A qualitative investigation of lived experiences of long-term health condition management with people who are food insecure.

Background: As more people are living with one or more chronic health conditions, supporting patients to become activated, self-managers of their conditions has become a key health policy focus both in the UK and internationally. There is also growing evidence in the UK that those with long term health conditions have an increased risk of being food insecure. While international evidence indicates that food insecurity adversely affects individual's health condition management capability, little is known about how those so affected manage their condition(s) in this context. An investigation of lived experience of health condition management was undertaken with food insecure people living in north east Scotland. The study aimed to explore the challenges facing food insecure people in terms of, i. their self-care condition management practices, and ii. disclosing and discussing the experience of managing their condition with a health care professional, and iii. Notions of the support they might wish to receive from them. Methods: Twenty in-depth interviews were conducted with individuals attending a food bank and food pantry in north east Scotland. Interview audio recordings were fully transcribed and thematically analysed. Results: Individuals reporting multiple physical and mental health conditions, took part in the study. Four main themes were identified i.e.: 1. food practices, trade-offs and compromises, that relate to economic constraints and lack of choice; 2. illness experiences and food as they relate to physical and mental ill-health; 3. (in) visibility of participants' economic vulnerability within health care consultations; and 4. perceptions and expectations of the health care system. Conclusions: This study, the first of its kind in the UK, indicated that participants' health condition management aspirations were undermined by the experience of food insecurity, and that their health care consultations in were, on the whole, devoid of discussions of those challenges. As such, the study indicated practical and ethical implications for health care policy, practice and research associated with the risk of intervention-generated health inequalities that were suggested by this study. Better understanding is needed about the impact of household food insecurity on existing ill health, wellbeing and health care use across the UK

Capturing complexity: Mixing methods in the analysis of a European tobacco control policy network

Social network analysis (SNA), a method which can be used to explore networks in various contexts, has received increasing attention. Drawing on the development of European smoke-free policy, this paper explores how a mixed method approach to SNA can be utilised to investigate a complex policy network. Textual data from public documents, consultation submissions and websites were extracted, converted and analysed using plagiarism detection software and quantitative network analysis, and qualitative data from public documents and 35 interviews were thematically analysed. While the quantitative analysis enabled understanding of the network's structure and components, the qualitative analysis provided in-depth information about specific actors' positions, relationships and interactions. The paper establishes that SNA is suited to empirically testing and analysing networks in EU policymaking. It contributes to methodological debates about the antagonism between qualitative and quantitative approaches and demonstrates that qualitative and quantitative network analysis can offer a powerful tool for policy analysis

Public perceptions of shale gas in the UK : framing effects and decision heuristics

Using two equivalent descriptions of the shale gas development process, we asked individuals to indicate their levels of support as well as their perceptions of the risks and costs involved. In version 1, shale gas development was framed as ‘fracking’, whereas under version 2 it was framed as ‘using hydraulic pressure to extract natural gas from the ground’. We find that individuals’ support for shale gas development is much lower when using the term ‘fracking’ as opposed to the synonymous descriptive term, and moreover, these differences were substantive. Our analysis suggests that these differences appear to be largely the result of different assessments of the risks associated with ‘fracking’ as opposed to ‘using hydraulic pressure to extract natural gas from the ground’. Our proposed explanation for these differences rests on the idea that shale gas development is a technical and complex process and many individuals will be bounded by the rationality of scientific knowledge when it comes to understanding this process. In turn, individuals may be relying on simple decision heuristics shaped by the way this issue is framed by the media and other interested parties which may constrain meaningful discourse on this topic with the public. Our findings also highlight some of the potential pitfalls when it comes to relying on survey research for assessing the public’s views towards complex environmental issues

The choice for EU theorists: Establishing a common framework for analysis

European Union (EU) studies have entered a highly contentious and, arguably, creative phase. A range of theoretical perspectives, seemingly quite highly differentiated from one another, now compete for influence and lsquospacersquo. However, the questions remain: is EU studies developing theories which are truly competing theories? Or is it developing theories that do not compete so much as they aim to explain distinctly different pieces of the EU puzzle? This paper responds directly to these two questions, while reviewing recent literature on EU governance. It argues, first, that we lack theories of EU governance that are true rivals; and, second, that leading models explain different outcomes at different levels in a multi-level system of governance. The result is somewhat phoney debates between compatible theories masquerading as rivals, and between lsquocomparative politicsrsquo and lsquointernational relationsrsquo approaches. Above all, perhaps, we find middle range theories posing as general or lsquometa-theoriesrsquo. In the absence of a plausible general theory of EU governance, theorists must choose precisely which type of outcome theywish to explain

Building envelope: heat, air and moisture interactions

Heat , air and moisture transport across a building envelope are in-separable phenomena. Each influences the others and is influenced by all the materials contained within the building envelope. Often we simplify the process of architectural design by relating control of each phenomenon to a particular material. The thermal insulation, for example, is perceived to control heat transfer and the air barrier to control air leakage. Likewise, the rain screen and the vapour barrier eliminate ingress of moisture to materials. However, these materials perform many different and interrelated functions, and frequently participate as one of several factors in overall system performance.La chaleur, l?air et l?humidit\ue9 qui sont transport\ue9s \ue0 travers l?enveloppe d?un b\ue2timent repr\ue9sentent un ph\ue9nom\ue8ne dont on ne peut s\ue9parer les \ue9l\ue9ments constituants. Chacun de ceux-ci influe sur les autres et en retour subit l?effet de tous les mat\ue9riaux contenus dans l?enveloppe. Dans bien des cas, nous simplifions le processus de la conception architecturale en corr\ue9lant le contr\uf4le de chacun de ces constituants \ue0 un mat\ue9riau en particulier. On per\ue7oit par exemple l?isolation thermique comme moyen de contr\uf4le du transfert de la chaleur, et le pare-air, comme moyen de contr\uf4le des fuites d?air. Dans la m\ueame optique, l?\ue9cran pare-pluie et le pare-vapeur \ue9liminent la p\ue9n\ue9tration de l?humidit\ue9 dans les mat\ue9riaux. Cependant, ces mat\ue9riaux remplissent de nombreuses fonctions vari\ue9es et interd\ue9pendantes, et fr\ue9quemment participent de l?un ou l?autre de plusieurs facteurs de la performance globale du syst\ue8me.Peer reviewed: YesNRC publication: Ye

Performance linkage approach: environmental control of buildings. Part I: construction today

This state-of-the art paper reviews the area of environmental control of buildings, outlines some research findings, and analyzes different aspects of the design process with a view to creating a comprehensive stage for the introduction of new ideas. This paper underlines shortcomings in the current design process and highlights areas where the current design and evaluation processes must be improved to enhance innovation in the construction industry. Part II of this work (to be published in JTIBE) proposes improvements based on a holistic approach to the environmental control of buildings.Dans ce document fond\ue9 sur l?\ue9tat actuel de la technologie, nous examinons le domaine de la r\ue9gulation d?ambiance dans les b\ue2timents, d\ue9crivons certains r\ue9sultats de recherches, et analysons divers aspects du processus de conception en vue de constituer une \ue9tape globale aux fins de l?introduction de nouvelles id\ue9es en ce sens. Ce document souligne les carences dans le processus actuel de la conception et met en lumi\ue8re les secteurs o\uf9 les processus de conception et d?\ue9valuation actuels doivent \ueatre am\ue9lior\ue9s afin de promouvoir l?innovation dans l?industrie de la construction. La partie II de ce travail (devant \ueatre publi\ue9e dans le Journal of Thermal Insulation and Building Envelope) propose des am\ue9liorations fond\ue9es sur une approche holistique \ue0 la r\ue9gulation d?ambiance dans les b\ue2timents.Peer reviewed: YesNRC publication: Ye