Background: The role of housing as a social determinant of health is well-established, but the causal pathways are poorly understood beyond the direct effects of physical housing defects. For low-income, vulnerable households there are particular challenges in creating a sense of home in a new tenancy which may have substantial effects on health and wellbeing. This study examines the role of these less tangible aspects of the housing experience for tenants in the social and private rented sectors in west central Scotland. Methods: The paper analyses quantitative data from a mixed methods, longitudinal study of tenants from three housing organisations, collected across the first year of their tenancy. The paper postulates causal hypotheses on the basis of staff interviews and then uses a Realist Research approach to test and refine these into a theoretical framework for the connections between tenants' broader experience of housing and their health and wellbeing. Results: Housing service provision, tenants' experience of property quality and aspects of neighbourhood are all demonstrated to be significantly correlated with measures of of health and wellbeing. Analysis of contextual factors provides additional detail within the theoretical framework, offering a basis for further empirical work. Conclusions: The findings provide an empirically-informed realist theoretical framework for causal pathways connecting less tangible aspects of the housing experience to health and wellbeing. Applying this within housing policy and practice would facilitate a focus on housing as a public health intervention, with potential for significant impacts on the lives of low-income and vulnerable tenants. The framework also offers a basis for further research to refine our understanding of housing as a social determinant of health.

A rapidly growing range of studies apply Theories of Change or Realist Evaluation approaches to get to grips with complex causal processes. Each methodology has been criticised in terms of practicality, usefulness and theoretical difficulties. The hypothesis that combining the two approaches could overcome some of these problems and generate deeper learning has been put forward, but there have been no published assessments of the combined methodology. This article provides findings from an evaluation of community participation policy and practice, which specifically aimed to utilise and evaluate the application of the two approaches within one study. It suggests that there are still challenges in applying Theories of Change and Realist Evaluation approaches, but they can be practically employed together, and that this synthesis can partially overcome the critiques of each individual methodology.

The last two decades have witnessed a significant turn towards community participation in public policy around the globe, raising concerns that states are resorting to 'government through community', shifting responsibilities onto communities. In order to unpack the ambiguous rhetoric of policy statements, this article employs ideas from evaluation methodology to develop a generic theory of change for community participation policy. The model is then utilised to analyse and compare the UK Coalition Government's Big Society/Localism agenda and the Scottish Government's Community Empowerment approach, demonstrating the ways in which these represent a clear example of policy divergence, and potentially significant alternatives to state-community relations in the context of austerity. The article also demonstrates the potential wider applicability of 'Theories of Change' methodology for policy analysis.

Community participation has become an essential element of government policy around the globe in recent decades. This move towards 'government through community' has been presented as an opportunity for citizens to gain power and as a necessary part of the shift from government to governance, enabling states and communities to tackle complex problems in tandem. However, it has also been critiqued as an attempt to shift responsibility from the state onto communities. Using evidence from detailed case studies, this article examines the implementation of Localism in England and Community Empowerment in Scotland. The findings suggest a need for a more nuanced analysis of community participation policy, incorporating risk alongside responsibility and power, as well as considering the agency of communities and the local state. Furthermore, understanding the constraints on community participation is key, particularly in terms of the enveloping impacts of austerity and state retrenchment.

Purpose Propofol is an intravenous anaesthetic agent commonly utilised in general anaesthesia, however in sub-anaesthetic concentrations can be utilised to provide sedation through automated dosing of target-controlled infusion (TCI). TCI has been shown to provide accurate and stable predicted plasma and effect-site concentrations of propofol. A four-part mixedmethod prospective study was undertaken to evaluate the safety and patient acceptability of intravenous propofol sedation in adolescent patients requiring dental care. There is a paucity in the literature on patient-reported outcomes and patient safety in the management of adolescent patients for dental treatment. Methods Demographics were recorded including age, gender, ASA Classification and Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) completed pre-operatively. Behaviour ratings of the Frankl and Houpt scales were recorded followed by post-operative questionnaire and telephone consultation. Consultation was completed following the procedure to determine patient satisfaction, memory of the procedure and any reported side effects of treatment. Qualitative thematic analysis was utilised. Results 55 patients were recruited for the study, of which 49 (mean age 14.67 years) completed the sedation study and were treated safely with no post-operative complications. The mean lowest oxygen saturation was 98.12% SpO 2 (SD 2.6). Thematic analysis demonstrated positive patient-reported outcomes to IV sedation. Conclusion Propofol TCI sedation is an effective treatment modality for the management of dentally anxious adolescents as a safe alternative to general anaesthesia, allowing the opportunity for increased provision of treatment per visit on those patients with a high dental need. Further randomised controlled trials comparing propofol TCI to other pharmacological managements are required.