Briefing: Infrastructure business models, valuation and innovation for local delivery

The UK’s Engineering and Physical Sciences Research Council and the Economic and Social Research Council have launched a £3·5 million, 4-year research programme to develop innovative business models for delivering infrastructure. Richard Dawson, Claire Walsh, Phil Purnell and Chris Rogers introduce infrastructure business models, valuation and innovation for local delivery (iBUILD). A growing population, extreme weather, decarbonisation, a proliferation of new technologies and their integration with ageing, existing systems are just some of the pressures on modern infrastructure. Unfortunately, the rate of investment in infrastructure has not kept up with the pace of change, and this is further complicated by fragmented, often reactive, regulation and governance arrangements. The UK Treasury Select Committee noted that existing infrastructure business models provide poor value (HM Treasury, 2011), but few alternatives are available; a point picked up by Infrastructure UK (Infrastructure UK, 2011) who called for research centres to be founded to address this. The iBUILD Centre will address this through development of a suite of alternative infrastructure business models, ranging from reforms to existing approaches to radical new models, each enabling more effective delivery of local infrastructures

Overheating in retrofitted flats: occupant practices, learning and interventions

© 2016 Informa UK Limited, trading as Taylor & Francis Group The overheating risk in flats (apartments) retrofitted to energy-efficient standards has been identified by previous studies as one that is particularly high. With climate change and rising mean temperatures this is a growing concern. There is a need to understand the kinds of practices, learning and interventions adopted by the occupants of individual homes to try to reduce overheating, as this area is poorly understood and under-researched. This case study focuses on the impact of different home-use practices in relation to the severity of overheating in 18 flats in one tower block in northern England. Internal temperatures monitored in comparable flats show that the percentage of time spent above the expected category II threshold of thermal comfort according to BS EN 15251 can differ by over 70%. Extensive monitoring, covering a full year, including two summer periods, has identified emergent changes in heatwave practices linked with increased home-use skills and understanding among the research participants. Close analysis of design intentions versus reality has identified key physical barriers and social learning opportunities for appropriate adaptation in relation to heatwaves. Recommendations for designers and policy-makers are highlighted in relation to these factors

Cervical screening uptake, political interest and voter turnout: a population-based survey of women in England.

To examine the relationship between cervical screening uptake and political engagement, and to test whether political engagement and voting behaviour mediate the association between age and cervical screening uptake

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

A review of the rural-digital policy agenda from a community resilience perspective

© 2016 The Authors This paper utilises a community resilience framework to critically examine the digital-rural policy agenda. Rural areas are sometimes seen as passive and static, set in contrast to the mobility of urban, technological and globalisation processes (Bell et al., 2010). In response to notions of rural decline (McManus et al., 2012) rural resilience literature posits rural communities as ‘active,’ and ‘proactive’ about their future (Skerratt, 2013), developing processes for building capacity and resources. We bring together rural development and digital policy-related literature, using resilience motifs developed from recent academic literature, including community resilience, digital divides, digital inclusion, and rural information and communication technologies (ICTs). Whilst community broadband initiatives have been linked to resilience (Plunkett-Carnegie, 2012; Heesen et al., 2013) digital inclusion, and engagement with new digital technologies more broadly, have not. We explore this through three resilience motifs: resilience as multi-scalar; as entailing normative assumptions; and as integrated and place-sensitive. We point to normative claims about the capacity of digital technology to aid rural development, to offer solutions to rural service provision and the challenges of implementing localism. Taking the UK as a focus, we explore the various scales at which this is evident, from European to UK country-level

Enhanced invitation methods and uptake of health checks in primary care. Rapid randomised controlled trial using electronic health records

Background: A national programme of health checks to identify risk of cardiovascular disease is being rolled out but is encountering difficulties of low uptake. Objective: To evaluate the effectiveness of an enhanced invitation method using the Question-Behaviour Effect (QBE), with or without the offer of a financial incentive to return the QBE questionnaire, at increasing the uptake of health checks. Secondary objectives were to evaluate reasons for low uptake of invitations and to compare case-mix for invited and opportunistic health checks. Trial design: Three-arm randomised trial. Participants: All participants invited for health checks from 18 general practices. Randomisation: Individual participants were randomised. Interventions: i) standard health check invitation only, ii) QBE questionnaire followed by standard invitation; iii) QBE questionnaire with offer of a financial incentive to return the questionnaire, followed by standard invitation. Outcomes: The primary outcome was completion of health check within six months of randomisation. A P value of 0.0167 was used for significance. Case-mix was evaluated for invited and opportunistic health checks. Blinding: Participants were not aware that several types of invitation were in use. The research team were blind to trial arm allocation at outcome data extraction. Results: There were 12,459 participants allocated and health check uptake was evaluated for 12,052 participants for whom outcome data were collected. Health check uptake was: standard invitation, 590 / 4,095 (14.4%); QBE questionnaire, 630 / 3,988 (15.8%); QBE questionnaire and financial incentive, 629 / 3,969 (15.9%). The increase in uptake associated with QBE questionnaire was 1.43% (95% confidence interval -0.12 to 2.97%, P=0.070) and for the QBE questionnaire and offer of financial incentive was 1.52% (-0.03 to 3.07%, P=0.054). The difference in uptake associated with the offer of an incentive to return the QBE questionnaire was -0.01% (-1.59 to 1.58%, P=0.995). During the study, 58% of health check cardiovascular risk assessments did not follow a trial invitation. People who received ‘opportunistic’ health checks had greater odds of ≥10% cardiovascular disease (CVD) risk; adjusted odds ratio 1.70, 95% confidence interval 1.45 to 1.99, P<0.001) compared with invited health checks. Conclusion: Uptake of health checks following an invitation letter is low and is not increased through an enhanced invitation method using the QBE, with or without an incentive. A high proportion of all health checks are performed opportunistically. Participants receiving opportunistic checks are at higher risk of CVD than those responding to standard invitations. Trial registration: Current Controlled Trials ISRCTN42856343

Youth, terrorism and education: Britain’s Prevent programme

Since the 7/7 bombings of July 2005, Britain has experienced a domestic terror threat posed by a small minority of young Muslims. In response, Britain has initiated ‘Prevent’, a preventative counter-terrorism programme. Building on previous, general critiques of Prevent, this article outlines and critically discusses the ways in which Prevent has approached young Muslims and their educational institutions. The article argues that, rather than trust in broader and non-stigmatising processes of anti-extremist education, the police-led Prevent has ‘engaged’ with and surveilled young Muslims. Within Prevent there is little evidence of educational processes that explicitly build youth resilience against extremism. Instead, Muslim youth are viewed as both ‘risky and at risk’ (Heath-Kelly, 2013), ‘at risk’ of catching the terrorist disease, with the contested model of ‘radicalisation’ and child protection concepts utilised to portray risks of exploitation by Islamist extremists that necessitate a deepening process of education-based surveillance. The article identifies non-stigmatising alternatives to the approach of Prevent, approaches of anti-extremism education that learn from previously problematic anti-racist educational efforts with white young people. This enables the article to advocate for enhanced human rights-based approaches of citizenship education (admittedly, in themselves contested) with all young people as the most effective way of building individual and collective youth resilience against terrorist ideologies