How did a lower drink‐drive limit affect bar trade and drinking practices?:A qualitative study of how alcohol retailers experienced a change in policy

Introduction and Aims Reducing the legal drink-drive limit from 0.08% to 0.05% blood alcohol concentration (BAC) can reduce road traffic accidents and deaths if properly enforced. Reduced limits may be opposed by alcohol retail and manufacturing industries on the basis of commercial impact. Our aim was to qualitatively explore how a reduction in the drink-drive limit from 0.08% to 0.05% BAC in Scotland, was experienced by bar owners or managers, including any resultant changes in customer drinking or business practice. This is the first study of this type. Design and Methods Semi-structured interviews were conducted with 16 owners and managers of on-trade premises in Scotland in 2018, approximately 3 years after the drink-drive limit was reduced. Data were analysed using thematic analysis. Results Most participants reported no long-term financial impact on their business, but a few, mainly from rural areas, reported some reduction in alcohol sales. Observed drinking changes included fewer people drinking after work or leaving premises earlier on weekdays. Adaptations to businesses included improving the range of no/low-alcohol drinks and food offered. Changes such as these were seen as key to minimising economic impact. Discussion and Conclusions Opposition to legislative measures that impact on commercial interests is often strong and receives significant public attention. This study found that Scottish businesses that adapted to the drink-drive limit change reported little long-term economic impact. These findings are of international relevance as potential BAC limit reductions in several other jurisdictions remain the subject of debate, including regarding the impact on business

The nature and extent of healthy architecture: the current state of progress

© 2019, Emerald Publishing Limited. Purpose: The design of the built environment is a determinant of health. Accordingly, there is an increasing need for greater harmonization of the architectural profession and public health. However, there is a lack of knowledge on whether designers of the built environment are changing their practices to deliver healthier urban habitats. The paper aims to discuss these issues. Design/methodology/approach: The research uses a multi-method approach to data analysis, including: systematic mapping study, structured review and thematic analysis. Findings: The research finds that there are almost no requirements for the compulsory inclusion of health across institutions and agencies that have the power to execute and mandate the scope of architectural profession, training, education, practice or knowledge. Despite the urgent need for action and the myriad entreatments for greater integration between architecture and health, there is very little evidence progress. Practical implications: The research has implications for the architectural profession and architectural education. Health and well-being is not currently an integral part of the educational or professional training requirements for architects. University educational curriculum and Continuing Professional Development criteria need to better integrate health and well-being into their knowledge-base. Social implications: The design of the built environment is currently undertaken by an architectural profession that lacks specialized knowledge of health and well-being. There is a risk to society of environments that fail to adequately protect and promote the health and well-being of its inhabitants. Originality/value: The research evidences, for the first time, the lack of integration of “health and wellbeing” within the architecture profession training or education systems

Impact of Emerging Interaction Techniques on Energy Use in the UK Social Housing

End use energy efficiency and fuel poverty is one of the major issues in the UK social housing sector. It is estimated that about 10% of English households live in fuel poverty. During 2015 UK greenhouse gas emission final figures show that the net CO2 emission was reduced by 4.1% between 2014 and 2015. This shows that the UK is on course to attain its second carbon budget with annual 2013–2015 emissions that are each below the estimated level for the period. However, the housing sector lags with a 4% increase in emissions over the same period. More work needs to be done in this sector. Householders can adopt more efficient energy use approaches and make better lifestyle choices to save money and have a safer environment. This research addresses government priorities to reduce energy demand, meet CO2 reduction targets, and reduce domestic reliance on fossil fuels, offering protection from price risks and fuel poverty as well as providing more affordable and comfortable domestic environments. The proposed research paper deals with novel interaction methods on energy use in social housing and how the aforesaid issues can be reflected on. A detailed background study on existing interaction methods and ongoing development of a serious game trialled in 19 households has been carried out. It has been noted that displaying real-time utility use and indoor environmental conditions to householders increased awareness and impacted how energy is being consumed. Furthermore, the proposed paper will investigate end use energy profile pattern changes due to novel interaction methods

The impact of ‘stop-go’ demand management policy on Britain's consumer durables industries, 1952-65

This article examines the impacts of British government ‘stop-go’ policy on domestic sales of consumer durables over the period 1952–65, via hire purchase restrictions and punitive Purchase Tax rates. Our analysis includes a general review of contemporary evidence regarding the impacts of these measures, a more detailed study of the television sector, and time-series econometric analysis for both televisions and a representative high-ticket labour-saving consumer durable: washing machines. We find that the restrictions had devastating impacts on Britain's consumer durables industries, preventing firms from fully exploiting economies of scale, reducing output growth and international competitiveness, and eroding industrial relations. Government officials were aware of these problems, but considered them a price worth paying to facilitate moves towards sterling convertibility and the re-establishment of the City as a leading financial and trading centre

Cytotoxic chemotherapy for incurable colorectal cancer: living with a PICC-line

<b>Aims.</b> (i) To determine which aspects of living with a peripherally inserted central catheter (PICC) line cause Modified de Gramont (MdG) patients most difficulty. (ii) To explore MdG patients' views of the PICC-line experience. (iii) To determine if patients view PICC-lines as a benefit or a burden when receiving ambulatory MdG chemotherapy. <b>Design.</b> A two-stage, descriptive study. <b>Methods.</b> Phase 1 comprised semi-structured interviews. Phase 2 surveyed the MdG population. Phase 1 interview data informed the Phase 2 questionnaire. The setting was a West of Scotland Cancer Care Centre and the sample was: Phase 1, a convenience sample of 10 MdG patients; Phase 2, 62 consecutive patients. <b>Results.</b> A response rate of 93·9% for Phase 2. The majority of PICC-line patients held favourable views towards having a PICC-line and adapted well with minimal disruption to daily life. Concerns were evident regarding coping at home with a PICC-line, chemotherapy spillage, dealing with complex information and the responsibility of patients/carers regarding PICC-line management. Patients preferred ambulatory chemotherapy to in-patient treatment. <b>Conclusions.</b> PICC-lines should be considered for more chemotherapy patients but service development is necessary to ensure individual needs are addressed. <b>Relevance to clinical practice.</b> Contributes to the PICC-line literature by providing a national patient perspective on a range of daily living activities (DLAs). PICC-line patients prefer out-patient ambulatory chemotherapy rather than in-patient treatment. The longer a patient has a PICC-line, the more able they are to manage activities such as dressing. Concerns remain over chemotherapy spillage, partner/carer responsibility for PICC-line maintenance and the proper balance between required information and what the patient wants to know

Changes in and predictors of length of stay in hospital after surgery for breast cancer between 1997/98 and 2004/05 in two regions of England: a population-based

BACKGROUND Decreases in length of stay (LOS) in hospital after breast cancer surgery can be partly attributed to the change to less radical surgery, but many other factors are operating at the patient, surgeon and hospital levels. This study aimed to describe the changes in and predictors of length of stay (LOS) in hospital after surgery for breast cancer between 1997/98 and 2004/05 in two regions of England. METHODS Cases of female invasive breast cancer diagnosed in two English cancer registry regions were linked to Hospital Episode Statistics data for the period 1st April 1997 to 31st March 2005. A subset of records where women underwent mastectomy or breast conserving surgery (BCS) was extracted (n = 44,877). Variations in LOS over the study period were investigated. A multilevel model with patients clustered within surgical teams and NHS Trusts was used to examine associations between LOS and a range of factors. RESULTS Over the study period the proportion of women having a mastectomy reduced from 58% to 52%. The proportion varied from 14% to 80% according to NHS Trust. LOS decreased by 21% from 1997/98 to 2004/05 (LOSratio = 0.79, 95%CI 0.77-0.80). BCS was associated with 33% shorter hospital stays compared to mastectomy (LOSratio = 0.67, 95%CI 0.66-0.68). Older age, advanced disease, presence of comorbidities, lymph node excision and reconstructive surgery were associated with increased LOS. Significant variation remained amongst Trusts and surgical teams. CONCLUSION The number of days spent in hospital after breast cancer surgery has continued to decline for several decades. The change from mastectomy to BCS accounts for only 9% of the overall decrease in LOS. Other explanations include the adoption of new techniques and practices, such as sentinel lymph node biopsy and early discharge. This study has identified wide variation in practice with substantial cost implications for the NHS. Further work is required to explain this variation

Local Flood Risk Management Strategies in England: Patterns of Application

In England, the Flood and Water Management Act 2010 provides specific roles for Lead Local Flood Authorities in flood and coastal erosion risk management. Under Section 9 of the Act, authorities are responsible for preparing, applying and monitoring a local flood risk management strategy that balances community input into flood management with national policy objectives. Authorities are legally obliged to consider specified requirements in strategy production, including consultation with the public. Using an evaluative framework based on legal requirements and local government guidelines, this article assesses the extent to which these requirements have been met in a sample of 43 strategies. Our findings suggest that strategies generally meet minimal legal requirements, although variance exists in approaches adopted, particularly in respect of consultation and links to other environmental management aspects. Recommendations for enhancing future practice are provided

Systems of education governance and cultures of justice in Ireland, Scotland and Pakistan

This chapter compares the issue of cultures of justice in the systems of education governance in three education systems: Ireland, Scotland and Pakistan. The focus for the comparison are the current policies which shape the regulation of education. These policies were reviewed to identify key issues relating to social justice and equality, decision-making and accountability. From the analysis of each system, three central issues were identified: firstly, the improvement of a state education system; secondly, the degree of decentralisation and centralisation in governance structures and thirdly, the expectations placed on school leaders. The chapter concludes by discussing the tensions between the drive for system improvement and opportunities for school leaders to build strategies to address issues of inequality in schools