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Background: Globally, 2.8 billion people rely on household solid fuels. Reducing the resulting adverse health, environmental, and development consequences will involve transitioning through a mix of clean fuels and improved solid fuel stoves (IS) of demonstrable effectiveness. To date, achieving uptake of IS has presented significant challenges.Objectives: We performed a systematic review of factors that enable or limit large-scale uptake of IS in low- and middle-income countries.Methods: We conducted systematic searches through multidisciplinary databases, specialist websites, and consulting experts. The review drew on qualitative, quantitative, and case studies and used standardized methods for screening, data extraction, critical appraisal, and synthesis. We summarized our findings as “factors” relating to one of seven domains—fuel and technology characteristics; household and setting characteristics; knowledge and perceptions; finance, tax, and subsidy aspects; market development; regulation, legislation, and standards; programmatic and policy mechanisms—and also recorded issues that impacted equity.Results: We identified 31 factors influencing uptake from 57 studies conducted in Asia, Africa, and Latin America. All domains matter. Although factors such as offering technologies that meet household needs and save fuel, user training and support, effective financing, and facilitative government action appear to be critical, none guarantee success: All factors can be influential, depending on context. The nature of available evidence did not permit further prioritization.Conclusions: Achieving adoption and sustained use of IS at a large scale requires that all factors, spanning household/community and program/societal levels, be assessed and supported by policy. We propose a planning tool that would aid this process and suggest further research to incorporate an evaluation of effectiveness.Citation: Rehfuess EA, Puzzolo E, Stanistreet D, Pope D, Bruce NG. 2014. Enablers and barriers to large-scale uptake of improved solid fuel stoves: a systematic review. Environ Health Perspect 122:120–130; http://dx.doi.org/10.1289/ehp.1306639

Background: This study is the first to examine the relationship between gender and self-assessed health (SAH), and the extent to which this varies by socioeconomic position in different European welfare state regimes (Liberal, Corporatist, Social Democratic, Southern). Methods: The EUROTHINE harmonised data set (based on representative cross-sectional national health surveys conducted between 1998 and 2004) was used to analyse SAH differences by gender and socioeconomic position (educational rank) in different welfare states. The sample sizes ranged from 7124 (Germany) to 118 245 (Italy) and concerned the adult population (aged >16 years). Results: Logistic regression analysis (adjusting for age) identified significant gender differences in SAH in nine European welfare states. In the UK (OR 0.88; 95% CI 0.78 to 0.99) and Finland (OR 0.85; 95% CI 0.77 to 0.95), men were significantly more likely to report ''bad'' or ''very bad'' health. In Denmark, Sweden, Norway, Holland, Italy, Spain and Portugal, a significantly higher proportion of women than men reported that their health was ''bad'' or ''very bad''. The increased risk of poor SAH experienced by women from these countries ranged from a 23% increase in Denmark (OR 1.23; 95% CI 1.08 to 1.39) to more than a twofold increase in Portugal (OR 2.01; 95% CI 1.87 to 2.15). For some countries (Italy, Portugal, Sweden), women's relatively worse SAH tended to be most prominent in the group with the highest level of education. Discussion: Women in the Social Democratic and Southern welfare states were more likely to report worse SAH than men. In the Corporatist countries, there were no gender differences in SAH. There was no consistent welfare state regime patterning for gender differences in SAH by socioeconomic position. These findings constitute a challenge to regime theory and comparative social epidemiology to engage more with issues of gender.Gender differences in health are well documented in terms of both mortality and morbidity. However, the extent to which gender differences in health vary by socioeconomic position is less well documented.2 Furthermore, although welfare state arrangements and social policies are increasingly being acknowledged as important determinants of health and of inequalities in health, [3][4][5][6][7][8] there is little research into how gender differences in health vary by welfare state; specifically, there has been little gendered analysis with a focus on the implications for women. [9][10][11] As part of the EUROTHINE project, this study focused on gender and health inequality in 13European welfare states, representing four welfare state regimes: Finland,

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Even though less satisfied, and particularly lonelier, individuals are more likely to report higher levels of depression, this is only the case because both higher loneliness and life dissatisfaction are associated with poorer health. These results are discussed in terms of their implications for the diagnosis and treatment of mental health disorders in developing nations.

These results have practical implications for the way in which health promotion interventions target men, which we discuss in conclusion.

Students' trajectories into university are often uniquely dependent on school qualifications though these alone are limited as predictors of academic potential. This study endorses this, examining associations between school grades, school type, school performance, socio-economic deprivation, neighbourhood participation, sex and academic achievement at a British university. Consistent with past research, large entry-level differences between students are generally narrowed by final year at university. Students from the most deprived areas performed less well than more affluent students. Asian and black students performed less well than white students. Female students performed better than their male counterparts. Contrasting with past research, though school performance was positively associated with entry grades, students from lowperforming schools were more likely to achieve the highest degree classifications. Additionally, independent school students performed less well than comprehensive school students at final year despite entering with higher grades. These variations exemplify how patterns observed nationally may differ between universities.Keywords: education; attainment; contextual background; inequality Despite a dramatic increase in higher education (HE) participation in England over the last half century, the under-representation of students from socio-economically disadvantaged backgrounds remains a glaring reality (Blanden and Machin 2004;Breen and Jonsson 2005;Croxford and Raffe 2013;Haveman and Smeeding 2006;Singleton 2010a). These students are known as Widening Participation (WP) students, who along with students with disabilities and some ethnic minority groups are currently under-represented in HE (Gorard 2008;Mason and Sparkes 2002). Differences in HE participation are largely attributed to the poorer school-level academic qualifications obtained by a large proportion of students within low socio-economic status (SES) classifications and are associated with educational disadvantage (Chowdry et al. 2013;Steele, Vignoles, and Jenkins 2007; Sutton Trust 2005). Further, research comparing the academic performance of students from different school types and

Objective To compare users of a home and mobile HIV counseling and testing service implemented in rural KwaZulu-Natal, South Africa. Methods Communities of similar population size and density were allocated HIV counseling and testing provision be either home or mobile services. Uptake of services was compared, including results from a brief questionnaire. Results Majority of individuals proceeded to test. Mobile services reported a higher proportion of clients who were male (41% vs. 31%; P < 0.001), younger than 25 years (53% vs. 28%; P < 0.001), single (66% vs. 40%; P < 0.001), and never previously tested (62% vs. 56%; P = 0.003). Home services reported a higher proportion of clients older than of 35 years (56% vs. 35%; P < 0.001) and married/partner (43% vs. 30%; P < 0.001). HIV prevalence amongst clients of the 2 services was comparable, with both services testing more clients daily than the local primary health care clinics, but similar to the local hospital. Conclusions The numbers tested, different populations reached, and high detection rates suggest both modalities have an important role to play, especially in rural communities where cost of transport may be a deterrent.