The end of the beginning? Taking forward local democratic renewal in the post-referendum North East.

This article draws upon the author’s commissioned research on the nature of regional governance following the 2004 Referendum in the North East on elected regional assemblies. The article aimed to both capture these views and to assess how the ‘No vote in the referendum has impacted on subsequent developments in sub-national governance. The article provides both an empirical overview of recent developments and engages with the wider conceptual debates on democratic renewal. The arguments covered in this output are aimed at both academic and practitioner audiences, and have been also disseminated at regional and national conferences

Improving the energy performance of UK households: Results from surveys of consumer adoption and use of low- and zero carbon technologies

This paper presents results from a UK Open University project which surveyed consumers' reasons for adoption, and non-adoption, of energy efficiency measures and renewable energy systems–collectively called low- and zero-carbon technologies–and their experiences of using these technologies. Data were gathered during 2006 via an online questionnaire with nearly 400 responses, plus 111 in-depth telephone interviews. The respondents were mainly environmentally concerned, 'green' consumers and therefore these are purposive rather than representative surveys. The paper outlines results for four energy efficiency measures (loft insulation, condensing boilers, heating controls and energy-efficient lighting) and four household renewables (solar thermal water heating, solar photovoltaics, micro-wind turbines and wood-burning stoves). These green consumers typically adopted these technologies to save energy, money and/or the environment, which many considered they achieved despite rebound effects. The reasons for considering but rejecting these technologies include the familiar price barriers, but there were also other obstacles that varied according to the technology concerned. Nearly a third of the surveyed consumers had adopted household renewables, over half of which were wood stoves and 10% solar thermal water heating systems. Most adopters of renewables had previously installed several energy efficiency measures, but only a fifth of those who seriously considered renewables actually installed a system. This suggests sell energy efficiency first, then renewables. There seems to be considerable interest in household renewables in the UK, especially among older, middle-class green consumers, but so far only relatively few pioneers have managed to overcome the barriers to adoption

Self-reported knowledge, correct knowledge and use of UK drinking guidelines among a representative sample of the English population

Aims: Promotion of lower risk drinking guidelines is a commonly used public health intervention with various purposes, including communicating alcohol consumption risks, informing drinkers' decision-making and, potentially, changing behaviour. UK drinking guidelines were revised in 2016. To inform potential promotion of the new guidelines, we aimed to examine public knowledge and use of the previous drinking guidelines, including by population subgroup. Methods: A demographically representative, cross-sectional online survey of 2100 adults living in England in July 2015 (i.e. two decades after adoption of previous guidelines and prior to introduction of new guidelines). Univariate and multivariate logistic regressions examined associations between demographic variables, alcohol consumption (AUDIT-C), smoking, and knowledge of health conditions and self-reported knowledge and use of drinking guidelines. Multinomial logistic regression examined the same set of variables in relation to accurate knowledge of drinking guidelines (underestimation, accurate-estimation, overestimation). Results: In total, 37.8% of drinkers self-reported knowing their own-gender drinking guideline, of whom 66.2% gave an accurate estimate. Compared to accurate estimation, underestimation was associated with male gender, lower education and AUDIT-C score, while overestimation was associated with smoking. Few (20.8%) reported using guidelines to monitor drinking at least sometimes. Drinking guideline use was associated with higher education, overestimating guidelines and lower AUDIT-C. Correctly endorsing a greater number of health conditions as alcohol-related was associated with self-reported knowledge of guidelines, but was not consistently associated with accurate estimation or use to monitor drinking. Conclusions: Two decades after their introduction, previous UK drinking guidelines were not well known or used by current drinkers. Those who reported using them tended to overestimate recommended daily limits. SHORT SUMMARY: We examined public knowledge and use of UK drinking guidelines just before new guidelines were released (2016). Despite previous guidelines being in place for two decades, only one in four drinkers accurately estimated these, with even fewer using guidelines to monitor drinking. Approximately 8% of drinkers overestimated maximum daily limits

The role of special schools for children with profound and multiple learning difficulties: is segregation always best?

This is the pre-peer reviewed version of the following article 'The role of special schools for children with profound and multiple learning difficulties: is segregation always best?' British Journal of Special Education 34(1) pp.19-24, which has been published in final form at http://www3.interscience.wiley.com/cgi-bin/fulltext/117989211/PDFSTART.The education of young people with profound and multiple learning difficulties continues to raise challenges and controversies. In this article, Ben Simmons, an ESRC funded PhD student and research assistant, and Phil Bayliss, programme director for the masters degree in special education and disability, both based in the School of Education and Lifelong Learning at the University of Exeter, describe their research into provision for pupils with profound and multiple learning difficulties in a special school in the south west of England. Their work, based in an interpretivist, qualitative approach, set out to illuminate issues relating to the inclusion of pupils with profound and multiple learning difficulties. The findings presented here suggest that the school, in spite of its strong reputation, struggled significantly to provide appropriate learning experiences for pupils with profound and multiple learning difficulties. Ben Simmons and Phil Bayliss discuss the need for improved staff development opportunities focused on enhancing current levels of knowledge and skills. They conclude by calling for a reappraisal of the established view that special schools necessarily provide the best learning environment for pupils with profound and multiple learning difficulties

Reaching in? The potential for E-petitions in local government in the United Kingdom

This article considers the extent to which petitions and e-petitions might allow citizens to ‘reach in’ to local authorities in the United Kingdom. It examines how e-petitions sit against wider debates about the use of technology and digital democracy and the extent to which petitions systems might align with traditional approaches to representative democracy. It highlights that, as with many other participative initiatives, digital or otherwise, there are a variety of issues and risks associated with e-petitions, including those associated with broad socio-economic factors, and others that are more specifically related to the use of e-petitions. However, drawing on existing examples of e-petitions systems in the UK, it suggests that, designed well, they may have potential value, not simply in terms of enabling ‘voice’ and participation, but also in helping educate and inform petitioners about local democracy and decision-making

Evaluation of Health in Pregnancy grants in Scotland: a natural experiment using routine data

No abstract avialable

The Local Economic Impact of Shale Gas Extraction

Advocates of UK shale gas expansion have focused upon predicted national economic benefits, but local and/or regional impact has been largely neglected. This paper seeks to address this deficit by creating a unique dataset, combining industry data with consumer and supply chain surveys, thereby overcoming the current absence of suitable secondary data. Local economic impact in the Bowland field is estimated via a simple Keynesian local income multiplier model. Results emphasize the importance of facilitating local employment opportunities, through skills initiatives, and development of regional supply chain clusters, to anchor economic benefits within the local economy. Policy implications are discussed

Cross-national comparative mixed-methods case study of recovery-focused mental health care planning and co-ordination: Collaborative Care Planning Project (COCAPP)

The care programme approach in England and care and treatment planning in Wales are systems designed to provide mental health service users with a named care co-ordinator who meets regularly with the service user, oversees their care and develops a written plan to guide the care that they receive. These approaches are meant to help people towards recovery. In this study, we investigated whether care is organised to help people’s recovery and whether this is done in a personalised way. We identified six NHS trust/health board sites in England and Wales, and surveyed staff and service users to measure views on recovery, empowerment and therapeutic relationships. At each site we also interviewed managers, clinical staff care co-ordinators, service users and carers about their experiences of care planning. We found that good relationships are important for service users, carers and care co-ordinators in care planning and supporting recovery. Experiences of care planning and co-ordination varied within all sites. People do not always feel involved in their own care. The understanding of recovery and personalisation varied among the service users and staff interviewed. Workers say that there is too much paperwork and, like service users, they rarely look at care plans once written. Staff focus on risk but this does not often appear to be discussed with people using services, which may be problematic. We recommend research to investigate new ways of working and training to increase staff contact time with service users and carers and to improve a focus on recovery

Towards reducing variations in infant mortality and morbidity : a population-based approach

Background: Our aims were (1) to improve understanding of regional variation in early-life mortality rates and the UK’s poor performance in international comparisons; and (2) to identify the extent to which late and moderately preterm (LMPT) birth contributes to early childhood mortality and morbidity. Objective: To undertake a programme of linked population-based research studies to work towards reducing variations in infant mortality and morbidity rates. Design: Two interlinked streams: (1) a detailed analysis of national and regional data sets and (2) establishment of cohorts of LMPT babies and term-born control babies. Setting: Cohorts were drawn from the geographically defined areas of Leicestershire and Nottinghamshire, and analyses were carried out at the University of Leicester. Data sources: For stream 1, national data were obtained from four sources: the Office for National Statistics, NHS Numbers for Babies, Centre for Maternal and Child Enquiries and East Midlands and South Yorkshire Congenital Anomalies Register. For stream 2, prospective data were collected for 1130 LMPT babies and 1255 term-born control babies. Main outcome measures: Detailed analysis of stillbirth and early childhood mortality rates with a particular focus on factors leading to biased or unfair comparison; review of clinical, health economic and developmental outcomes over the first 2 years of life for LMPT and term-born babies. Results: The deprivation gap in neonatal mortality has widened over time, despite government efforts to reduce it. Stillbirth rates are twice as high in the most deprived as in the least deprived decile. Approximately 70% of all infant deaths are the result of either preterm birth or a major congenital abnormality, and these are heavily influenced by mothers’ exposure to deprivation. Births at < 24 weeks’ gestation constitute only 1% of all births, but account for 20% of infant mortality. Classification of birth status for these babies varies widely across England. Risk of LMPT birth is greatest in the most deprived groups within society. Compared with term-born peers, LMPT babies are at an increased risk of neonatal morbidity, neonatal unit admission and poorer long-term health and developmental outcomes. Cognitive and socioemotional development problems confer the greatest long-term burden, with the risk being amplified by socioeconomic factors. During the first 24 months of life each child born LMPT generates approximately £3500 of additional health and societal costs. Conclusions: Health professionals should be cautious in reviewing unadjusted early-life mortality rates, particularly when these relate to individual trusts. When more sophisticated analysis is not possible, babies of < 24 weeks’ gestation should be excluded. Neonatal services should review the care they offer to babies born LMPT to ensure that it is appropriate to their needs. The risk of adverse outcome is low in LMPT children. However, the risk appears higher for some types of antenatal problems and when the mother is from a deprived background