Tackling ageing continence through theory, tools & technology (TACT3)

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2012 Common Ground.After dementia, nothing is more feared by older people than the loss of continence. It is often the reason many people enter care facilities and can contribute to the breakdown of caring relationships. This paper reports on a three-year research project funded by the UK New Dynamics of Aging programme, which has explored three key issues in the predicament of maintaining continence from the “user’s” perspective. Firstly, understanding how continence services operated by the UK National Health Service can be improved to offer cost effective benefits that encourage people to report this sometimes embarrassing condition with confidence. Secondly, working directly with the US Simon Foundation, the project has developed user-requested, assistive devices that target the most embarrassing aspects of the condition, namely issues of personal odor control and urine leakage from continence pads. Lastly, understanding the challenges of managing continence in daily living outside of the home, with particular reference to accessing publicly accessible toilet facilities. The paper will highlight the research that has provided the basis for innovative design solutions.ESRC, EPSRC, BBSRC, MRC, and AHRC

Improving public services through open data: public toilets

Bichard’s work for the TACT3 project (Bichard REF Output 3) found that UK toilet provision is not centrally collated and no national map or database of toilets exists. In contrast, the UK government’s white paper Open Public Services (2011) emphasised its commitment to incorporating the use of Open Data in public services provision that could be tailored to community preferences, and therefore be more sustainable. Incorporating Open Data on public toilet provision, Bichard and Knight (RCA) developed The Great British Public Toilet Map (GBPTM). Whilst a number of other websites and applications map toilets by ‘crowd surfing’, GBPTM is entirely populated by Open Data, and not only uses the data as information for users, but informs members of the public that such information is available and accessible for their use. This paper presents the development of the GBPTM, including inclusive design research and studies that compare accuracy of information directly provided by users with Open Data collected by local authorities. It suggests that, to meet the health and well-being of an ageing population, a sustainable and cost-effective solution must be found for ‘publicly accessible’ toilet provision, including opening up provision beyond that ‘for customers only’ and providing accurate information on current public provision. The paper highlights the barriers encountered in the production of Open Data by local authorities. A review of the paper in the journal Civil Engineering (May 2013) described the design of the GBPTM as a ‘simple and elegant solution’. The development of a digital output and an understanding of digitally based research led to Bichard’s successful submission to an EPSRC Digital Economy sandpit, in which she developed an interdisciplinary project with the Universities of Newcastle, Bournemouth and the West of England. The project, Family Rituals 2.0, secured £750,000 in research funding with Bichard as co-investigator (2013–15)

Palliative care for cirrhosis: a UK survey of health professionals' perceptions, current practice and future needs

Objective: To determine the knowledge and practice patterns of a UK cohort of relevant healthcare professionals (HCPs) about delivering palliative care in cirrhosis, and to inform priorities for future research. / Design: An on-line questionnaire survey with closed and open responses. / Setting: HCPs identified from the mailing list of special interest groups in hepatology and gastroenterology (liver), general practice and specialist palliative care (SPC) across the UK. / Results: Of the 6181 potential contacts identified, 517 HCPs responded. Most believed a role exists for SPC in caring for people with cirrhosis, but many SPC HCPs felt ill prepared to provide good care to those facing death. Further training was needed in managing liver-related symptoms, symptom control and end of life issues. All HCP groups wished to increase community provision of palliative care support, but many general practitioners felt unable to manage advanced cirrhosis in the community. There were differences in the optimal trigger for SPC referral with liver HCPs less likely to refer at symptom deterioration. Prognostication, symptom management and service configuration were key areas identified for future research. / Conclusions: All who responded acknowledged the role of SPC in caring for those dying with cirrhosis and need for further training to improve confidence and enable joint working between SPC, general practice and liver teams. Low response rates make it difficult to generalise these findings, which require further validation

Analysing decision logs to understand decision-making in serious crime investigations

Objective: To study decision-making by detectives when investigating serious crime through the examination of Decision Logs to explore hypothesis generation and evidence selection. Background: Decision logs are used to record and justify decisions made during serious crime investigations. The complexity of investigative decision-making is well documented, as are the errors associated with miscarriages of justice and inquests. The use of decision logs has not been the subject of an empirical investigation, yet they offer an important window into the nature of investigative decision-making in dynamic, time-critical environments. Method: A sample of decision logs from British police forces was analyzed qualitatively and quantitatively to explore hypothesis generation and evidence selection by police detectives. Results: Analyses revealed diversity in documentation of decisions that did not correlate with case type, and identified significant limitations of the decision log approach to supporting investigative decision-making. Differences emerged between experienced and less experienced officers’ decision log records in exploration of alternative hypotheses, generation of hypotheses, and sources of evidential enquiry opened over phase of investigation. Conclusion: The practical use of decision logs is highly constrained by their format and context of use. Despite this, decision log records suggest that experienced detectives display strategic decision-making to avoid confirmation and satisficing that affect less experienced detectives. Application: Potential applications of this research include both training in case documentation and the development of new decision log media that encourage detectives, irrespective of experience, to generate multiple hypotheses and optimize the timely selection of evidence to test them

Forward to the past: reinventing intelligence-led policing in Britain

Drawing on archival, secondary material and primary research, this paper examines 'Total Policing', the strategy recently adopted by London's Metropolitan Police. It situates that analysis within a critical examination of other innovative policing strategies previously employed in Britain. It argues that the prospects for Total Policing depend upon the resolution of long-standing problems such as: the inadequacy and inefficiency of local intelligence work; the paucity of evidence for the success of commanders' previous efforts to harness together the component parts of their forces in pursuit of a single mission; and, above all, a seeming inability to learn the lessons of the past. © 2013 © 2013 Taylor & Francis

Assessing sustainability in housing LED urban regeneration : insights from a housing association in Northern England

How far do current assessment methods allow the thorough evaluation of sustainable urban regeneration? Would it be useful, to approach the evaluation of the environmental and social impacts of housing regeneration schemes, by making both hidden pitfalls and potentials explicit, and budgeting costs and benefits in the stakeholders’ perspective? The paper aims at answering these questions, by focusing on a case study located in the Manchester area, the City West Housing Trust, a nonprofit housing association. Drawing from extensive fieldwork and including several interviews with key experts from this housing association, the paper first attempts to monetize the environmental and social value of two extant projects – a high-rise housing estate and an environmentally-led program. It then discusses whether and how a stakeholder-oriented approach would allow more engagement of both current and potential funders in the projects at hand. Findings from both the literature and the empirical data that was gathered show how in current housing regeneration processes, room for significant improvements in terms of assessment methods still exist. Findings additionally show that the environmental and social spillovers are largely disregarded because of a gap in the evaluation tools. This may also hinder the potential contributions of further funders in the achievements of higher impacts in terms of sustainability

Assessing the value of intangible benefits of property level flood risk adaptation (PLFRA) measures

© 2015, Springer Science+Business Media Dordrecht. Studies in the UK and elsewhere have identified that flooding can result in diverse impacts, ranging from significant financial costs (tangible) to social (intangible) impacts on households. At the same time, it is now clear that large-scale flood defence schemes are not the panacea to flood risk, and there is an increasing responsibility on property owners to protect their own properties. Hence, there is an emerging expectation for homeowners to take action in the form of investing in property level flood risk adaptation (PLFRA) measures to protect their properties. However, hitherto the level of uptake of such measures remains very low. The tangible financial benefits of investing in PLFRA measures are generally well understood and have been demonstrated to be cost beneficial for many properties at risk from frequent flooding. Importantly, these estimates tend to take little account of the value of the intangible benefits of PLFRA measures and therefore may be under estimating their full benefits. There remains a need to develop an improved understanding of these intangible benefits, and this research sets out to bridge this knowledge gap. Based on a synthesis of the literature, the contingent valuation method was selected as a means to value intangible impacts of flooding on households. A questionnaire survey of homeowners affected in the 2007 flooding was employed to elicit willingness to pay (WTP) values to avoid the intangible impacts of flooding on their households. The analysis of the questionnaire survey data revealed that the average WTP per household per year to avoid intangible flood impacts was £653. This therefore represents the value of the intangible benefits of investing in PLFRA measures and is significantly higher than previously estimated. This research builds on previous research in suggesting a higher value to the intangible impacts of flooding on households by assessing wider range of intangible impacts and focussing on more experienced individuals. Furthermore, the research indicates that factors which influence the WTP values were principally stress of flood, worrying about loss of house values, worrying about future flooding and age of respondents, with income showing a weak correlation. The establishment of a new value for the intangible impacts of flooding on households in the UK is helpful in the domain of flood risk management when evaluating the total benefits (tangible and intangible) of investing in flood protection measures, thus providing a robust assessment for decision-making on flood adaptation measures at an individual property level

Are homeowners willing to adapt to and mitigate the effects of climate change?

The need to adapt to climate change impacts, whilst simultaneously limiting greenhouse gas emissions, requires that the government’s efforts are joined by public action. In England and Wales, housing contributes significantly to the emissions and many properties are at risk of flooding. This paper investigates the preparedness of homeowners in England and Wales to make changes to their homes in response to the predicted effects of climate change. A telephone survey of 961 homeowners investigated their interest in purchasing mitigation and adaptation improvements against their concern about climate change, awareness of flood risk and attribution of responsibility for action. Whilst the majority of homes had some energy-saving improvements, few were found to have property-level flood protection. The high levels of awareness about climate change and flooding were coupled with the perception of risks as low. Whilst some respondents accepted personal responsibility for action, most believed that the authorities were responsible for flood protection, and would not pay the costs required to make their home more energy-efficient and better prepared for the eventuality of floods. The results suggest that there is scope for further improvement of energy-saving measures, and that the levels of adoption of flood-protection measures are very low. Multi-faceted strategies, including more effective communication of risks and responsibilities, incentives, and material support for the poorest, will need to be developed to overcome the current reluctance by homeowners to invest in flood-protection measures and further energy conservation solutions in the futur