Summative behaviour change evaluation of up-to-date metered energy feedback in European public buildings

Energy consumption practices and behaviour are increasingly an important focus of attention, for energy efficiency measures. Such is the demand caused by behaviour at the level of the individual, it may cancel out the benefits of engineering solutions, such as more energy efficient appliances (Adua, 2010). This paper focuses on an evaluation of the SMARTSPACES project and its effect on energy-related behaviour change. The project provided two services: an energy management service (EMS) and an energy decision support service (EDSS). These services were implemented in over 450 public buildings across 11 European cities in 8 European countries (Serbia, France, Germany, Italy, The Netherlands, Spain, Turkey and United Kingdom). Building professionals (energy managers) primarily used the EMS and building staff used the EDSS. These services intended to inform, support and enable target audiences to use up-to-date metered feedback to reduce energy use in public buildings. The theory of change that underpins the evaluation framework is based in the Elaboration Likelihood Model which aims to understand how communication can influence attitudes and the Theory of Planned Behaviour that examines which attitudes are more likely to predict intentions and behaviours (Wilson, 2014). The paper presents results of ex-ante and ex-post surveys to building staff about their levels of awareness, attitudes, perceived control behaviour and intentions in three selected cities: Bristol, Leicester and Venlo. Outcomes varied across the examined cities depending upon the type of information presented, the level of engagement of users with the energy saving campaigns and the amount of previous energy management work undertaken by buildings’ facilities and energy management professionals

Unplanned, urgent and emergency care: what are the roles that EMS plays in providing for older people with dementia? An integrative review of policy, professional recommendations and evidence.

OBJECTIVE: To synthesise the existing literature on the roles that emergency medical services (EMS) play in unplanned, urgent and emergency care for older people with dementia (OPWD), to define these roles, understand the strength of current research and to identify where the focus of future research should lie. DESIGN: An integrative review of the synthesised reports, briefings, professional recommendations and evidence. English-language articles were included if they made any reference to the role of EMS in the urgent or emergency care of OPWD. Preparatory scoping and qualitative work with frontline ambulance and primary care staff and carers of OPWD informed our review question and subsequent synthesis. RESULTS: Seventeen literature sources were included. Over half were from the grey literature. There was no research that directly addressed the review question. There was evidence in reports, briefings and professional recommendations of EMS addressing some of the issues they face in caring for OPWD. Three roles of EMS could be drawn out of the literature: emergency transport, assess and manage and a 'last resort' or safety net role. CONCLUSIONS: The use of EMS by OPWD is not well understood, although the literature reviewed demonstrated a concern for this group and awareness that services are not optimum. Research in dementia care should consider the role that EMS plays, particularly if considering crises, urgent care responses and transitions between care settings. EMS research into new ways of working, training or extended paramedical roles should consider specific needs and challenges of responding to people with dementia.The research was funded / supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire and Peterborough NHS Foundation Trust.This is the accepted manuscript. The final version is available from BMJ Group at http://dx.doi.org/10.1136/emermed-2014-20394

The birth satisfaction scale (BSS).

Purpose - The purpose of this paper is to develop a psychometric scale - the birth satisfaction scale (BSS) - for assessing women's birth perceptions. Design/methodology/approach - literature review and transcribed research-based perceived birth satisfaction and dissatisfaction expression statements were converted into a scored questionnaire. Findings - three overarching themes were identified: service provision (home assessment, birth environment, support, relationships with health care professionals); personal attributes (ability to cope during labour, feeling in control, childbirth preparation, relationship with baby); and stress experienced during labour (distress, obstetric injuries, receiving sufficient medical care, obstetric intervention, pain, long labour and baby's health). Research limitations/implications - women construct their birth experience differently. Views are directed by personal beliefs, reactions, emotions and reflections, which alter in relation to mood, humour, disposition, frame of mind and company kept. Nevertheless, healthcare professionals can use BSS to assess women's birth satisfaction and dissatisfaction. Scores measure their service quality experiences. Social implications - scores provide a global measure of care that women perceived they received during labour. Originality/value - finding out more about what causes birth satisfaction and dissatisfaction helps maternity care professionals improve intra-natal care standards and allocate resources effectively. An attempt has been made to capture birth satisfaction's generalised meaning and incorporate it into an evidence-based measuring tool

A 15-step model for writing a research proposal.

On occasion midwives may be required to construct a research proposal. In the current climate of evidence-based practice. Such activity is considered an elemental skill for career progression in both education and service. Examples of where writing a research proposal may be required include: writing an assessment for under and post graduate research modules or designing a dissertation, MPhil, Prof Doc or PhD. Within clinical practice there are also audit and evaluation of practice responsibilities. With these factors at the forefront, this article provides a template specifically designed to direct midwives through the procedures of constructing a research proposal. The purpose of a research proposal is to produce a template of common understanding from which tasks are allocated, divided and discussed by researchers, clinical staff and in some cases participants. The finished product is then used to communicate intent to the ethics committees and grant funding bodies before authorization and money are awarded

Controlled, parametric, individualized, 2D and 3D imaging measurements of aerosol deposition in the respiratory tract of healthy human volunteers: in vivo data analysis

Background: To provide a validation dataset for aerosol deposition modeling, a clinical trial was performed in which the inhalation parameters and the inhaled aerosol were controlled or characterized.Methods: Eleven, healthy, never-smokers, male participants completed the study. Each participant performed two inhalations of 99mTc-labeled aerosol from a vibrating mesh nebulizer, which differed by a single controlled parameter (aerosol particle size: “small” or “large”; inhalation: “deep” or “shallow”; carrier gas: air or a helium–oxygen mix). The deposition measurements were made by planar imaging, and single photon emission computed tomography–computed tomography (SPECT-CT).Results: The difference between the mean activity measured by two-dimensional imaging and that delivered from the nebulizer was 2.7%, which was not statistically significant. The total activity deposited was significantly lower in the left lung than in the right lung (p&lt;0.0001) with a mean ratio (left/right) of 0.87±0.1 standard deviation (SD). However, when normalized to lung air volume, the left lung deposition was significantly higher (p=0.0085) with a mean ratio of 1.08±0.12 SD. A comparison of the three-dimensional central-to-peripheral (nC/P3D) ratio showed that it was significantly higher for the left lung (p&lt;0.0001) with a mean ratio (left/right) of 1.36±0.20 SD. The effect of particle size was statistically significant on the nC/P3D ratio (p=0.0014), extrathoracic deposition (p=0.0037), and 24-hr clearance (p&lt;0.0001), contrary to the inhalation parameters, which showed no effect.Conclusions: This article presents the results of an analysis of the in vivo deposition data, obtained in a clinical study designed to provide data for model validation. This study has demonstrated the value of SPECT imaging over planar, the influence of particle size on regional distribution within the lung, and differences in deposition between the left and right lungs.<br/

Engineering a detect and destroy skin probiotic to combat methicillin-resistant Staphylococcus aureus.

The prevalence and virulence of pathogens such as methicillin-resistant Staphylococcus (S.) aureus (MRSA), which can cause recurrent skin infections, are of significant clinical concern. Prolonged antibiotic exposure to treat or decolonize S. aureus contributes to development of antibiotic resistance, as well as depletion of the microbiome, and its numerous beneficial functions. We hypothesized an engineered skin probiotic with the ability to selectively deliver antimicrobials only in the presence of the target organism could provide local bioremediation of pathogen colonization. We constructed a biosensing S. epidermidis capable of detecting the presence of S. aureus quorum sensing autoinducer peptide and producing lysostaphin in response. Here, we demonstrate in vitro activity of this biosensor and present and discuss challenges to deployment of this and other engineered topical skin probiotics