A network approach to overcoming barriers to market engagement for SMEs in energy efficiency initiatives such as the Green Deal

The Green Deal (GD) was launched in 2013 by the UK Government as a market-led scheme to encourage uptake of energy efficiency measures in the UK and create green sector jobs. The scheme closed in July 2015 after 30 months due to government concerns over low uptake and industry standards but additional factors potentially contributed to its failure such as poor scheme design and lack of understanding of the customer and supply chain journey. We explore the role of key delivery agents of GD services, specifically SMEs, and we use the LoCal-Net project as a case study to examine the use of networks to identify and reduce barriers to SME market engagement. We find that SMEs experienced multiple barriers to interaction with the GD such as lack of access to information, training, and confusion over delivery of the scheme but benefited from interaction with the network to access information, improve understanding of the scheme, increasing networking opportunities and forming new business models and partnerships to reduce risk. The importance of SMEs as delivery agents and their role in the design of market-led schemes such as the GD are discussed with recommendations for improving SME engagement in green sector initiatives

An evaluation of water treatment technologies for sustainable rural communities

This paper presents the initial stages of research funded by the Scottish Government to enable an evaluation of the suitability of drinking water treatment technologies at small to medium scales to facilitate the application of the Scottish Government’s Sustainable Rural Communities concept. The research included a technology scan to identify relevant drinking water treatment technologies suitable for small and medium sized rural communities in Scotland and an expert stakeholder workshop to verify and refine the technology inventory. The stakeholder workshop was also used to identify suitable selection criteria for Sustainable Rural Community drinking water projects. The criteria can be used in subsequent multi-stakeholder decision making for the most sustainable treatment options for specific communities. An explanation is provided on the methodology and the types of information that were collected and the outcomes of the research. <br/

Tackling health inequalities through developing evidence-based policy and practice with childbearing women in prison: a consultation

A collaborative partnership between the Hallam Centre for Community Justice and the Mother and Infant Research Unit (MIRU) at the University of York was successful in securing funding to conduct this consultation project. This collaboration brought together the knowledge and expertise of researchers working in maternal and infant health and those with knowledge of the prison sector. This consultation scopes and maps the health needs and health care of childbearing women in prison, using the Yorkshire and Humberside region as a case study

Characterising non-urgent users of the emergency department (ED): A retrospective analysis of routine ED data

Background The pressures of patient demand on emergency departments (EDs) continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times. It has also been reported that a proportion of attendances to EDs in different international systems could be managed in settings such as primary care. This study used routine ED data to define, measure and profile non-urgent ED attendances that were suitable for management in alternative, non-emergency settings. Methods We undertook a retrospective analysis of three years of Hospital Episode and Statistics Accident Emergency (HES A&E) data for one large region in England, United Kingdom (April 1st 2011 to March 31st 2014). Data was collected on all adult (>16 years) ED attendances from each of the 19 EDs in the region. A validated process based definition of nonurgent attendance was refined for this study and applied to the data. Using summary statistics non-urgent attenders were examined by variables hypothesised to influence them as follows: age at arrival, time of day and day of week and mode of arrival. Odds ratios were calculated to compare non-urgent attenders between groups. Results There were 3,667,601 first time attendances to EDs, of which 554,564 were defined as nonurgent (15.1%). Non-urgent attendances were significantly more likely to present out of hours than in hours (OR = 1.19, 95% CI: 1.18 to 1.20, P<0.001). The odds of a non-urgent attendance were significantly higher for younger patients (aged 16–44) compared to those aged 45–64 (odds ratio: 1.42, 95% CI: 1.41 to 1.43, P<0.001) and the over 65’s (odds ratio: 3.81, 95% CI: 3.78 to 3.85, P<0.001). Younger patients were significantly more likely to attend non-urgently out of hours compared to the 45–64’s (OR = 1.24, 95% CI: 1.22 to 1.25, P<0.001) and the 65+’s (OR = 1.38, 95% CI: 1.35 to 1.40, P<0.001). 110,605/554,564 (19.9%) of the non-urgent attendances arrived by ambulance, increasing significantly out of hours versus in hours (OR = 2.12, 95% CI: 2.09 to 2.15, P<0.001). Conclusions Younger adults are significantly more likely as older counterparts to use the ED to obtain healthcare that could be provided in a less urgent setting and also more likely to do this out of hours. Alternative services are required to manage non-urgent demand, currently being borne by the ED and the ambulance service, particularly in out of hours

A systematic review and meta-analysis of the long-term effects of physical activity interventions on objectively measured outcomes

Abstract Background Although physical activity interventions are frequently reported to be effective, long-term changes are needed to generate meaningful health benefits. There are criticisms that evaluations of physical activity interventions mostly report short-term outcomes and that these are often self-reported rather than measured objectively. This study therefore aimed to assess the long-term (at least 24 month) effectiveness of behavioural interventions on objectively measured physical activity. Methods We conducted a systematic review with a meta-analysis of effects on objectively measured physical activity. We searched: Cochrane CENTRAL, EMBASE, PsychInfo, CINAHL and Pubmed up to 10th January 2022. Studies were included if they were in English and included a physical intervention that assessed physical activity in the long-term (defined as at least 24 months). Results Eight studies with 8480 participants were identified with data suitable for meta-analysis. There was a significant effect of interventions on daily steps 24 months post baseline (four studies, SMD: 0.15, 95% CI: 0.02 to 0.28) with similar results at 36 to 48 months of follow up (four studies, SMD: 0.17, 95% CI: 0.07 to 0.27). There was a significant effect of interventions on moderate-to-vigorous physical activity 24 months post baseline (four studies, SMD: 0.18 95% CI: 0.07 to 0.29) and at 36 to 48 months (three studies, SMD: 0.16 95% CI: 0.09 to 0.23). The mean effect size was small. However, the changes in moderate-to-vigorous physical activity and steps per day were clinically meaningful in the best-performing studies. Conclusion This review suggests that behavioural interventions can be effective in promoting small, but clinically meaningful increases in objectively measured physical activity for up to 48 months. There is therefore a need to develop interventions that can achieve greater increases in long-term physical activity with greater efficiency

Sensitivity of nonlinear photoionization to resonance substructure in collective excitation

Collective behaviour is a characteristic feature in many-body systems, important for developments in fields such as magnetism, superconductivity, photonics and electronics. Recently, there has been increasing interest in the optically nonlinear response of collective excitations. Here we demonstrate how the nonlinear interaction of a many-body system with intense XUV radiation can be used as an effective probe for characterizing otherwise unresolved features of its collective response. Resonant photoionization of atomic xenon was chosen as a case study. The excellent agreement between experiment and theory strongly supports the prediction that two distinct poles underlie the giant dipole resonance. Our results pave the way towards a deeper understanding of collective behaviour in atoms, molecules and solid-state systems using nonlinear spectroscopic techniques enabled by modern short-wavelength light sources

Auras and the risk of seizures with impaired consciousness following epilepsy surgery: implications for driving

OBJECTIVE: To calculate the chance of a seizure in the next year (COSY) for seizures with impaired awareness in those experiencing auras only, those with no seizures and those with continuing seizures. Epilepsy surgery is an effective treatment for refractory focal epilepsy. Driving is an important factor affecting quality of life. In the UK, driving is not permitted if focal seizures with no impairment of awareness (auras, simple partial seizures) continue, if there is a prior history of seizures with impaired awareness, as will invariably be the case in those having epilepsy surgery. Current UK driving regulations allow driving if COSY is less than 20%. METHOD: We calculated COSY in 819 epilepsy surgery patients with up to 25 years follow-up. Each patient year was graded on the The International League against Epilepsy surgery outcome scale. RESULTS: Patients who were entirely seizure-free for 1, 2 and 3 years had COSY of 4.9%, 3.5% and 2.4% respectively. Patients with only auras within the last 1, 2 or 3 years had a COSY of 11.3%, 9.2% and 7.8% respectively. CONCLUSIONS: Individuals with auras only after epilepsy surgery had a higher COSY than those who were seizure-free. If a COSY of below 20% is regarded as an acceptable risk, it may be suggested that those with auras only in a given year be allowed to drive. The relative risk of these patients causing accidents is lower than population groups such as those aged 75 years, who are permitted to drive

A data-linkage study of suspected seizures in the urgent and emergency care system in the UK

Introduction The urgent and emergency care system (UEC) is struggling with increased demand, some of which is clinically unnecessary. Patients suffering suspected seizures commonly present to emergency departments, but most seizures are self-limiting and have low risk of short-term adverse outcomes. We aimed to investigate the flow of suspected seizure patients through the UEC system using datalinkage to facilitate development of new models of care. Methods We used a two-stage process of deterministic linking to perform a cross-sectional analysis of data from adults in a large region in England (population 5.4 million) during 2014. The core dataset comprised a total of 739,436 ambulance emergency incidents, 1,033,778 ED attendances and 362,358 admissions. Results A high proportion of cases were successfully linked (86.9% ED-inpatient, 77.7% ED-ambulance). Suspected seizures represented 2.8% of all ambulance service incidents. 61.7% of these incidents led to dispatch of a rapid-response ambulance (8 minutes) and 72.1% were conveyed to hospital. 37 patients died before being conveyed to hospital and 24 died in the ED (total 61; 0.3%). The in-patient death rate was 0.4%. Suspected seizures represented 0.71% of ED attendances, 89.8% of these arrived by emergency ambulance, 45.4% were admitted and 44.5% of these admissions lasted under 48 hours. Conclusions This study confirms previously published data from smaller unlinked datasets, validating the linkage method, and provides new data for suspected seizures. There are significant barriers to realising the full potential of data-linkage. Collaborative action is needed to create facilitative governance frameworks and improve data quality and analytical capacity

Fractionation and identification of antioxidant peptides from an enzymatically hydrolysed Palmaria palmata protein isolate

peer-reviewedProteins derived from the macroalgal species Palmaria palmata have emerged as potential substrates for the generation of bioactive peptides. The aim of this study was to fractionate, identify and characterize antioxidant peptides from a P. palmata protein hydrolysate. The P. palmata protein hydrolysate generated with the food-grade proteolytic enzyme Corolase PP was sequentially fractionated using solid phase extraction and semi-preparative (SP) RP-HPLC. The most active SP-RP-HPLC peptide fraction (SP-RP-HPLC-30-F26) was analysed by ESI-MS/MS. Seventeen novel peptide sequences were identified in this fraction. Of the peptides selected for synthesis, Ser-Asp-Ile-Thr-Arg-Pro-Gly-Gly-Asn-Met, showed the highest oxygen radical absorbance capacity (ORAC) and ferric reducing antioxidant power (FRAP) activity with values of 152.43 ± 2.73 and 21.23 ± 0.90 nmol TE/μmol peptide, respectively. The results presented herein indicate that P. palmata derived peptides may have potential applications as health enhancing ingredients and as food preservatives due to their antioxidant activity.ACCEPTEDpeer-reviewe

The use of semi-structured interviews for the characterisation of farmer irrigation practices

For the development of sustainable and realistic water security, generating information on the behaviours, characteristics, and drivers of users, as well as on the resource itself, is essential. In this paper we present a methodology for collecting qualitative and quantitative data on water use practices through semi-structured interviews. This approach facilitates the collection of detailed information on actors' decisions in a convenient and cost-effective manner. Semi-structured interviews are organised around a topic guide, which helps lead the conversation in a standardised way while allowing sufficient opportunity for relevant issues to emerge. In addition, they can be used to obtain certain types of quantitative data. While not as accurate as direct measurements, they can provide useful information on local practices and users' insights. We present an application of the methodology on farmer water use in two districts in the state of Uttar Pradesh in northern India. By means of 100 farmer interviews, information was collected on various aspects of irrigation practices, including irrigation water volumes, irrigation cost, water source, and their spatial variability. Statistical analyses of the information, along with data visualisation, are also presented, indicating a significant variation in irrigation practices both within and between districts. Our application shows that semi-structured interviews are an effective and efficient method of collecting both qualitative and quantitative information for the assessment of drivers, behaviours, and their outcomes in a data-scarce region. The collection of this type of data could significantly improve insights on water resources, leading to more realistic management options and increased water security in the future