The co-construction of energy provision and everyday practice: integrating heat pumps in social housing in England

Challenges of energy security, low carbon transitions, and electricity network constraints have led to a shift to new, efficient technologies for household energy services. Studies of such technological innovations usually focus on consumer information and changes in behaviour to realise their full potential. We suggest that regarding such technologies in existing energy provision systems opens up questions concerning how and why such interventions are delivered. We argue that we must understand the ways by which energy systems are co-constituted through the habits and expectations of households, their technologies and appliances, alongside arrangements associated with large-scale socio-technical infrastructures. Drawing on research with air-source-to-water heat pumps (ASWHP), installed as part of a large trans-disciplinary, utility-led research and demonstration project in the north of England, we investigate how energy services provision and everyday practice shapes new technologies uptake, and how such technologies mediate and reconfigure relations between users, providers and infrastructure networks. While the installation of ASWHP has led to role differentiation through which energy services are provided, the space for new forms of co-provision to emerge is limited by existing commitments to delivering energy services. Simultaneously, new forms of interdependency emerge between users, providers and intermediaries through sites of installation, instruction, repair and feedback. We find that although new technologies do lead to the rearrangement of practices, this is often disrupted by obduracy in the conventions and habits around domestic heating and hot water practices that have been established in relation to existing systems of provision. Rather being simply a matter of increasing levels of knowledge in order to ensure that such technologies are adopted effi ciently and effectively, our paper demonstrates how systemic arrangements of energy provision and everyday practice are co-implicated in socio-technical innovation by changing the nature of energy supply and use

Fostering active network management through SMEs’practises

Managing the electricity network through ‘smart grid’ systems is a key strategy to address challenges of energy security, low carbon transitions and the replacement of ageing infrastructure networks in the UK. Small and medium enterprises (SMEs) have a significant role in shaping patterns of energy consumption. Understanding how their activities interrelate with changes in electricity systems is critical for active network management. A significant challenge for the transformation of electricity systems involves comprehending the complexity that stems from the variety of commercial activities and diversity of social and organizational practises among SMEs that interact with material infrastructures. We engage with SMEs to consider how smart grid interventions ‘fit’ into everyday operational activities. Drawing on analysis of empirical data on electricity use, smart metre data, surveys, interviews and ‘energy tours’ with SMEs to understand lighting, space heating and cooling, refrigeration and IT use, this paper argues for experimenting with the use of practise theory as a framework for bringing together technical and social aspects of energy use in SMEs. This approach reveals that material circumstances and temporal factors shape current energy demand among SMEs, with ‘connectedness’ an emergent factor

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

The Co-Construction of Energy Provision and Everyday Practice: Integrating Heat Pumps in Social Housing in England

Challenges of energy security, low carbon transitions, and electricity network constraints have led to a shift to new, efficient technologies for household energy services. Studies of such technological innovations usually focus on consumer information and changes in behaviour to realise their full potential. We suggest that regarding such technologies in existing energy provision systems opens up questions concerning how and why such interventions are delivered. We argue that we must understand the ways by which energy systems are co-constituted through the habits and expectations of households, their technologies and appliances, alongside arrangements associated with large-scale socio-technical infrastructures. Drawing on research with air-source-to-water heat pumps (ASWHP), installed as part of a large trans-disciplinary, utility-led research and demonstration project in the north of England, we investigate how energy services provision and everyday practice shapes new technologies uptake, and how such technologies mediate and reconfigure relations between users, providers and infrastructure networks. While the installation of ASWHP has led to role differentiation through which energy services are provided, the space for new forms of co-provision to emerge is limited by existing commitments to delivering energy services. Simultaneously, new forms of interdependency emerge between users, providers and intermediaries through sites of installation, instruction, repair and feedback. We find that although new technologies do lead to the rearrangement of practices, this is often disrupted by obduracy in the conventions and habits around domestic heating and hot water practices that have been established in relation to existing systems of provision. Rather being simply a matter of increasing levels of knowledge in order to ensure that such technologies are adopted effi ciently and effectively, our paper demonstrates how systemic arrangements of energy provision and everyday practice are co-implicated in socio-technical innovation by changing the nature of energy supply and use