources and case-finding, study design and study implementation. In particular issues relevant to the use of the SCCS method are addressed such as ensuring independence of multiple events and bias due to vaccine contraindication. In conclusion the usefulness of epidemiological studies on vaccine safety and of the SCCS method has been demonstrated within a framework that can help with performing future studies.

This dissertation examines the transformation of the French built environment alongside medical discourses of the body in the early 19th century, arguing that emerging theories on health and hygiene comprised a politically charged subtext in the design of spaces where gender and class identities were formed. Following the military defeats that led to the collapse of the Napoleonic Empire, fears over national decline spurred medical thought on the regeneration of French citizens. The ensuing debates about the body and hygiene gave rise to new architectural programs - such as gymnasiums, swimming schools, and public gardens - where emergent practices for rehabilitating the bourgeois body, both male and female, were implemented. I trace the translation of these spatial forms and practices across a range of military, educational, and recreational settings, to analyze the role of architecture in shaping 19th-century embodiments and expressions of gender, class, and citizenship.

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This item was digitized as part of the Million Books Project led by Carnegie Mellon University and supported by grants from the National Science Foundation (NSF). Cornell University coordinated the participation of land-grant and agricultural libraries in providing historical agricultural information for the digitization project; the University of Arizona Libraries, the College of Agriculture and Life Sciences, and the Office of Arid Lands Studies collaborated in the selection and provision of material for the digitization project.