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• There has been a limited scope of investigation of the contextual factors affecting driver decision-making during narrow passage interactions. • The study found that the likelihood of giving way may alter due to characteristics of the interaction partners, including their vehicle type. • It was also found that factors, external to the direct interaction partners, may affect the likelihood of giving way, such as the presence of vehicles beyond the direct interaction partners. • This paper validates previous communication findings in a UK context. Narrow passage interactions have received increased attention from academics seeking to create behavioural models of the interaction and those looking to define how autonomous vehicles (AVs) should interact with their human counterparts in a composite road system. Despite this increased attention, many factors remain unexplored in the narrow passage literature, with the literature also encompassing few driving culture contexts. To this end, this study employs an explorative survey to identify additional factors that affect driver decision-making during narrow passage interactions, as well as driver perceptions of different communications in a UK context. The study's 243 participants were presented with a range of different narrow passage scenarios and asked to indicate how likely they were to give way/yield to a vehicle approaching the narrow passage from the opposite direction. In addition, they also completed the Multidimensional Driving Style Inventory to identify their driving styles and asked to identify which signals they look for from their interaction partner during narrow passage interactions, as well as the meaning of those signals. The results of the study show that situational characteristics such as the vehicle type being interacted with, being in a rush and being followed by vehicles alter the likelihood of drivers giving way at narrow passages, whilst a person's driving style can also indicate how likely someone is to give way to another vehicle. These results highlight the factors that are considered by drivers, increasing our understanding of the factors that need to be incorporated in driver behaviour models and in AV development. [ABSTRACT FROM AUTHOR]

Cardiac Rehabilitation (CR) has become an established intervention to support patient recovery after a cardiac event, with evidence supporting its effectiveness and cost-effectiveness in improving patient health and reducing future burden on healthcare systems. However, this evidence has focussed on the national value case for CR rather than at the point at which it is commissioned. This analysis uses the UK as a case-study to explore variation in current CR engagement and disassemble the value case from a commissioner perspective. Using data collected by the National Audit of CR (NACR), and an existing model of cost-effectiveness, we present details on the current level of CR uptake by commissioning region (Specialist Clinical Networks) in light of the current UK target of achieving 85% uptake. We then interrogate the value case for achieving the target at a commissioner level, highlighting the expected profile of health benefits and healthcare system costs over the long-term. Importantly we consider where this may differ from the national value case. Each commissioning region has a unique level of CR uptake and sociodemographic profile. Concurrently, the value case for commissioning CR relies on the upfront cost of the service being offset by long-term healthcare savings, and health improvements. The shift in the UK and internationally to more localised commissioning necessitates evidence of cost-effectiveness that better reflects the realities of those decision makers. This paper provides vital additional data to facilitate such commissioners to understand the value case in increasing CR uptake in line with national policy. • Many nations are aiming to increase rates of CR uptake. • Commissioning of services is complex and different from national decision making. • The challenges in reaching targets are different for each region. • It is important to consider equity when commissioning CR. [ABSTRACT FROM AUTHOR]

Previous work by the authors has addressed the issue of local bus policy implementation in Britain outside London by studies of local transport documents, survey and interviews of local transport officers working in local authorities. The findings from these studies highlight that some of the key elements to successful implementation could be understood in more depth by taking a case study approach. This paper analyses four case studies of the implementation of specific bus policy measures in four different cities in Great Britain: the Quality Contract Scheme (QCS) in Tyne and Wear, the Fastlink Scheme in Glasgow, a Bus Priority Scheme in Solihull and a Smart Ticketing Scheme in Dundee. The findings in this paper show that policy champions, collaboration and interaction help to build a relationship between the parties involved, ensure limited changes due to bureaucratic power and changes to the policy, and help to overcome opposition, conflict and ambiguities. It is important that those involved in the policy process are provided with relevant training, supervision and support to help overcome the staffing difficulties and to deal with barriers external to the implementing organisation such as economic, social and political conditions. • Greatest influences on implementation are identified. • Greatest challenges faced by local authorities are identified. • Those involved in policy process require relevant training, supervision and support. • Authorities must be certain from the planning stage that resources are available. • Clear strategies and tactics improve policy development and collaboration, stakeholder engagement and decision making. [ABSTRACT FROM AUTHOR]

This paper argues that existing English and Welsh mental health legislation (The Mental Health Act 1983 (MHA)) should be changed to make provision for advance decision-making (ADM) within statute and makes detailed recommendations as to what should constitute this statutory provision. The recommendations seek to enable a culture change in relation to written statements made with capacity such that they are developed within mental health services and involve joint working on mental health requests as well as potential refusals. In formulating our recommendations, we consider the historical background of ADM, similarities and differences between physical and mental health, a taxonomy of ADM, the evidence base for mental health ADM, the ethics of ADM, the necessity for statutory ADM and the possibility of capacity based 'fusion' law on ADM. It is argued that the introduction of mental health ADM into the MHA will provide clarity within what has become a confusing area and will enable and promote the development and realisation of ADM as a form of self-determination. The paper originated as a report commissioned by, and submitted to, the UK Government's 2018 Independent Review of the Mental Health Act 1983. [ABSTRACT FROM AUTHOR]

Causal machine learning (ML) algorithms recover graphical structures that tell us something about cause-and-effect relationships. The causal representation provided by these algorithms enables transparency and explainability, which is necessary for decision making in critical real-world problems. Yet, causal ML has had limited impact in practice compared to associational ML. This paper investigates the challenges of causal ML with application to COVID-19 UK pandemic data. We collate data from various public sources and investigate what the various structure learning algorithms learn from these data. We explore the impact of different data formats on algorithms spanning different classes of learning, and assess the results produced by each algorithm, and groups of algorithms, in terms of graphical structure, model dimensionality, sensitivity analysis, confounding variables, predictive and interventional inference. We use these results to highlight open problems in causal structure learning and directions for future research. To facilitate future work, we make all graphs, models, data sets, and source code publicly available online. [ABSTRACT FROM AUTHOR]

‘Experiential knowledge’ is increasingly recognised as an important influence on reproductive decision-making. ‘Experiential knowledge of disability’ in particular is a significant resource within prenatal testing/screening contexts, enabling prospective parents to imagine and appraise future lives affected by disability. However, the concept of ‘experiential knowledge’ has been widely critiqued for its idiosyncrasy, its impermanence and consequently its perceived inferiority to (medical) knowledge. This paper explores some of these key critiques of experiential knowledge through an analysis of its constitution and uses in the context of reproductive decision-making. Seventeen UK-resident women with Spinal Muscular Atrophy (SMA), or with SMA in their family, took part in two in-depth interviews: one in 2007–9 and the other in 2013–4. By comparing and contrasting these women's accounts at two time points, this paper demonstrates the stark contrast between ‘lived experience’ of SMA (the visceral everyday realities of life with the condition) and the various way(s) this experience was transformed into, and presented as, ‘knowledge’ through the processes of making, and accounting, for reproductive decisions. The analysis highlights that multiple, distinct and sometimes competing experiential frameworks are used to conceptualise SMA across time and context. However, rather than evidence of its fallibility, this finding highlights that ‘knowledge’ is an inappropriate vessel with which to capture and transfer ‘experiential knowledge’. Rather, we need to consider how to value such insight in ways that harnesses its inherent strength without leaving it vulnerable to the epistemological critiques attracted by labelling it ‘knowledge’. [ABSTRACT FROM AUTHOR]

There is a wide-ranging debate about the merits and demerits of searching for, and sending messages to, extraterrestrial intelligences (SETI and METI). There is however reasonable (but not universal) consensus that replying to a message from an extraterrestrial intelligence should not be done unilaterally, without consultation with wider society and the rest of the world. But how should this consultation actually work? In this paper we discuss various ways that decision making in such a scenario could be done democratically, and gain legitimacy. In particular we consider a scientist-led response, a politician-led response, deciding a response using a referendum, and finally using citizens' assemblies. We present the results of a survey of a representative survey of 2000 people in the UK on how they thought a response should best be determined, and finally discuss parallels to how the public is responding to scientific expertise in the COVID-19 Pandemic. • Democratic accountability regarding communication with extra-terrestrials. • How to make the decision whether or not to communicate with aliens. • Democracy, SETI and METI. • SETI and METI: Who has the right to decide what messages we send to aliens. • Voting in a referendum, or electing representatives, to determine response to First Contact. [ABSTRACT FROM AUTHOR]

Local level decision-making can provide a vital and practicable means through which to deliver carbon reductions at individual, household and community levels. This paper explores the opportunities and challenges associated with the role of local government action in delivering a resilient, low carbon future. Drawing on qualitative data gathered through interviews with six case study local authorities in the UK, the paper examines in particular the ways in which they have tried to address energy and environmental goals in their areas of jurisdiction. The principles of Multi-Level Perspective (MLP) are employed to provide fresh insights on the potential for local government to encourage ‘niche’ level influences on economic, technological and social/behavioural innovation. In doing so, we identify the enabling factors and drivers that have given rise to success in linking microlevel goals with existing macro-level objectives, as well as highlighting some of the persistent obstacles that continue to hamper progress. [ABSTRACT FROM AUTHOR]

The UK Supreme Court Montgomery judgement marks a decisive shift in the legal test of duty of care in the context of consent to treatment from the perspective of the clinician (as represented by Bolam rules) to that of the patient. This has important implications in the surgical field worldwide, where informed consent is critical. This paper aims to explain the ruling and how it impacts the consent process. The case and ruling are outlined and summarised as pertaining to consent and requirements for validity; a shift from the clinician's interpretation about what would be best for patients to the values of the particular patient concerned in the decision in question. A sample of recent commentaries is reviewed. Four examples illustrate some of the practical applications of the Montgomery ruling on consent and how the ruling can empower doctors and patients to make mutually beneficial shared decisions. Future consent should be obtained using a Montgomery compliant strategy in accordance with the principles of shared decision making. [ABSTRACT FROM AUTHOR]

The inherent uncertainties associated with offshore wind are substantial, as are the investments. Therefore, investors are keen to identify and evaluate the risks. This paper presents a model to economically evaluate projects from an offshore transmission owner's perspective by considering the revenue streams, capital costs, and operational expenditure. To allow a more realistic economic evaluation, data, regulatory information, and expert knowledge are collected, curated and, where necessary, combined with statistical techniques. A generic 1.2 GW project is used as a case study. This research contributes to a deeper understanding of the severe uncertainties involved in offshore transmission planning and their impact on a project's expected profit. Understanding their impact, through a sensitivity analysis where individually one factor is varied within an interval, supports informed decision making with limited information. Uncertainty in interest rates, planned operational expenditure and, particularly, cable failure rates were found to be critical to an investor's return. For the case study considered, comparing cable failure rates based on operational experience to inputs based on literature, resulted in a 64.2% lower net present value. In conclusion, further research into cable failures, and addressing the uncertainty in inputs used for economic evaluations could be beneficial to the industry. • Economic model formulation from a UK offshore transmission owner's perspective. • Proposes model to support decision making of future offshore transmission systems. • Discusses input uncertainties regarding economic analysis of offshore transmission. • Impact of severe uncertainty on the investor's expected profit is investigated. • Severe uncertainty in cable failure rate significantly impacts the expected profit. [ABSTRACT FROM AUTHOR]

This paper considers how discretion, understood as both a capacity to make decisions and a form of influence that is often hidden, operates within the accommodation and support of asylum seekers. Combining critical discussions of discretion with accounts of a 'local turn' in migration policy, I argue that discretion plays a key role in shaping how policy is implemented and offers insight into the changing governance of asylum at national and local levels. Drawing on empirical material examining the development of the UK's asylum dispersal system, the paper extends accounts of discretion beyond 'street-level' to argue for a focus on how discretion reflects different claims to institutional authority. Addressing four accounts of discretion in dispersal, I argue that tracing discretion can offer insights into how 'implementation gaps' in asylum policy are negotiated and how tensions between national and local governments are contained. Tracing discretion in this way may advance critical interrogations of power relations in welfare bureaucracies and develop understandings of institutional agency and influence within liberal democracies. [ABSTRACT FROM AUTHOR]

Digital forensics is an important and growing forensic domain. Research on miscarriages of justice and misleading evidence, as well as various inquires in the UK and the US, have highlighted human error as an issue within forensic science. This has led to increased attention to the sources of cognitive bias and potential countermeasures within many forensic disciplines. However, the area of digital forensics has yet to pay sufficient attention to this issue. The main goal of this article is to contribute to a more scientifically sound digital forensics domain by addressing the issues of cognitive bias as a source of error. In this paper we present an analysis of seven sources of cognitive and human error specifically within the digital forensics process, and discuss relevant countermeasures. We conclude that although some cognitive and bias issues are very similar across forensic domains, others are different and dependent on the specific characteristic of the domain in question, such as digital forensics. There is a need for new directions in research with regard to cognitive and human factors in digital forensics. [ABSTRACT FROM AUTHOR]

Abstract: Cattle and sheep breeders in the UK and elsewhere are increasingly being encouraged to use a variety of genetic technologies to help them make breeding decisions. The technology of particular interest here is ‘classical’ statistical genetics, which use a series of measurements taken from animals' bodies to provide an estimate of their ‘genetic merit’ known as Estimated Breeding Values (EBVs). Drawing on empirical research with the representatives of national cattle breed societies and individual cattle breeders the paper explores the complex ways in which they are engaging with genetic breeding technologies. The concept of ‘heterogeneous biosocial collectivity’ is mobilised to inform an understanding of processes of co-construction of breeding technologies, livestock animals and humans. The paper presents case studies of livestock breeding collectivities at different scales, arguing that the ways in which the ‘life’ of livestock animals is problematised is specific to different scales, and varies too between different collectivities at the same scale. This conceptualisation problematises earlier models of innovation-adoption that view farmers as either ‘adopters’ or ‘non-adopters’ of technologies and in which individual attitudes alone are seen as determining the decision to adopt or not adopt. Instead, the paper emphasises the particularity and specificity of co-construction, and that the co-construction of collectivities and technologies is always in process. [Copyright &y& Elsevier]

Abstract: This paper is a comparative analysis of the contribution to UK marine governance of two recent EU initiatives: the Marine Strategy Framework Directive (MSFD) and Marine Spatial Planning (MSP). MSFD imposed a duty on Member States to achieve Good Environmental Status (GES) in four regional seas, while MSP required Member States to replace their fragmented, sector-based system of maritime decision making with an integrated approach. This paper explains MSFD and MSP, examines their relationship, and compares their practicability, concluding that MSP is both the more dominant and the more practicable instrument, reflecting the UK's preference for sustainable development over conservationism in marine policy. A recent proposal by the European Commission to make MSP and integrated coastal management a Directive reinforces the UK position. [Copyright &y& Elsevier]

Prioritising testing activities is essential for new product development to identify the most valuable tests and distinguish the critical ones from the trivial ones. Most research solves this prioritisation problem based on the high risks identified in Failure Mode and Effect Analysis (FMEA). However, an empirical case study on a UK-based engine manufacturer highlights that the aim of testing is not only to detect technical failures but also to validate customer requirements. Based on the findings identified from the empirical study, this paper proposes a systematic approach for testing activity prioritisation, where fuzzy relational decision matrices are established to link customer requirements, technical objectives and testing activities. An XOR Best–Worst Method (BWM) and an extended simple additive weighting (SAW) method are developed to calculate the weights of customer requirements and score the testing activities. The approach also handles two uncertainty scenarios during the prioritisation process, i.e. the subjective judgements of choosing from options and the linguistic vagueness of the decisions. The application in a case from the engine manufacturing company illustrates the methodological improvement in the prioritisation process. The proposed method ranks the testing activities, which suggests an order of effort distribution for the test plan. • Challenges of prioritisation identified in an empirical case study. • A systematic fuzzy hybrid approach to testing prioritisation in new product development. • Both customer requirements and technical risk are critical factors in prioritisation. • The method is applied to an example case from the engine company. • The results show methodological improvement in the prioritisation process. [ABSTRACT FROM AUTHOR]

Abstract: The paper examines government IT outsourcing polices. The paper critiques the concept of ‘the Contract State’, and suggests how more disciplined uses of outsourcing can assist the creation of public value, more broadly conceived. Within the context of international developments, we study the United Kingdom Inland Revenue (IR), Customs and Excise (HMRC) and Department of Social Security (DSS) and their IT outsourcing contracts. The evidence suggests that outsourcing and marketization initiatives have adverse public value impacts, and may need to be rethought. Major IT operations and innovations, for example e-government, National Health Service (NHS) and identity card IT policies in the UK, are managed and generate legacies that do not always make efficient and effective use of the market. Moreover, their objectives, implementation and management over time may truncate their value to the public at large. Applying a revised Public Value policy approach offers a richer perspective to guide central government decisions worldwide about future IT outsourcing. [Copyright &y& Elsevier]

Abstract: This paper examines how cumulative effects assessment (CEA) has been considered in Strategic Environmental Assessments (SEA) of regional and local plans in a number of case studies in the UK. Initially, the paper presents the legislative and regulatory requirements for assessing cumulative effects in plans and programmes in the UK. The two approaches for assessing plans in the UK, Sustainability Appraisal (SA) and SEA are discussed and in most cases, a combined SA and SEA process is undertaken by Regional and Local Planning Authorities. The strengths and weaknesses of this approach are explored, as well as their usefulness in decision making. There are problems relating to baseline, establishing trends and predicting cumulative effects at the strategic level. The issues in assessing cumulative effects within this SA/SEA framework are discussed and recommendations for improvements are made. [Copyright &y& Elsevier]

Abstract: This paper focuses on firms’ voluntary compliance with the reporting requirements of the International Accounting Standard (IAS) 1 before the official adoption of IASs. The paper seeks to identify the motives for the voluntary adoption of IAS 1 and investigates the relation to the provision of voluntary accounting disclosures, the increase in equity capital, managers’ remuneration and firms’ stock returns. The study shows that the decision-making process of firms is significantly influenced by the intention to improve key financial measures, such as leverage, profitability and growth. Firms would tend to adopt an accounting policy or regulation when they feel that adoption would favourably impact on their financial situation. For example, the study indicates that firms voluntarily adopted IAS 1 before the official IAS adoption date in order to provide evidence of superior managerial ability and high quality reported accounting information. It is found that firms that perform well are more motivated to voluntarily abide by IAS 1. The study also reports that firms that provide voluntary accounting disclosures and perform increases in their equity capital appear to voluntarily adopt IAS 1. Similar findings are obtained for firms that display higher management remuneration and stock returns. [Copyright &y& Elsevier]

Abstract: This paper explores some of the key institutional transformations in livestock breeding associated with the increasing significance of genetic techniques, situating this within an assessment of an emerging agricultural bioeconomy. Focusing on beef cattle and sheep breeding in the United Kingdom, the paper examines how a move towards the involvement of international and corporate interests in livestock breeding is restructuring the network of institutional interests affecting the knowledge and decision making of individual breeders. The paper suggests that the structural transformation of beef cattle and sheep breeding is complicated by the need for negotiation between breeders’ ‘traditional’ knowledge-practices and the ‘geneticised’ techniques being made available to them. We are thus seeing the emergence of new and complex interactions between the major actors which are reconfiguring power relationships in the UK livestock breeding sector. [Copyright &y& Elsevier]

Abstract: There has been resurgence in interest in new nuclear power stations over the last couple of years. The UK Government has taken steps to encourage the private sector to build new stations in the UK, a change in its previous neutral stance toward nuclear power. This paper examines the change in government policy asking what drivers have led to this decision and what barriers were preventing new nuclear power in the past and what barriers are still faced by both government and industry. Three main drivers are discussed: security of energy supply; diminishing energy generation capacity; and climate change. The paper also examines other key factors that play a part in facilitating a shift in government policy, namely economics, public perception and waste management policy. Barriers are identified through examination of public perception, and policy. The changes to the planning system are also discussed. The paper concludes by comparing drivers and barriers for other technologies and contrasting the UK experience with that of other countries. [Copyright &y& Elsevier]

This paper reports on research carried out into the consumer behaviour displayed by UK association conference delegates when deciding to attend a conference. Examination of the available literature suggested that there has been little investigation of the delegate's perspective on attending a conference, as most research into business events has traditionally been centred on the supply side particularly convention destination image, and association site selection. The paper found six underlying dimensions of the UK association conference delegate decision-making process – personal/professional development, networking opportunities, cost, location, time and convenience and health and wellbeing. Additionally, regression analysis showed that two of the dimensions (networking opportunities and cost) were significant predictors of intention to attend the conference again in the future. [Copyright &y& Elsevier]

This paper proposes a new systems approach to foresight studies. The paper will first indicate the complex and conflicting nature of long-term decision-making process. Then, the need for systems approach will be highlighted by the analysis of 1995 UK Delphi survey results and the scenarios of 2000 UK foresight scenarios. The paper proposes two methodologies, namely Integrated Management Model (IMM) and Roadmapping, in order to overcome challenges introduced by the multidimensional characteristics and complex nature of foresight studies. Based on systemic approach, IMM offers a useful way of developing long-term normative policies and strategies and their transformations into actions by considering necessary changes in organizational structures and behaviors. In addition, roadmapping is used to capture, manipulate and manage information to decrease complexity in the foresight by constructing roadmaps. In the paper, IMM and roadmapping are employed first to analyze UK foresight results and then to develop a new methodology to formulate Delphi events and scenarios for the successful implementation of foresight. This paper also promotes the integrated use of foresight techniques such as scenarios and Delphi rather than one for another. [Copyright &y& Elsevier]

Abstract: Background and objectives: Public concern about an unsubstantiated link between MMR vaccine and autism stemmed from a 1998 paper by Dr Andrew Wakefield and colleagues, and the substantial media coverage which that work attracted. Though the Wakefield paper is now discredited and an MMR-autism link has never been demonstrated empirically, this concern has manifested in over a decade of suboptimal MMR uptake. Few qualitative studies have explored parents’ MMR decision-making since uptake began to improve in 2004. This study updates and adds methodological rigour to the evidence base. Methods: 24 mothers planning to accept, postpone or decline the first MMR dose (MMR1) for their 11–36 month-old children, described their decision-making in semi-structured interviews. Mothers were recruited via General Practice, parents’ groups/online forums, and chain referral. MMR1 status was obtained from General Practice records 6 months post-interview. Interview transcripts were coded and interpreted using a modified Grounded Theory approach. Results: Five themes were identified: MMR vaccine and controversy; Social and personal consequences of MMR decision; Health professionals and policy; Severity and prevalence of measles, mumps and rubella infections; Information about MMR and alternatives. Results indicated that MMR1 acceptors were sympathetic toward Wakefield as a person, but universally rejected his study which sparked the controversy; parents opting for single vaccines expressed the sense that immune overload is not a consideration but that not all three components of MMR are warranted by disease severity; and MMR1 rejectors openly criticised other parents’ MMR decisions and decision-making. Conclusions: This study corroborated some previous qualitative work but indicated that the shrinking group of parents now rejecting MMR comprises mainly those with more extreme and complex anti-immunisation views, whilst parents opting for single vaccines may use second-hand information about the controversy. In response, policymakers and practitioners should revise their expectations of today''s MMR decision-makers, and their methods for supporting them. [Copyright &y& Elsevier]

Abstract: Evidence Based Policy has been articulated and practiced in Europe, particularly under the ‘New Labour’ policies of the former Labour government in the United Kingdom. In the United States, the impact of research on policy has been inconsistent due to differing relationships between researchers and policy makers. This paper gives an overview of evidence based policy and presents critiques based on its reliance on positivist methods and technical approach to policy making. Using these critiques as a framework, the paper discusses the case of Housing First, a policy adopted by the Bush Administration in order to address the problem of chronic homelessness. The case is an example of research driven policy making but also resulted in a progressive policy being promoted by a conservative administration. In discussing the case, the paper elaborates on the relationship between evidence and policy, arguing that evidence based policy fails to integrate evidence and values into policy deliberations. The paper concludes with alternative models of policy decision making and their implications for research. [Copyright &y& Elsevier]

Abstract: This paper reports on a qualitative study examining everyday practices of healthy living (HL). Forty-four semi-structured interviews were undertaken with Canadian and UK citizens, aged 45 – 70, in April–May 2010. The research sits within the now substantial literature concerned with how health information is mediated, both by people and technologies, and employed in the context of ‘good’ health citizenship. Throughout this work, notions of ‘choice’ and ‘empowerment’ have been interrogated, theoretically and empirically, to reveal both the knowledge/power relationships integral to ‘informing’ processes and the shifting relationship between information and care in contemporary health encounters. In this paper, we analyse how people make sense of what it means to live healthily and how they know if they are doing so by focussing on three ways in which study participants become informed about healthy living: through their engagement with universal HL messages, through their own information searches, and through their attempts to measure their ‘healthiness’. Following critique of the “logic of choice” in contemporary healthcare, we understand healthy living as a “situation of choice” where complex problems are framed as simple matters of choice and where information and technologies are understood as neutral aids to decision-making in support of ‘correct’ choices. Our analysis builds on and extends Mol’s work by exploring how participants negotiate between this “logic of choice” and her alternative “logic of care” in their accounts of everyday HL informing practices and how the two logics “interfere” with one another. These accounts show resistance to the logic of choice through ‘calls for care’ but they also show clearly how the disciplining logic of choice works to (re)present such calls for care as failed attempts at healthy living, undermining the very practices the logic of choice seeks to encourage. [Copyright &y& Elsevier]

• Isolating the impact of heat pumps on national electricity under historic weather. • Validations with measured data indicate the best heat demand generation method. • 41 % heat pumps would increase Great Britain's winter electricity demand by 30 TWh. • Year-to-year variability of electricity demand increases by 37 %. • 25 % inaccuracy of future peak electricity demand estimates. Amongst all future developments it is the electrification of heat that is anticipated to have the largest impact on seasonal and interannual electricity demand. There is therefore a need to accurately quantify and assess this impact. This paper uses a combination of existing advanced techniques to modify the historic electricity demand to incorporate the impact of heat pumps alone for long-term historic weather data using Great Britain as an example. The methods for generating time series were compared and extensively validated. This includes comparisons with measured data that have not been used previously for this purpose. The research reveals that for predicted 2050 heat pump penetration levels the monthly demand for electricity doubles in winter. This leads to an increase of approximately 30 TWh for each winter month and a 37 % increase in year-to-year variability of electricity demand due to weather. Peak electricity demand is very sensitive to the method of generating heat demand and the assumptions on hourly heat pump operating profiles, suggesting inaccuracies of 25 % in estimates of future peak demand. This work, rather than just assessing the impact of projected changes provides a reference case for policy makers to guide the decision process and planning for future scenarios. [ABSTRACT FROM AUTHOR]

[Display omitted] • The application of a MCDM methodology based on Graph Theory and Matrix approach leads to selection of Cao/Ca(OH) 2 for high temperature thermochemical storage. • Target based, universal and user-friendly MATLAB program based on MCDM methodology allows the simple selection of candidate materials. • The MCDM tool is tested against a real-life situation, namely the capture of waste heat from Tata Steel UK Port Talbot steelworks. • Practicality of proposed MCDM method is validated with selection of a suitable heat storage material for low-medium temperature application. • Proposed method can be applied to other scenarios such as heat storage from high and low temperature coupled with solar thermal generators. Industrial waste heat is currently underutilized due to the techno-economic challenges, inherent variability and intermittency of this source. To overcome the existing barriers, reduce the emission of greenhouse gases and protect the global environmental conditions, energy recovery is one of the most effective strategies. In the design of heat storage systems, the material selection procedure plays an important role and requires complex interrelationships between the various factors and parameters to be elucidated toachieve the best candidate material for a given application. This paper presents a Multi-Criteria Decision Making (MCDM) methodology based on Graph Theory and Matrix approach for high temperature thermochemical storage (TCS) material selection. Furthermore, the presented approach has been used to select the suitable candidate material for recovering the high temperature waste heat (over 500 °C) in Port Talbot Steelworks. [ABSTRACT FROM AUTHOR]

Abstract: This paper explores the spread of ideas within health economics, in relation to the impact of the capability approach to date and the extent to which it might impact in the future. The paper uses UK decision making to illustrate this spread of ideas. Within health economics, Culyer used the capability approach in developing the extra-welfarist perspective (where health status directly influences which social state is preferred). It is not a direct application of capability as the evaluation''s focus remains narrow; the concern is with functioning, and maximisation is retained. Culyer''s work provided a theoretical basis for using quality-adjusted life-years in decision making and this perspective is accepted as the basis for evaluation by the UK National Institute of Health and Clinical Excellence (NICE). To the extent that extra-welfarism represents a capability approach, capabilities influence NICE''s decision making and hence UK health care provision. This paper explores the extent to which extra-welfarism draws on the capability approach; the spread of extra-welfarist ideas; and recent interest in more direct applications of the capability approach. [Copyright &y& Elsevier]

Abstract: This paper argues that existing semi-quantitative risk estimation methodologies commonly applied within UK health and safety risk assessment practice are biased towards considerations of possible consequence rather than overall risk. This is seen to be leading to a slow shift towards risk aversion within UK health and safety decision making. A reworking of existing risk estimation methodology is proposed. Instead of seeking an explicit value for the level of risk the paper suggests that in lower risk industrial and commercial sectors it is sufficient to establish whether the risk is likely to fall within an intolerable, tolerable or acceptable risk zone. Once this evaluation has been completed it is further argued that risks judged to fall within the tolerable zone, which equates to a legal duty to reduce risk so far as reasonably practicable in UK, can be prioritised using values of exposure to the hazard. The method is seen as having significant advantages over other semi-quantitative risk estimation approaches presently used in UK. [Copyright &y& Elsevier]

This paper presents analysis of citizen encounters with specialists in a deliberative process, called Deliberative Mapping, which explored options for addressing the shortage of organs for transplantation in the UK. There is a rich theoretical literature about the extent to which citizens are competent to question the knowledge claims of specialists in complex decision-making processes, suggesting the trustworthiness of scientific expertise will depend on the qualities of social interaction in face-to-face dialogue, but little empirical analysis of specific encounters. This paper presents evidence of how citizens located specialist expertise in making judgements about the legitimacy and credibility of specialist knowledge claims, in ways that reflect differences in epistemic procedures valued by the panels of men and women in this process. [ABSTRACT FROM AUTHOR]

Many factors can conspire to limit the scope for policy development at the national level. In this paper, we consider whether blockages in national policy processes − resulting for example from austerity or small state political philosophies − might be overcome by the development of more polycentric governance arrangements. Drawing on evidence from three stakeholder workshops and fifteen interviews, we address this question by exploring the United Kingdom’s recent retrenchment in the area of climate change policy, and the ways in which its policy community have responded. We identify two broad strategies based on polycentric principles: ‘working with gatekeepers’ to unlock political capital and ‘collaborate to innovate’ to develop policy outputs. We then empirically examine the advantages that these actions bring, analysing coordination across overlapping sites of authority, such as those associated with international regimes, devolved administrations and civic and private initiatives that operate in conjunction with, and sometimes independently of, the state. Despite constraining political and economic factors, which are by no means unique to the UK, we find that a polycentric climate policy network can create opportunities for overcoming central government blockages. However, we also argue that the ambiguous role of the state in empowering but also in constraining such a network will determine whether a polycentric approach to climate policy and governance is genuinely additional and innovative, or whether it is merely a temporary ‘sticking plaster’ for the retreat of the state and policy retrenchment during austere times. [ABSTRACT FROM AUTHOR]

Understanding homeowners' renovation decisions is essential for policy and business activity to improve the efficiency of owner-occupied housing stock. This paper develops, validates and applies a novel modelling framework for explaining renovation decisions, with an emphasis on energy-efficiency measures. The framework is tested using quantitative data from a nationally-representative survey of owner-occupied households in the UK (n = 1028). The modelling advances formal representations of renovation decisions by including background conditions of domestic life to which renovating is an adaptive response. Path analysis confirms that three conditions of domestic life are particularly influential on renovation decisions: balancing competing commitments for how space at home is used; signalling identity through homemaking activities; and managing physical vulnerabilities of household members. These conditions of domestic life also capture the influence of property characteristics (age, type) and household characteristics (size, composition, length of tenure) on renovation decisions but with greater descriptive realism. Multivariate probit models are used to provide rigorous, transparent and analytically tractable representations of the full renovation decision process. Model fits to the representative national sample of UK homeowners are good. The modelling shows that renovation intentions emerge initially from certain conditions of domestic life at which point energy efficiency is not a distinctive type of renovation. The modelling also shows clearly that influences on renovation decisions change through the decision process. This has important implications for policy and service providers. Efficiency measures should be bundled into broader types of home improvements, and incentives should target the underlying reasons why homeowners decide to renovate in the first place. [ABSTRACT FROM AUTHOR]

The role of ‘advocacy’ within public health attracts considerable debate but is rarely the subject of empirical research. This paper reviews the available literature and presents data from qualitative research (interviews and focus groups conducted in the UK in 2011–2013) involving 147 professionals (working in academia, the public sector, the third sector and policy settings) concerned with public health in the UK. It seeks to address the following questions: (i) What is public health advocacy and how does it relate to research?; (ii) What role (if any) do professionals concerned with public health feel researchers ought to play in advocacy?; and (iii) For those researchers who do engage in advocacy, what are the risks and challenges and to what extent can these be managed/mitigated? In answering these questions, we argue that two deeply contrasting conceptualisations of ‘advocacy’ exist within public health, the most dominant of which (‘representational’) centres on strategies for ‘selling’ public health goals to decision-makers and the wider public. This contrasts with an alternative (less widely employed) conceptualisation of advocacy as ‘facilitational’. This approach focuses on working with communities whose voices are often unheard/ignored in policy to enable their views to contribute to debates. We argue that these divergent ways of thinking about advocacy speak to a more fundamental challenge regarding the role of the public in research, policy and practice and the activities that connect these various strands of public health research. [ABSTRACT FROM AUTHOR]

The technical expertise that politicians relied on in the past to produce cost-effective and environmentally sound solutions no longer provides sufficient justification to approve waste facilities. Local authorities need to find more effective ways to involve stakeholders and communities in decision-making since public acceptance of municipal waste facilities is integral to delivering effective waste strategies. This paper presents findings from a research project that explored attitudes towards greater levels of public involvement in UK waste management decision-making. The study addressed questions of perception, interests, the decision context, the means of engagement and the necessary resources and capacity for adopting a participatory decision process. Adopting a mixed methods approach, the research produced an empirical framework for negotiating the mode and level of public involvement in waste management decision-making. The framework captures and builds on theories of public involvement and the experiences of practitioners, and offers guidance for integrating analysis and deliberation with public groups in different waste management decision contexts. Principles in the framework operate on the premise that the decision about ‘more’ and ‘better’ forms of public involvement can be negotiated, based on the nature of the waste problem and wider social context of decision-making. The collection of opinions from the wide range of stakeholders involved in the study has produced new insights for the design of public engagement processes that are context-dependent and ‘fit-for-purpose’; these suggest a need for greater inclusivity in the case of contentious technologies and high levels of uncertainty regarding decision outcomes. [ABSTRACT FROM AUTHOR]

The nexus represents a multi-dimensional means of scientific enquiry which seeks to describe the complex and non-linear interactions between water, energy, food, with the climate, and further understand wider implications for society. These resources are fundamental for human life but are negatively affected by shocks such as climate change and characterize some of the main challenges for global sustainable development. Given the multidimensional and complex nature of the nexus, a transdisciplinary approach to knowledge development through co-production is needed to timely and effectively inform the decision making processes to build societal resilience to these shocks going beyond the sectorality of current research practice. The paper presents findings from five themed workshops (shocks and hazards, infrastructure, local economy, governance and governments, finance and insurance) with 80 stakeholders from academia, government and industry in the UK to explore the impact of climate and weather shocks across the energy-food-water nexus and barriers to related responses. The research identified key stakeholders’ concerns, opportunities and barriers to better inform decision making centred on four themes: communication and collaboration, decision making processes, social and cultural dimensions, and the nature of responses to nexus shocks. We discuss implications of these barriers and how addressing these can better facilitate constructive dialogue and more efficient decision-making in response to nexus shocks. [ABSTRACT FROM AUTHOR]

Past models and tools that support in the decision making process based on Asset Management Principles (AMP) are lacking in terms of the effective outcomes and transparency of the process in the highway maintenance. There is also little research on how to align the decision areas when applying AMP and how to improve the inclusive effectiveness. Hence, the paper focuses on examining the challenges and prospects of applying AMP in a highway maintenance agency or department. An exploratory research method was used through an extensive review of literature and an industry survey. The findings from the literature and case study review were used to design a questionnaire and conduct the survey. The survey results revealed that the AMP are only being implemented ineffectively in maintaining highways, and a strong commitment is required to improve the asset management capability for effective use of the asset data. It is highly recommended that the Highway Agency should issue a guideline for implementing asset management policy and also encourage associate departments to achieve asset management maturity level 3 so that ISO55000 certification can be achieved. The study concludes that there is still substantial work needed within the asset management process, particularly in highway maintenance before its effectiveness can be realised and measured. [ABSTRACT FROM AUTHOR]

The UK has one of the highest rates of self harm (SH) in Europe, and almost four times more people die by suicide than in road traffic collisions. Emergency ambulance paramedics are often the first health professionals involved in the care of people who have self-harmed, yet little is known about the care provided or issues raised in these encounters. The aim of this study is to explore paramedics' perceptions and experiences of caring for people who SH, to inform education and policy. Semi structured interviews were conducted with paramedics, and themes generated by constant comparison coding. This paper reports two emerging themes: Firstly, professional, legal, clinical and ethical tensions, linked to limited decision support, referral options and education. The second theme of relationships with police, revealed practices and surreptitious strategies related to care and detention, aimed at overcoming complexities of care. In the absence of tailored education, guidance or support for self-harm care, 'ways and means' have evolved which may negatively influence care and challenge ethical and legal frameworks. There is an urgent need to include evidence from this study in revised guidance and educational materials for paramedics working with people who self-harm in the prehospital emergency setting. [ABSTRACT FROM AUTHOR]

As nations develop policies for low-carbon transitions, conflicts with existing policies and planning tools are leading to competing demands for land and other resources. This raises fundamental questions over how multiple demands can best be managed. Taking the UK as an empirical example, this paper critiques current policies and practices to explore the interdependencies at the water-energy-food nexus. It considers how current land uses and related policies affect the UK’s resilience to climate change, setting out an agenda for research and practice relevant to stakeholders in land-use management, policy and modelling. Despite recent progress in recognising such nexus challenges, most UK land-related policies and associated science continue to be compartmentalised by both scale and sector and seldom acknowledge nexus interconnections. On a temporal level, the absence of an over-arching strategy leaves inter-generational trade-offs poorly considered. Given the system lock-in and the lengthy policy-making process, it is essential to develop alternative ways of providing dynamic, flexible, practical and scientifically robust decision support for policy-makers. A range of ecosystem services need to be valued and integrated into a resilient land-use strategy, including the introduction of non-monetary, physical-unit constraints on the use of particular services. [ABSTRACT FROM AUTHOR]

Most people want to be both happy and healthy. But which matters most when there is a trade-off between them? This paper addresses this question by asking 4000 members of the UK and US public to make various choices between being happy or being physically healthy. The results suggest that these trade-offs are determined in substantial part by the respondent's own levels of happiness and health, with unhappy people more likely to choose unhappy lives and unhealthy people more likely to choose unhealthy ones: "better the devil you know, than the devil you don't". Age also plays an important role; older people are more likely to choose being healthy over being happy. Information about adaptation to physical health conditions matters too, but less so than respondent characteristics. These results further our understanding of public preferences with important implications for policymakers concerned with satisfying those preferences. • Most people want to be both happy and healthy, but which matters most? • We trade-off levels of happiness and physical health in the UK and the US. • Choices are determined by respondents' own levels of happiness and health. • Information about adaptation to physical health conditions matters too. • The results have implications for policymakers seeking to satisfy those preferences. [ABSTRACT FROM AUTHOR]

Background The recognition, assessment and management of pain in hospital settings is suboptimal, and is a particular challenge in patients with dementia. The existing process guiding pain assessment and management in clinical settings is based on the assumption that nurses follow a sequential linear approach to decision making. In this paper we re-evaluate this theoretical assumption drawing on findings from a study of pain recognition, assessment and management in patients with dementia. Aim To provide a revised conceptual model of pain recognition, assessment and management based on sense-making theories of decision making. Methods The research we refer to is an exploratory ethnographic study using nested case sites. Patients with dementia ( n = 31) were the unit of data collection, nested in 11 wards (vascular, continuing care, stroke rehabilitation, orthopaedic, acute medicine, care of the elderly, elective and emergency surgery), located in four NHS hospital organizations in the UK. Data consisted of observations of patients at bedside (170 h in total); observations of the context of care; audits of patient hospital records; documentary analysis of artefacts; semi-structured interviews ( n = 56) and informal open conversations with staff and carers (family members). Findings Existing conceptualizations of pain recognition, assessment and management do not fully explain how the decision process occurs in clinical practice. Our research indicates that pain recognition, assessment and management is not an individual cognitive activity; rather it is carried out by groups of individuals over time and within a specific organizational culture or climate, which influences both health care professional and patient behaviour. Conclusions We propose a revised theoretical model of decision making related to pain assessment and management for patients with dementia based on theories of sense-making, which is reflective of the reality of clinical decision making in acute hospital wards. The revised model recognizes the salience of individual cognition as well as acknowledging that decisions are constructed through social interaction and organizational context. The model will be used in further research to develop decision support interventions to assist with the assessment and management of patients with dementia in acute hospital settings. [ABSTRACT FROM AUTHOR]

Campus greening is often the first step universities take towards sustainability. In order to infer the current level of environmental performance and the progress being made it is imperative that universities measure and report their campus greening efforts. This paper shows that sustainability reporting can be a simple task and is of significant value for directing sustainable campus operations. To do this, Environmentally Extended Input Output Analysis was used to derive the carbon footprint for the University of Leeds. Being driven by financial data which is readily available to universities the assessment is easy to conduct and maintain through time. Environmentally Extended Input Output Analysis provides complete coverage of the campus system and thus accounts for the majority of emissions sources. Accordingly, it enables comparisons of environmental performance to be made between institutions. The reliability of comparisons falters when organisational boundaries vary between carbon footprints, and thus, in the interest of methodological consistency, a framework should be established that defines universal organisational boundaries which universities must adhere to. Interviews with university procurement staff showed that carbon footprints can provide a screening assessment which identifies emissions hotspots in supply chains. Such as assessment is currently lacking and provides evidence of win win situations where emissions and costs can be reduced simultaneously. Although carbon footprinting considers only the environmental dimension of the triple bottom line, it is recommended that universities intensify its application. For the institutions themselves the results will be of significant practical value for directing initiatives such as sustainable procurement and for enhancing stakeholder engagement with the sustainability agenda, whilst an increased application will help build much needed momentum for sustainability reporting overall. [ABSTRACT FROM AUTHOR]

Objectives: The Centre for Public Health (CPH), at the United Kingdom's National Institute for Health and Care Excellence (NICE) is responsible for producing national guidance relating to the promotion of good health and the prevention and treatment of disease. Given the challenges of developing guidance in this area, choosing the most appropriate topics for further study is of fundamental importance. This paper explores the current prioritisation process and describes how the Analytic Hierarchy Process (AHP), a multi criteria decision analysis (MCDA) technique, might be used to do so. Study design: A proposed approach is outlined, which was tested in a proof of concept pilot. This consisted of eight participants with experience of related NICE committees building scores for each topic together in a 'decision conference' setting. Methods: Criteria were identified and subsequently weighted to indicate the relative importance of each. Participants then collaboratively estimated the performance of each topic on each criterion. Results: Total scores for each topic were calculated, which could be ranked and used as the basis for better informed discussion for prioritising topics to recommend to the Minister for future guidance. Sensitivity analyses of the dataset found it to be robust. Conclusions: Choosing the right topics for guidance at the earliest possible time is of fundamental importance to public health guidance, and judgement is likely to play an important part in doing so. MCDA techniques offer a potentially useful approach to structuring the problem in a rational and transparent way. NICE should consider carefully whether such an approach might be worth pursuing in the future. [ABSTRACT FROM AUTHOR]

Universities, like other types of public and private institutions, when located in a city, have both positive and negative impacts on the area where they are situated. On the one hand, they contribute to the prestige of the area; on the other hand, they are large generators/attractors of traffic. The ability to successfully balance the pros and cons of the urban location of these large traffic-generating institutions is crucial for their success and for the livability of the city. In this paper this issue has been analyzed selecting as a representative case the University of Trieste. The aim of the research is to understand: (a) how mode choice decisions are made by the teaching and administrative staff and by the students at the various locations where academic activities take place, and (b) how they would be affected by 8 different transport management policies. It is found that changing the parking regulations (via the annual permit cost, the hourly parking fee, the number of parking spaces and the location of the parking lots) greatly influences mode choice in favor of bus use, especially for teaching and administrative staff and in the suburban locations. The students would be impacted by such changes only if an hourly parking tariff is introduced. The alternative approach of fully subsidizing the bus services would also have a large impact on bus ridership, affecting the mode choice in particular of the teaching staff and in the main university suburban sites. Since the implementation of these bus-favoring policies could face the opposition either of the university staff or of the bus company, two more balanced policy mixes were tested: the first one, increasing parking price and imposing new parking restrictions, would increase bus ridership by 19%; the second one, reducing both bus and parking subsidies, would increase bus ridership by 13%. [ABSTRACT FROM AUTHOR]

Abstract: In this paper we employ rhetoric culture theory, and a case study of upland channel truncation in the UK, to explore the nuanced processes of negotiation associated with environmental decision-making. In contrast to much of the literature on rhetoric in environmental management, which focuses on the means by which decisions are communicated and justified to an external audience, we focus on the dynamics of interaction and persuasion in and amongst a small group of decision-makers, and how, despite initial misgivings and conflict, they arrived at a decision consensus. We reflect on the importance of the rhetorical situation as a determinant of action and demonstrate how antagonisms were caused by competing moral notions of environmental restoration. We show that consensus was finally achieved through a process of divergent reframing, as individuals reframed the problem according to their own prior values. The outcome, therefore, was a consensus of action but a divergence of opinion, which sheds new light on the role of reframing in environmental management. Finally, we argue for a better understanding of how nuanced interactional processes influence not only small-scale interventions, but all environmental decision processes. [Copyright &y& Elsevier]

Nurses' judgements and decisions have the potential to help healthcare systems allocate resources efficiently, promote health gain and patient benefit and prevent harm. Evidence from healthcare systems throughout the world suggests that judgements and decisions made by clinicians could be improved: around half of all adverse events have some kind of error at their core. For nursing to contribute to raising quality though improved judgements and decisions within health systems we need to know more about the decisions and judgements themselves, the interventions likely to improve judgement and decision processes and outcomes, and where best to target finite intellectual and educational resources. There is a rich heritage of research into decision making and judgement, both from within the discipline of nursing and from other perspectives, but which focus on nurses. Much of this evidence plays only a minor role in the development of educational and technological efforts at decision improvement. This paper presents nine unanswered questions that researchers and educators might like to consider as a potential agenda for the future of research into this important area of nursing practice, training and development. [ABSTRACT FROM AUTHOR]

Abstract: The impacts of storm surges represent an increasing risk to the world's coastlines. Coastal planners require accurate estimates of flood risk in order to provide suitable defensive measures. Therefore a reliable methodology is required for the estimation of extreme sea-level probabilities at high spatial resolution along coastlines. This paper describes a new method for estimating these probabilities, with application to the UK coastline. The method consists of two components: the estimation of extreme sea-levels by applying a newly developed statistical method, termed the Skew Surge Joint Probability Method, with tide gauge records, and the use of hindcast sea-levels to dynamically interpolate these estimates around complex coastlines. The skew surge parameter is a more reliable indicator of meteorological impacts on sea-level than the non-tidal residual used in the Revised Joint Probability Method, as previously used in the United Kingdom. The method has been applied to the UK coastline to provide a database of extreme sea-level probabilities for the Environment Agency for England and Wales and the Scottish Environment Protection Agency. The database will be used to inform coastal defense strategy, flood mapping and forecasting and to support policy, implementation and operational decision-making. [Copyright &y& Elsevier]

Abstract: In order to reduce carbon emissions and alleviate fuel poverty, the UK Government has outlined proposals for a “Green Deal” to help provide financing for the installation of cost-effective retrofit measures to the existing UK housing stock. However, the Green Deal proposals have the potential to generate financial risk, due to a possible overestimation of the energy savings arising from retrofit measures. This paper proposes a framework for handling the uncertainties associated with the prediction of these energy savings, as well as demonstrating how decisions can be made in the face of the uncertainties involved in the retrofit analysis of a housing stock. The proposed framework is applied to a case study set of dwellings and it is seen that a limited range of measures will be cost-effective under the Green Deal proposals for these dwellings; as a result, subsidies will be required if higher impact measures are to be considered viable. Finally, however, it is also seen that the monetary value of additional societal benefits, such as reduced carbon emissions and improved thermal comfort, is likely to more than outweigh the cost of any subsidies. [Copyright &y& Elsevier]

Background: Parents with young children often worry about whether or not to seek medical help for a sick child. Previous research identified parents' anxieties surrounding help seeking from health services but did not explore or explain the underlying psychosocial processes taking place in families at these times. Objectives: This paper presents findings from a British grounded theory study on family management of acute childhood illness at home, which provide an explanation for parent's helping seeking behaviours. Design: Glaserian grounded theory methodology was used for the study. Setting: The sampling sites for the study were in two towns in the East Midlands with population profiles close to the national average for the UK. Participants: Initial purposeful and later theoretical sampling resulted in a sample of fifteen families with children aged between 1 month and 8 years of age. Methods: Four sets of data collection took place between 2001 and 2007. Unstructured family interviews were conducted with adult family members and a draw, write or tell technique was used to interview any children over 4 years of age. Theoretical sensitivity and constant comparative analysis were employed to achieve theoretical saturation around a core category. Findings: Felt or enacted criticism teaches parents informal social rules which direct how they are expected to behave. Their desire to avoid such criticism of their moral status as 'good' parents creates significant hidden anxiety about when to seek medical help. This anxiety sometimes leads to late consultation with potentially serious consequences for their child's health. Conclusion: The grounded theory indicates the need for significant investment in the training of nurses and other health professionals to reduce parents' (and other patients') experiences of felt or enacted criticism and the consequent hidden anxiety. When parents are worried about their child's health, they need to be able to seek help from health professionals without fear of criticism. These conclusions are primarily limited to universal health care environments. [ABSTRACT FROM AUTHOR]

Abstract: Many energy system optimization studies show that hydrogen may be an important part of an optimal decarbonisation mix, but such analyses are unable to examine the uncertainties associated with breaking the ‘locked-in’ nature of incumbent systems. Uncertainties around technical learning rates; consumer behaviour; and the strategic interactions of governments, automakers and fuel providers are particularly acute. System dynamics and agent-based models, and studies of historical alternative fuel transitions, have furthered our understanding of possible transition dynamics, but these types of analysis exclude broader systemic issues concerning energy system evolution (e.g. supplies and prices of low-carbon energy) and the politics of transitions.This paper presents a hybrid approach to assessing hydrogen transitions in the UK, by linking qualitative scenarios with quantitative energy systems modelling using the UK MARKAL model. Three possible transition pathways are explored, each exploring different uncertainties and possible decision points, with modelling used to inform and test key elements of each scenario. The scenarios draw on literature review and participatory input, and the scenario structure is based on archetypal transition dynamics drawn from historical energy system transitions, reflecting insights relating to innovation system development and resistance to change. Conclusions are drawn about appropriate policy responses. [Copyright &y& Elsevier]

Abstract: Abstract: Strategic environmental assessment (SEA) for offshore oil and gas planning and development is utilized in select international jurisdictions, but the sector has received limited attention in the SEA literature. While the potential benefits of and rationale for SEA are well argued, there have been few empirical studies of SEA processes for the offshore sector. Hence, little is known about the efficacy of SEA offshore, in particular its influence on planning and development decisions. This paper examines SEA practice and influence in three international offshore systems: Norway, Atlantic Canada and the United Kingdom, with the intent to identify the challenges, lessons and opportunities for advancing SEA in offshore planning and impact assessment. Results demonstrate that SEA can help inform and improve the efficacy and efficiency of project-based assessment in the offshore sector, however weak coordination between higher and lower tiers limit SEA''s ability to influence planning and development decisions in a broad regional environmental and socioeconomic context. [Copyright &y& Elsevier]