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Abstract: In July 2010, the new Coalition Government unveiled its plans to make major changes to the English National Health Service (NHS). This paper, which provides a commentary on the NHS White Paper, Equity and Excellence: Liberating the NHS, casts doubt upon the extent to which the proposals will bring about the fundamental reform that the Government intends, not least because both the British public and GP commissioners (who are expected to play a central role in transforming the NHS) appear to have a limited appetite for radical market reform. The paper also identifies a number of unintended risks, including the large transitional costs and organisational turbulence resulting from further NHS reorganisation; and the fact that key aspects of the White Paper proposals could result in significant financial instability. Given the real world limitations to translating a rhetoric of localism and democratic legitimacy into reality and a lack of hard evidence about the benefits of market reform, the Government would be well advised to take a more cautious approach to health policy formulation and implementation and to ensure that any further changes to the NHS are based on evidence, piloting and evaluation. [Copyright &y& Elsevier]

This study unveils the establishment of the United Kingdom-Netherlands Decomposition Experimental Research (UNDER) working group, marking a pioneering initiative in practical Forensic Taphonomy within the UK. Our primary objective was to craft a cohesive multidisciplinary framework, designed to ethically orchestrate, execute, and assess human decomposition. Concurrently, we aimed to amass data through human burials, fostering collaboration among diverse forensic experts across Europe. The compilation of data collected over the year, elucidates the comprehensive utilisation of cadavers through a multifaceted scientific methodology. This paper discusses the triumphs, challenges, and innovative solutions encountered during this undertaking, providing a blueprint for forthcoming European research in Forensic Taphonomy. Our efforts support the comparability of longitudinal studies and give strategies to address the challenges posed by the scarcity and diversity of human donors in forensic science. Moreover, we propose the adoption of a dynamic scientific research management framework, which includes thorough identification, measurement, analysis, and application of solutions. Emphasis is also placed on adeptly managing business processes to ensure sustained relevance in both research and other stakeholders. [ABSTRACT FROM AUTHOR]

Lameness is a significant health and welfare issue in farmed animals. This paper uses a governmentality approach, which focuses on how a problem is made governable, to examine an emerging 'ecology of devices' introduced to intervene in, and attempt to reduce, on-farm incidence of lameness. These devices are associated with advisers who work with farmers on-farm; they enact lameness as a governable entity, are tools to assess the existence of lameness against established norms, and prescribe actions to be taken in response to evidence of lameness. In doing this they subjectify farmers and advisers into seeing and responding to lameness in particular ways. Using concepts of governmentality alongside other perspectives on the power relations and the simplifications and complexities involved in interventions in animal health and farm practice, the paper draws on in-depth research with advisers including vets and other paraprofessionals who work with farmers, and their cows and sheep. It explores how this set of devices introduces particular techniques and practices in lameness management, and produces farmer and adviser subjectivities. It then explores some of the problematics of this mode of governing lameness, including analysis of the limitations and unintended consequences of attempts to simplify lameness management. The paper concludes by arguing that its approach is valuable in analysing ongoing intensification of interventions in farming practices and in understanding the limits of such interventions and the unanticipated divergences from expected conduct. • A governmentality approach to livestock lameness provides valuable insight into recent attempts to reduce its prevalence and severity on farms. • The government of lameness produces farmer and adviser subjectivities linked to new tools and devices aiming to reduce the incidence of lameness. • The government of lameness is limited by complexities linked with attempts to simplify interventions and deviation from expected practices. [ABSTRACT FROM AUTHOR]

This paper analyses two differing approaches to the improvement of local bus services, using the analytical lens of formal and informal institutions. Both formal and informal institutions govern the behaviour of authorities and operators, but they do it in different ways and they have advantages and disadvantages. In so doing we seek to understand both how the informal institutional approach (e.g. voluntary partnership working) can be used effectively, but also to assess its limits; and to understand why a formal institutional approach (e.g. franchising), in spite of its strong underlying basis in law, may nonetheless not always function. Through doing so, this paper contributes to the current understanding of how to handle the unintended consequences of a deregulated market through the different (formal and informal) ways available. • Compares two differing approaches to the improvement of local bus services. • Contrasts informal (voluntary partnership) with formal (franchsing) models. • Explores how to handle the unintended consequences of a deregulated market. [ABSTRACT FROM AUTHOR]

Rising temperatures exacerbated by climate change are a growing concern in the UK. This paper assesses the state of heat risk governance in the country through an analysis of the Adverse Weather and Health Plan (AWHP) launched in 2023, which replaces the former Heatwave Plan (HWP) for England — the prominent policy for addressing heatwaves in the UK. Through 17 semi-structured interviews with key stakeholders, the paper assesses the perceived effectiveness of the new plan in addressing heat risk. The findings demonstrate that AWHP has been positively received and is considered to have well-functioning institutional arrangements and strategies tailored to manage immediate heat risks. However, areas for improvement are identified: the need to enhance public communication and broaden the cross-sectoral understanding of heat impacts beyond the domain of 'health'. Further, the research reveals gaps in leadership, institutional structure, delineation of roles and responsibilities, and funding and resources for addressing long-term heat risk and preparedness in the UK. The paper explores these and highlights the need for strengthening governance and capacity to tackle the multi-dimensional climate risk, i.e., heat, effectively. • UK heat policy lacks consideration for long-term risks. • Understanding heat impacts beyond health is crucial for effective risk mitigation. • Establishing an institutional structure with clear leadership is essential. [ABSTRACT FROM AUTHOR]

The design of energy and climate policy is usually seen as an 'expert' domain, relying on technical tools such as economic analysis. However, policy requires the support of politicians and citizens alike, through the democratic process. Many policies, such as reducing carbon emissions from homes and transport, also affect people's lives directly. It is thus necessary to supplement technical analysis with methods that allow an exploration of people's views, values and behaviours. One such method is codesign, whereby groups of citizens work with policy analysts to develop strategies informed by the lived experience of citizens, as well as the specialist knowledge of analysts. There is a history of co-design approaches in public services such as healthcare, but there have been few attempts to co-design public policy measures. This paper reports on a Citizens' Panel, a representative group of people working with specialists to create co-designed policy recommendations for reducing carbon emissions from homes. The process revealed that policy co-design can provide detailed, viable proposals. In this case, panellists emphasised the necessity of leadership and support from government; tailored, consistent information; targeted regulation; and financial incentives. Finally, the wider potential role for policy co-design for energy and climate is addressed. • Co-design processes are widely used but rarely applied to the design of energy and climate policy. • Co-design processes can embed citizen perspectives in policy design. • The paper reports on an experimental panel on home energy decarbonisation. • Co-design can ensure that policies are effective and will gain support of politicians and publics. • Changes to cultures of policymaking are needed to embed such approaches. [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]

Rising demand for emergency food during the last couple of decades in the UK has led to a great deal of academic interest in food aid provision, and food banking in particular. Efforts have also been made to examine food poverty and responses to it in more critical terms, which has entailed moving beyond a focus on emergency food support to engage with 'more than food aid' approaches. In this paper, I discuss how these latter approaches are beginning to be mobilised by national organisations, local authorities and place-based food partnerships in the UK. An important catalyst for this shift was the Covid-19 pandemic, which provided the crisis conditions that encouraged public and third-sector actors to think about, and act upon, food poverty in different ways. Drawing on an analysis of submissions to a Covid-19 food inquiry, place-based food initiatives implemented during the pandemic period and more recent initiatives instigated by national food support and anti-hunger groups, the paper examines how a diverse range of organisations are becoming more critical of existing (food aid) responses to food poverty and are seeking to develop more supportive local foodscapes based on a 'more than food aid' approach. The paper concludes with a discussion of the implications of this shift for future research on food poverty. [ABSTRACT FROM AUTHOR]

[Display omitted] • We constructed OD data for the UK domestic and international aviation sector. • Data allows exploration of passenger flows and emissions from 1990 to 2021. • Aviation demand is compared to current and future rail network. • 41 % of passengers could switch to rail, accounting for 14 % of aviation emissions. • Minority of long-haul flights account for most aviation emissions. We analyse UK airport origin–destination data from 1990 to 2021 to understand the extent to which a modal shift to rail may reduce aviation emissions. We find that 41 % of UK aviation passengers travel on routes that can be done by rail in less than 24 h. However, these passengers account for only 14 % of UK aviation emissions because long-haul flights contribute the majority of emissions. Some popular destinations (e.g. Spanish Islands) are inaccessible by rail and may be suitable for destination switching. We also find rapid growth in flights to international hub airports used for connecting journeys. This has implications for carbon accounting, suggesting that a significant and growing proportion of UK residents' aviation emissions are being excluded from national accounts. Finally, the paper recommends some interventions that might encourage a modal shift to rail. [ABSTRACT FROM AUTHOR]

• This study estimates the effect of education on trust with a RD design. • Education and trust are positively and significantly correlated. • The OLS estimates may suffer from omitted variable bias. • RD estimates imply the effects of education on trust may be small. • We need to interpret the relationship between education and trust with caution. Although many studies document that education and trust are positively correlated, few studies examine whether this correlation represents a causal effect. This paper fills in the gap with data from the British Social Attitudes Survey. Firstly, using the OLS method, this paper finds that education and the three measures of trust—trust in people, trust in politicians, and trust in government—are all positively and significantly correlated. Secondly, to examine whether this correlation represents a causal effect, this paper exploits exogenous variation in educational attainment induced by the compulsory schooling reform in 1972. The regression discontinuity estimates suggest that the effects of education on the three measures of trust are all small and statistically insignificant. The findings imply that the OLS estimates may suffer from omitted variable bias and the effects of education on trust may be small. [ABSTRACT FROM AUTHOR]

This paper examines how power and knowledge are involved in the workings of speech and language therapy and in the work of speech and language therapists (SLTs). The paper draws on Foucault for its conceptual frame, with reference to his exposition of governmentality, biopolitics and pastoral power. Based on interviews with thirty-three SLTs in the UK, the findings show that evidence-based practice (EBP) is ever-present in speech and language therapy, despite its apparent absence; and that its power circulates in a multitude of ways. EBP as a process, and not an outcome, was workable. When competent practice was at risk, however, the SLTs challenged the dominance of EBP by saying it needed to 'get real' but then were troubled when it did. Working the 'wise' - those people involved with the client, including the SLTs themselves - was key to speech and language therapy; as was the making of subjects into biopolitical objects. At its most rewarding, but also most personally challenging, the work of SLTs involves mediating between different ways of being in the world and reimagining life, personhood and citizenship; to capture this complex labour process, the paper introduces the term 'pastoral labour'. • Uses Foucauldian lens to examine how power and knowledge govern the work of SLTs. • Evidence-based practice discriminates against some clients, it needs to 'get real'. • Reflective practice can inhibit the sharing of clinical practice knowledge. • SLTs' work means working the 'wise' i.e. other professionals, family, and themselves. • Pastoral labour - labour mediates knowledges and knowing in the 'making' of citizens. [ABSTRACT FROM AUTHOR]

Highlights • This papers explores perceptions of UK 'supply-side' microcredit stakeholders. • Conceptions of alterity are then used as an analytic lens to examine these results. • A new, detailed conceptualisation of microcredit is provided. • Lenders are conceptualised as alternative-oppositional institutions. • Policies are outlined to protect this 'alternative' economic space. Abstract One response to the major societal challenge of financial exclusion in the United Kingdom (UK) is microcredit lending for enterprise. Typically delivered via Community Development Finance Institutions (CDFIs) in the UK, these lending institutions can be conceptualised as 'alternative' economic spaces. Yet the nature of their alterity is unclear as categorisations of alternative-oppositional or alternative-substitute institutions are possible and could also be influenced by complexities in the UK relating to the welfare system and sustainability. Alterity is rarely static, being influenced by policies and regulation, and the nature of institutions' alterity could have consequences for wellbeing, as different values and ideals underpin different conceptions of alterity which affect how these institutions operate. In this paper, the complexities of microcredit for enterprise lending within the UK are explored through in-depth interviews with UK 'supply-side' stakeholders. Conceptions of alterity are then used as an analytic lens to examine these results. Results suggest that these lenders remain in opposition to the mainstream as the needs of low-income individuals are embedded within their operating model. Microcredit lending is conceptualised in terms of responsible lenders offering fair credit to financially-excluded individuals using relationship banking practices. Such a conceptualisation provides a touchstone against which to assess shifts in lenders' alterity and a platform from which to introduce legislative and regulatory changes to protect these 'alternative-oppositional' economic spaces. This paper begins to outline these responses that could help to ensure and grow a more community-engaged and varied local financial infrastructure within the UK. [ABSTRACT FROM AUTHOR]

Abstract Recent health policy renders patients increasingly responsible for managing their health via digital technology such as health apps and online patient platforms. This paper discusses underlying tensions between empowerment and self-discipline embodied in discourses of technological self-care. It presents findings from documentary analysis and interviews with key players in the English digital health context including policy makers, health designers and patient organisations. We show how discourses ascribe to patients an enterprising identity, which is inculcated with economic interests and engenders self-discipline. However, this reading does not capture all implications of technological self-care. A governmentality lens also shows that technological self-care opens up the potential for a de-centring of medical knowledge and its subsequent communalization. The paper contributes to Foucauldian healthcare scholarship by showing how technology could engender agential actions that operate at the margins of an enterprising discourse. Highlights • Digital health policy in UK assumes an enterprising & empowered patient identity. • Tensions between empowerment & discipline occur as patients self-care digitally. • Digital health creates space for agential actions that improve communal health. • A health-making agency operates in the margins of governmental self-care discourse. [ABSTRACT FROM AUTHOR]

The notion of ‘fuel poverty’, referring to affordable warmth, underpins established research and policy agendas in the UK and has been extremely influential worldwide. In this context, British researchers, official policymaking bodies and NGOs have put forward the notion of ‘transport poverty’, building on an implicit analogy between (recognised) fuel poverty and (neglected) transport affordability issues. However, the conceptual similarities and differences between ’fuel’ and ’transport’ poverty remain largely unaddressed in the UK. This paper systematically compares and contrasts the two concepts, examining critically the assumption of a simple equivalence between them. We illustrate similarities and differences under four headings: (i) negative consequences of lack of warmth and lack of access; (ii) drivers of fuel and transport poverty; (iii) definition and measurement; (iv) policy interventions. Our review suggests that there are important conceptual and practical differences between transport and domestic energy consumption, with crucial consequences for how affordability problems amongst households are to be conceptualised and addressed. In a context where transport and energy exhibit two parallel policy worlds, the analysis in the paper and these conclusions reinforce how and why these differences matter. As we embark on an ever closer union between our domestic energy and transport energy systems the importance of these contradictions will become increasingly evident and problematic. This work contributes to the long-term debate about how best to manage these issues in a radical energy transition that properly pays attention to issues of equity and affordability. [ABSTRACT FROM AUTHOR]

• Common simplifications in transformation discourse can entrench unsustainability. • Acknowledgement of complex dimensionalities and temporalities is crucial. • Clear-cut dimensions of distinction before/after transformation cannot be assumed. • Transformations do not always unfold neatly and cumulatively in a given direction. • Examples from Kenya (cities) and the UK (energy) are discussed. Through interlinked theoretical and empirical analysis, this paper explores some important but neglected questions concerning efforts to achieve sustainability. To what extents do currently dominant forms of academic study and policy visions in this field, satisfactorily address the full political depth and scope of vital complexities in pathways for emerging social transformations? Are there dangers that common simplifications in mainstream ways of thinking about transformation, inadvertently help invisibly to reproduce entrenched patterns of privilege and power that drive focal problems of unsustainability? In particular, does a ' monothetic ' focus on circumscribed sites or sectoral formations with notionally few clear-cut dimensions of distinction before and after, risk missing more multiple and messy ' polythetic ' dimensionalities in which power and privilege can hide? What are the implications of common assumptions that pathways for change proceed ' monotonically ' – neatly and cumulatively in a particular direction, if real world transformations actually unfold according to more plural, undulating and unruly ' non-monotonic ' temporalities? In order to investigate these questions, the paper employs the concept of sociotechnical imaginaries to explore the constituting dimensions of contrasting understandings of 'urban transformations' in Kenya and 'the nuclear renaissance' in the UK. Q method and in-depth interpretive policy analysis are used to test patterns in relationships between imagined transformations and their unfoldings over time. The findings suggest that current mainstream approaches may indeed unduly simplify vital complexities in the ways these political dynamics play out – with potentially important practical implications. [ABSTRACT FROM AUTHOR]

Abstract: In September 2008, the human papillomavirus (HPV) immunisation programme was introduced in the UK for schoolgirls aged between 12 and 18 years of age. The vaccine shows high efficacy in preventing infection against HPV types 16 and 18 responsible for 70% of cervical cancer. However, to be most effective, the vaccine needs to be administered before exposure to the viruses and therefore, ideally, before young people become sexually active. The introduction of any new vaccine, and perhaps particularly one given to young teenage girls to prevent a sexually transmitted cancer-causing virus, has the potential to attract a great deal of media attention. This paper reports on content analysis of 344 articles published between January 2005 and December 2008 in 15 UK newspapers. It includes both manifest and latent analysis to examine newsprint media coverage of the introduction of the HPV vaccination programme and its role in HPV advocacy. We concluded that the newspapers were generally positive towards the new HPV vaccination and that over the 4 years period the newsworthiness of the HPV vaccination programme increased. In 2008 two events dominated coverage, firstly, the introduction of the HPV programme in September 2008 and secondly, in August 2008 the diagnosis on camera of cervical cancer given to Jade Goody, a 27 year old mother of two, who gained fame and notoriety in the UK through her participation in several reality television shows. There are two conclusions from this study. Firstly, the positive media coverage surrounding the introduction of the HPV vaccination programme is to be welcomed as it is likely to contribute towards influencing public perceptions about the acceptability and need for HPV vaccination. Secondly, the focus on prevalence rates of HPV infection among women and on women''s sexual behaviours, in relation to HPV vaccination ‘encouraging’ promiscuity, is an unhelpful aspect of media coverage. [Copyright &y& Elsevier]

The notion of ‘fuel poverty’, referring to affordable warmth, underpins established research and policy agendas in the UK and has been extremely influential worldwide. In this context, British researchers, official policymaking bodies and NGOs have put forward the notion of ‘transport poverty’, building on an implicit analogy between (recognised) fuel poverty and (neglected) transport affordability issues. However, the conceptual similarities and differences between 'fuel' and 'transport' poverty remain largely unaddressed in the UK. This paper systematically compares and contrasts the two concepts, examining critically the assumption of a simple equivalence between them. We illustrate similarities and differences under four headings: (i) negative consequences of lack of warmth and lack of access; (ii) drivers of fuel and transport poverty; (iii) definition and measurement; (iv) policy interventions. Our review suggests that there are important conceptual and practical differences between transport and domestic energy consumption, with crucial consequences for how affordability problems amongst households are to be conceptualised and addressed. In a context where transport and energy exhibit two parallel policy worlds, the analysis in the paper and these conclusions reinforce how and why these differences matter. As we embark on an ever closer union between our domestic energy and transport energy systems the importance of these contradictions will become increasingly evident and problematic. This work contributes to the long-term debate about how best to manage these issues in a radical energy transition that properly pays attention to issues of equity and affordability. [ABSTRACT FROM AUTHOR]

Although sustainable supply chain management (SSCM) has recently received increasing attention among UK manufacturing firms, there is a concern as to whether SSCM practices are being implemented because they are profitable or only because of governance coercive pressure. Thus, the aims of this paper are twofold: first, determining the role of governance in the adoption of SSCM practices; second, investigating whether SSCM practices can be both environmentally beneficial and commercially viable. In light of these issues, this paper develops and empirically assesses an integrated model of governance pressures-SSCM practices-performance. Data was collected from 146 UK manufacturing managers, and analysed using the structural equation modelling method. Exogenous driving forces of governance were found to be precursors to the successful implementation of SSCM practices. The empirical results further suggest that while the implementation of sustainable supply chain management has a positive effect on environmental performance, it does not necessarily lead to improved economic performance, as only sustainable procurement was found to have a positive effect on economic performance. This paper contributes to the literature by highlighting the role of governance in SSCM adoption and performance gains in environmental protection while economic performance is partially compromised. The results also provide useful insights for both managers seeking to adopt sustainable practices and policy-makers seeking to further promote sustainable supply chain. [ABSTRACT FROM AUTHOR]

Efforts to diagnose Alzheimer's disease (AD) at earlier stages as a means to managing the risks of an ageing population, dominate scientific research and healthcare policy in the UK. It is anticipated that early diagnosis will maximise treatment options and enable patients to 'prepare for their future' in terms of care. Drawing on qualitative data gathered across an out-patient memory service and in-patient hospital in the UK, the purpose of this paper is to examine the ways in which the hopeful promissory claims of early diagnosis as it maintains the dominant biomedical model for managing AD, are negotiated by healthcare practitioners. Developing the analytical standpoint of the sociology of expectations, this paper demonstrates that early diagnosis has the potential to ‘close off’ hopeful promissory visions of the future in two ways. Firstly, it (re)produces the fearful anticipations of AD built around expectations concerning the ageing future ‘self’, and secondly it produces uncertainty in terms of the availability of care as material resource. Whilst practitioners account for the uncertainties and anxieties it produces for patients and their families, they also convey a sense of ambivalence concerning early diagnosis. This article captures the internal conflicts and contradictions inherent to practitioners' perspectives regarding the repercussions of early diagnosis and concludes by arguing that it effaces the uncertainties and anxieties that it produces in practice as it restricts the co-existence of narratives for making sense of memory loss beyond ‘loss of self’, and fails to recognise care as a viable alternative for managing AD. [ABSTRACT FROM AUTHOR]

Pressure from global retailers to reduce food costs has altered downstream agri-food work regimes, with many food producers having adopted more flexible modes of working and employed migrant labour from lower income countries. Since the expansion of the European Union (EU) in 2004, the farming and food sector in the UK has recruited large numbers of migrant workers from central and eastern EU countries. The decision by the UK electorate in 2016 to leave the EU - what has been termed Brexit - has created a 'crisis' in relation to the continued supply of migrant labour. In this paper we explore the role of migrant labour within the UK's agri-food system and the ways that migrant workers have been positioned by different actors within recent discussions of farming, food and Brexit. We do this through an analysis of national survey data on migrant agricultural workers and materials from interviews with more than 70 agri-food organisations in the UK. What emerges from this research is that rather than viewing Brexit as a key moment to critique the state of the UK's agri-food system, including the structural conditions of work, dominant actors have used it more narrowly to construct a 'crisis' of migrant labour supply, arguing for new policy mechanisms to guarantee the future provision of low-cost imported labour. Within these narratives of post-Brexit agri-food futures, the presence of migrant labour has been both normalised and institutionalised by conventional food organisations but the realities of migrant work and the voices of migrants themselves have been conspicuous largely by their absence. • The UK agri-food sector's dependency on migrant workers from central and eastern EU countries has been threatened by Brexit. • Brexit has been used by dominant agri-food actors to construct a 'crisis' of migrant labour supply. • The centrality of migrant labour to food production in the UK has been both normalised and institutionalised by dominant agri-food actors. • The realities of migrant work and migrants' voices have largely been ignored within post-Brexit agri-food discussions. • There is a need to revalue the role of labour (ers) within the UK's agri-food system as well as in other countries. [ABSTRACT FROM AUTHOR]

• A pre-1919 primary school with single glazing in Edinburgh has an oversizing of its space heating system of 32 % at design conditions. • Supply temperature can be operated below 70 °C all year round. • Supply temperatures can be reduced below 55 °C all year-round during daytime. As part of the decarbonization of its existing building stock the UK needs to replace gas boilers with heat pumps and low-temperature heat networks. Both technologies are efficient at supply temperatures of 55 °C, with a maximum of 70 °C for heat networks, when existing systems have been designed to operate at 82 °C. Most space heating systems are expected oversized and operate most of the year in part-load, which facilitate the temperature reduction, but little is known about the degree of oversizing. This paper uses the case study of a pre-1919 school in Edinburgh to evaluate the true oversizing of its heating system and its consequences on minimum supply temperatures. This building is still equipped with single glazing and is therefore a worst-case scenario. An oversizing of 32 % was estimated which enables the use of a supply temperature below 70 °C all year round. Moreover, the supply temperature can be kept below 55 °C all year round during daytime due to internal heat gains. In conclusion, this building shows a nascent readiness for low-temperature heat. It would benefit from energy efficiency measures such as double-glazed windows, but this is not pre-requisite. Those results are important for the heat network industry when sizing their systems, but also energy and asset managers when they schedule renovation programmes to have their buildings low-temperature-ready. [ABSTRACT FROM AUTHOR]

Green and sustainable food procurement has benefits for human health, the environment and economies. Public sector actors have purchasing power behind procurement decisions, and there is significant support for sustainably sourced food from consumers and the third sector. A sustainability transition in the public procurement of food would appear to be achievable, yet change remains incremental. This paper analyses supply chain stakeholder narratives about pathways to more localised public food procurement. Based on forty interviews with actors in the procurement supply chain in the South West of England, we examine the barriers and opportunities for more localised food supply and sourcing. Our findings indicate that if public food procurement is to become a viable, feasible and desirable market channel for operators of regional food businesses, we need to give greater attention to supply chain stakeholders' experiences of the interface between procurers and suppliers. Tensions exist between stakeholders' shared need for efficiency and logistical convenience, and their mutual desire for closer procurer-supplier relations and aspirations for a regional economic community. Results demonstrate that alongside the need for new physical and digital infrastructure, there is an urgent need to address socio-cultural barriers to change. • A sustainability transition in the public food procurement should be achievable. • Barriers persist despite social benefits, state buying power and policy ambitions. • Narratives of the interface between procurers and suppliers display tensions. • Change requires integration of low-cost food, convenience and economic community. • Closer procurer-supplier relationships are needed, not just new infrastructure. [ABSTRACT FROM AUTHOR]

The United Nations Decade of Education for Sustainable Development steered by The United Nations Organization for Education, Science and Culture (UNESCO) since 2005 ended in 2014. It looked into the integration principles, values and practices of sustainable development in all aspects of education and learning, with the intention of addressing the global social, economic, cultural and environmental issues in the 21st century. It has become an essential issue in architectural education to create awareness among future generations of architects to be more sensitive towards the environmental impact of architecture on human behavior. This encouraged every school of architecture to incorporate sustainability knowledge into its curriculum and promote ‘sustainable architectural education’, leading to the questions of: what type of structural model of integration approach being applied in promoting architectural sustainable education? The objectives of this paper are to investigate the type of structural models that have been applied in architectural curriculum in selected schools of architecture in both countries and evaluate the level of emphasis in incorporating sustainability knowledge in the curriculum. Therefore, this paper reviewed the approach of integration principles, values and practices of sustainable development at 10 conveniently sampled architecture schools in the United Kingdom (UK) and the United States of America (USA). Data was collected from their respective web sites and their concepts of integration were reviewed and the distribution of credit hours revealed to determine the level of emphasis considered. Findings showed various paths taken by the different institutions in integrating the knowledge of sustainability into their architectural curriculum. This paper concludes with recommendations for further research into gauging the effectiveness of architectural curricula with integrated sustainability knowledge. [ABSTRACT FROM AUTHOR]

This paper explores cyclists’ experiences of non-injury incidents, arguing that these are important for cycling experience and uptake as well as for injury prevention. It discusses different types of non-injury incident collected in a recent survey of UK cyclists. These are everyday occurrences that in some cases have a substantially negative impact on cycling experiences. This article explores the impact of different incident types on people cycling both immediately and in the future. It analyses what near misses tell us about cyclists’ experience of problems related to road user behaviour and culture, and infrastructural conditions for cycling. The paper explores what cyclists experiencing near misses think might have prevented them. Based on this and on a comparison with common types of injury incidents, summary recommendations are made for policy and future research. [ABSTRACT FROM AUTHOR]

Cross-regional correlations between average IQ and socio-economic development have been reported for many different countries. This paper analyses data on average IQ and a range of socio-economic variables at the local authority level in the UK. Local authorities are administrative bodies in local government; there are over 400 in the UK, and they contain anywhere from tens of thousands to more than a million people. The paper finds that local authority IQ is positively related to indicators of health, socio-economic status and tertiary industrial activity; and is negatively related to indicators of disability, unemployment and single parenthood. A general socio-economic factor is correlated with local authority IQ at r = .56. This correlation increases to r = .65 when correcting for measurement error in the estimates of IQ. [ABSTRACT FROM AUTHOR]

• The UK policy and guidance for heatwaves is inadequate. • 'Silo' thinking in heatwave research hinders robust policymaking. • Heatwaves are often framed only as a health sector risk. • More research, across different sectors, is urgently needed. In 2019, a heatwave – an unusual extended period of hot weather – broke the UK's highest recorded temperature of 38.7 °C set in 2003. Of concern is that for summer 2019, this resulted in 892 excess deaths. With the intensity and frequency of UK heatwaves projected to increase, and summer temperatures predicted to be 5 °C hotter by 2070, urgent action is needed to prepare for, and adapt to, the changes now and to come. Yet it remains unclear what actions are needed and by whom. In response, a systematic literature review of UK heatwaves peer-reviewed publications, inclusive of keyword criteria (total papers returned = 183), was conducted to understand what lessons have been learnt and what needs to happen next. Our research shows that heatwaves remain largely an invisible risk in the UK. Communication over what UK residents should do, the support needed to make changes, and their capacity to enact those changes, is often lacking. In turn, there is an inherent bias where research focuses too narrowly on the health and building sectors over other critical sectors, such as agriculture. An increased amount of action and leadership is therefore necessary from the UK government to address this. [ABSTRACT FROM AUTHOR]

Rapid increase in the scale, speed and spread of immigration over the past two decades has led to an increase in complexity of populations termed superdiversity. Concerns have been expressed about impacts of the pressure that superdiversity is said to place upon maternity services. High migrant fertility and infant and maternal mortality rates have long been observed in diverse areas with inadequate antenatal monitoring seen as a major causal factor in migrants' maternity outcomes. Using qualitative data from a study of new migrants' access to maternity services in the UK's West Midlands region, with some of the highest infant and maternal mortality rates in Europe, this paper looks at the reasons migrants' access to antenatal care is poor. The paper finds that contrary to earlier studies which pointed to a lack of priority placed on such care by migrants, a combination of structural, legal and institutional barriers prevent migrant women accessing effective antenatal care. [ABSTRACT FROM AUTHOR]

Census-based deprivation indices have been widely used in Aotearoa/New Zealand, Canada and UK to measure area-based socio-economic inequalities. This paper examines the indicators used in census-based area deprivation indices using a political ecology approach. We question whether the current indicators of deprivation derived from census data are meaningful for the all age groups and minority groups in the population, with a particular focus on deprivation indicators used in New Zealand, Canada and the United Kingdom. We comparatively reviewed methodological papers and reports that describe the indicators of deprivation in Aotearoa/New Zealand, Canada and the UK from 1975 to 2014. We consider the relationship between the notion of standards of living and measurements of deprivation and explore how hegemonic cultural constructs are implicit in measures of deprivation that privilege a Eurocentric, ageist and gender normative construction of statistics. We argue for more political ecological analyses to studying the relationship between social inequalities, geographies, health inequities and political economy to transform structures of oppression and inequality. This requires turning the analytical gaze on the wealthy and privileged instead of defaulting into deficit models to account for inequality. Studies of deprivation and inequality would benefit from understanding the processes and operations of power in the (re)production of socio-economic and health inequities to inform holistic strategies for social justice. [ABSTRACT FROM AUTHOR]

Globally, excess salt intake is a significant cause of preventable heart disease and stroke, given the established links between high salt intake, high blood pressure, and cardiovascular disease. This paper describes and evaluates the voluntary approaches to salt reduction that operate in the United Kingdom and the United States, and proposes a new strategy for improving their performance. Drawing on developments in the theory and practice of public health governance, as well as theoretical ideas from the field of regulatory studies, this paper proposes a responsive regulatory model for managing food reformulation initiatives, including salt reduction programs. This model provides a transparent framework for guiding industry behavior, making full use of industry's willingness to participate in efforts to create healthier products, but using 'legislative scaffolding' to escalate from self-regulation towards co-regulation if industry fails to play its part in achieving national goals and targets. [ABSTRACT FROM AUTHOR]

Globally, excess salt intake is a significant cause of preventable heart disease and stroke, given the established links between high salt intake, high blood pressure, and cardiovascular disease. This paper describes and evaluates the voluntary approaches to salt reduction that operate in the United Kingdom and the United States, and proposes a new strategy for improving their performance. Drawing on developments in the theory and practice of public health governance, as well as theoretical ideas theoretical ideas from the field of regulatory studies, this paper proposes a responsive regulatory model for managing food reformulation initiatives, including salt reduction programs. This model provides a transparent framework for guiding industry behavior, making full use of industry's willingness to participate in efforts to create healthier products, but using 'legislative scaffolding' to escalate from self-regulation towards co-regulation if industry fails to play its part in achieving national goals and targets. [ABSTRACT FROM AUTHOR]

Understanding workforce pressures within surgery is an inexact science. This paper assembles evidence regarding oral and maxillofacial surgery (OMFS) consultant appointments in the UK and plans for prospective data collection in the future. Information about the number of OMFS specialists joining the UK specialist list was obtained from the General Medical Council and compared to a database of substantive OMFS consultant posts. OMFS consultants were asked to contribute information about their training programmes and consultant appointments (date, interview experience, and sub-specialty interest). This information was collated on Excel© and analysed using WinStat©. Data on OMFS consultant posts advertised in 'NHS Jobs' and the British Medical Journal were collected. The mean (SD) number of specialists joining the specialist list per year is 24.1 (5.2) with a median of 24 and a range of 15 – 36. The number of trainees completing training and numbers joining the OMFS specialist list are in balance at present. The median delay between OMFS specialist listing and appointment as a consultant was 72 days and mean of 169 with the 25th centile of five days, standard deviation of 239 days and maximum of 5.2 years. Of those returning data, 135 (47%) candidates were the sole interviewee and 83 (29%) had one other candidate at their successful interview. The mean application ratio for each post was 1.9 and the median number of candidates was one, mean 1.6 and maximum candidates seven. About half of the posts were filled by trainees from their regional training rotation. Prospective data collection on advertised posts, interviews held, expected retirements/new posts, combined with a route for trainees approaching CCT to highlight their availability may streamline recruitment and allow a more rapid recognition of recruitment problems. [ABSTRACT FROM AUTHOR]

This paper assesses developments in transdisciplinary research in the UK. While we support the thesis that transdisciplinarity is still not mainstream and is rarely supported per se by funders of research, this paper examines the extent to which UK research policy has embraced the concept of transdisciplinarity. Five empirical case studies provide data about the interrelationship between the interdisciplinary and impact or knowledge exchange aspirations of Research Council UK (RCUK) investments. We find evidence that, to an extent, UK research funding policy is achieving some elements of transdisciplinarity in practice, if not in name. Drawing on broader debates about the limitations of knowledge mobilisation and the challenges of conducting interdisciplinary research, we reflect on how the situation has changed since our original 2004 paper. The evidence suggests that the absence of the ‘transdisciplinary’ label is not necessarily impeding the framing of research funding schemes oriented towards societal issues. Nevertheless, several areas where capacity-building is required, including training for early career interdisciplinary researchers; improved research leadership skills; and the capacity to evaluate the quality of transdisciplinary processes and to learn from such evaluations, are identified. [ABSTRACT FROM AUTHOR]

The paper describes the integration between what used to be a passive element of the energy value chain – the grid – and both upstream and downstream elements. The evolution of communications among the elements has permitted a more robust and adaptable structure that already is being implemented: the Smart Grid. The paper relates the evolution of EU policy concerning both the development and the rolling-out of solutions to exploit the potential of the Smart Grid concept and describes what has been done by the regulators of three countries that share the same goal but seek to attain it via distinct paths. The article starts with a justification of the need for more integrated networks and a definition of the Smart Grid. A second part covers the risks and difficulties of implementation within an established network, introducing the role of the regulator. The third part describes EU policy response and three different approaches by regulators in the UK, Italy and Portugal, showing how in each case policy is influenced by characteristics of their respective national electricity markets in terms of competition dynamics. [ABSTRACT FROM AUTHOR]

There is ongoing debate regarding the shape of life-course trajectories in mental health. Many argue the relationship is U-shaped, with mental health declining with age to mid-life, then improving. However, I argue that these models are beset by the age–period–cohort (APC) identification problem, whereby age, cohort and year of measurement are exactly collinear and their effects cannot be meaningfully separated. This means an apparent life-course effect could be explained by cohorts. This paper critiques two sets of literature: the substantive literature regarding life-course trajectories in mental health, and the methodological literature that claims erroneously to have ‘solved’ the APC identification problem statistically (e.g. using Yang and Land's Hierarchical APC–HAPC-model). I then use a variant of the HAPC model, making strong but justified assumptions that allow the modelling of life-course trajectories in mental health (measured by the General Health Questionnaire) net of any cohort effects, using data from the British Household Panel Survey, 1991–2008. The model additionally employs a complex multilevel structure that allows the relative importance of spatial (households, local authority districts) and temporal (periods, cohorts) levels to be assessed. Mental health is found to increase throughout the life-course; this slows at mid-life before worsening again into old age, but there is no evidence of a U-shape – I argue that such findings result from confounding with cohort processes (whereby more recent cohorts have generally worse mental health). Other covariates were also evaluated; income, smoking, education, social class, urbanity, ethnicity, gender and marriage were all related to mental health, with the latter two in particular affecting life-course and cohort trajectories. The paper shows the importance of understanding APC in life-course research generally, and mental health research in particular. [ABSTRACT FROM AUTHOR]

This paper looks at the transformation of UK drug treatment policy in the priority that is now being given to recovery. The paper explores the factors that helped shape that transformation and notes that in the main the influences were external to those directly involved in delivering drug treatment (research, politicians, media, think tanks) and that whilst the combined influence of these elements succeeded in reframing policy, it has left the realm of drug treatment service delivery unclear in a number of key areas including: determining how long drug users should remain in treatment; avoiding relapse; relations between professional drug workers and peer supporters; and meeting the diverse needs of drug users including those who are not seeking to become drug free. The paper concludes by considering what kind of initiatives and mechanisms may be needed to ensure a closer alignment between policy and practice within the drug treatment sphere. [ABSTRACT FROM AUTHOR]

Abstract: The expressivist objection to prenatal testing is acknowledged as a significant critique of prenatal testing practices most commonly advanced by disability rights supporters. Such writers argue that prenatal testing and selective termination practices are objectionable as they express disvalue not only of the foetus being tested, but also of disabled people as a whole, by focusing exclusively on the disabling trait. While the objection has been widely critiqued on the basis of its theoretical incoherence, this paper highlights the way in which it, nevertheless, is a significant mediator in decisions around the use of reproductive genetic technologies. By drawing on 41 in-depth qualitative interviews (drawn from a sample of 61) conducted in the UK between 2007 and 2009 with families and individuals living with a genetic disease, Spinal Muscular Atrophy (SMA), this paper highlights the ways in which expressivist objections feature prominently in the reproductive decisions of families living with SMA and the significant emotional burden they represent. While the literature on the expressivist objection has focused on the reproductive decisions of those undergoing prenatal testing for a condition of which they have little (or no) prior knowledge, the context of intimate familial relationships and extensive experience with the tested-for condition fundamentally alters the nature and impact of expressivist objections within families living with an inheritable condition. By focussing on the reproductive decisions of families living with SMA and their strategic management of the expressivist objection, this paper will address the call, made primarily by disability rights supporters, for ‘experientially based’ (as opposed to medical) information about the tested-for disability to be made available to would-be parents considering selective termination. It will be argued that parents' experiential knowledge of the tested-for disability can, in fact, amplify expressivist objections to prenatal testing, and thus paradoxically constrain, rather than facilitate, reproductive decisions. [Copyright &y& Elsevier]

Abstract: Recent policy initiatives in the UK and internationally have sought to promote knowledge translation between the ‘producers’ and ‘users’ of research. Within this paper we explore how boundary-spanning interventions used within such initiatives can support knowledge translation between diverse groups. Using qualitative data from a 3-year research study conducted from January 2010 to December 2012 of two case-sites drawn from the CLAHRC initiative in the UK, we distinguish two different approaches to supporting knowledge translation; a ‘bridging’ approach that involves designated roles, discrete events and activities to span the boundaries between communities, and a ‘blurring’ approach that de-emphasises the boundaries between groups, enabling a more continuous process of knowledge translation as part of day-to-day work-practices. In this paper, we identify and differentiate these boundary-spanning approaches and describe how they emerged from the context defined by the wider CLAHRC networks. This highlights the need to develop a more contextualised analysis of the boundary-spanning that underpins knowledge translation processes, relating this to the distinctive features of a particular case. [Copyright &y& Elsevier]

Abstract: Parking management is a strategy that has been extensively employed by authorities and organisations world-wide in an attempt to address traffic-related congestion and associated environmental impacts at a variety of sites and scales. At airports, parking control and pricing regimes are used to generate revenue and manage traffic demand. On the supply side, within the last few years a new trend in unregulated off-site, predominately residential, car parking provision around UK airports has emerged and quickly grown in popularity. Through a survey of three UK-based self-styled ‘parking marketplace’ websites and an in-depth analysis of one, this paper provides an empirical examination of the growing phenomenon of off-site residential car parking provision around the UK’s 25 busiest passenger airports and discusses the potential implications of this niche but growing phenomenon. Data is provided on the supply and the demand for these alternative spaces, as well as their physical location, attributes, and pricing regimes. The empirical findings indicate that, while this currently represents a relatively small proportion of overall airport parking supply it is experiencing rapid growth and may become significant in the future. The paper concludes by contending that airport operators and local authorities need to be cognisant of the existence of, and the challenges and opportunities associated with, alternative parking provision in order to be able to better plan for, and respond to the planning, environmental, and consumer implications it may create. [Copyright &y& Elsevier]

Abstract: Migrant labour has been particularly significant in the British rural agribusiness sector, where employers often struggle to source labour regardless of economic conditions. While most research on East-Central European migration has focused on the experiences of members of the migrant community, this paper is one of a small number of studies that has gathered evidence from employers and labour recruiters. The paper draws on in-depth interviews undertaken in four case study areas. The analysis focuses on the practices of employers and recruiters that have shaped how migrant labour is sourced and used in the UK labour market, and how labour migration channels have evolved since 2004. The two main conceptual contributions of this paper are a new typology of recruitment/employment practices and a schema illustrating the changing spatial impacts of migration channels in areas of destination. [Copyright &y& Elsevier]

In this paper we examine the failure of the zero carbon homes agenda in the UK and argue that it represents a case of policy dismantling, where a range of policies and programmes have been introduced, revised and then removed by government. We bring together the sustainability transitions literature with the literature on policy dismantling, regime resistance and regime detractors, and suggest that the zero carbon housing agenda in the UK offers useful insights into the politics of sustainability transitions. We identify three phases of policy change, from policy expansion, symbolic dismantling and eventual active policy dismantling. In the conclusions we offer some suggestions on processes of policy dismantling and what this might mean for future sustainability transitions given the significant contributions of buildings to greenhouse gas emissions and the urgent need for rapid low carbon transitions. [ABSTRACT FROM AUTHOR]

Abstract: Food poverty is an important contributing factor to health inequalities in industrialised countries; it refers to the inability to acquire or eat an adequate quality or sufficient quantity of food in socially acceptable ways (or the uncertainty of being able to do so). Synonymous with household food insecurity, the issue needs to be located within a social justice framework. Recognising the clear interdependence between the right to food and the right to health, this paper explores how international human rights obligations could inform approaches to addressing food poverty and insecurity with specific reference to Ireland and the UK. Little attention has been paid to how countries should meet their obligations to respect, protect and fulfil the right to food in developed countries. The paper contributes by examining the social and policy circumstances which inhibit poor households from obtaining sufficient food to eat healthily, along with strategies and interventions from State and civil society actors in the two countries. In practice, problems and potential solutions have largely been directed towards the individual rather than at social determinants, particularly as research on environmental factors such as distance to shops has produced equivocal results. Other key structural aspects such as income sufficiency for food are broadly ignored by the State, and anti-poverty strategies are often implemented without monitoring for effects on food outcomes. Thus scant evidence exists for either Ireland or the UK meeting its rights to food obligations to date, in terms of roles and responsibilities in ensuring access to affordable, available and appropriate food for all. [Copyright &y& Elsevier]

Recent work in geography has begun to look at the opportunities for care from siblings, friends and neighbours alongside parents and spouses. This paper examines the daily relationships that middle to older age adults with a learning disability have with remaining kin members, friends, and neighbours, within the context of declining formal day services. Adults with learning disabilities are more likely to have different life course experiences and be living on low incomes and in poor housing than the rest of the population as they have had less opportunity to work and save money through their lives. We draw on two qualitative studies with adults with learning disabilities. Findings suggest that friend and kin networks are anything but certain, as opportunities to meet and socialise shrink, and connections with siblings do not necessarily lend themselves to support. The findings raise the possibility of a space of attenuated care to convey the increasingly limited fronts from which support can be derived. • Study examines informal care gaps in times of austerity. • It focuses on middle to older age adults with learning disabilities. • Findings suggest support from friends, neighbours and siblings is very uncertain. • There are also retreating opportunities and spaces to meet friends and socialise. • Study contributes idea of 'care desert' to geographies of care and disability. [ABSTRACT FROM AUTHOR]

Abstract: While there is growing scholarly interest in returned and cyclical migration, and on young adult cultural or adventure seeking migration, there is still a lack of systematic empirical insights into how the experiences of being abroad, and after return, are mediated by exposure to different cultural environments. Addressing this conceptual and empirical gap, the paper analyses the experiences of New Zealand return migrants, or sojourners, who lived and worked in European countries (other than the UK) for more than one year and compares them with the experiences of NZ returnees from the UK. Drawing on 20 ‘non-UK’ and 22 ‘UK’ in-depth interviews, the paper revisits typology of cross-cultural, or intercultural, adjustment (largely ignored in studies of return migration) to assess sojourners’ experiences throughout the migration cycle and serve as a useful tool for identifying and reporting psychological and socio-cultural elements in the returnees stories. The findings of sojourners’ possible identity shifts during intercultural transition are discussed with reference to the four-member paradigm of Cultural Identity Model (CIM) () while addressing argument that overseas adaptation and repatriation experiences are not directly associated. This paper demonstrates the need to understand first that the costs and benefits of circular migration or sojourning are country-specific, and that they do not ‘just happen’ at a particular moment or in one phase but are forged through a veritable rollercoaster of experiences of intercultural adjustment. [Copyright &y& Elsevier]

Abstract: Previous studies of groups representing patients, users and carers in the UK indicate that their principal focus is on health care and treatment services. In recent years, UK government policy has emphasised prevention and health promotion as part of its wider public health agenda. This paper investigates how this might have affected health consumer and patients’ organisations (HCPOs) by presenting findings from an online survey of 312 UK groups undertaken in the summer of 2010. The sample was identified using the publicly available membership lists of a number of large alliance organisations. The survey achieved a 39% response rate. The findings suggest that the main focus of lobbying and campaigning remains on health care rather than public health issues. However, a significant minority of groups stated they prioritised public health campaigning and lobbying. Possible explanations for engagement with the public health agenda include: the presence of public health on the government’s agenda, the influence of other, more powerful interests in the health policy process, and growing awareness among groups of health promotion, prevention and environmental causes of illness. The paper argues that although HCPOs may be more active in the public health policy arena, more research is needed – notably with regard to their relationship with devolved governments, EU institutions and the current UK government’s public health and voluntary sector agenda. The reasons why some groups engage more than others with the public health agenda also merit closer investigation. Moreover, not enough is currently known about the influence of HCPOs on the public health agenda and policies in this field. [Copyright &y& Elsevier]

Abstract: This paper reports the first stage of work being undertaken to understand the factors that have impacted on the current state of food safety in the UK food manufacturing sector. The paper first explores developments in international food safety regulation in general and in particular, the UK. Using a survey and case study methodology, the paper examines the response of food manufacturing enterprises to food safety regulation, and uses statistical techniques to investigate the effects of enterprise size on the drivers for, benefits of, and challenges to compliance. Further, the factors that influence the successful implementation of an integrated food safety management system are also examined. The results show a great deal of both statutory and private regulation that has incentivised enterprises. In response, enterprises have implemented integrated food safety management systems to proactively deal with the risks associated with food safety, however, enterprises claim that statutory regulations are biased towards consumers, without adequate impact assessments on all stakeholders within the chain, and hence causing industry to incur significant costs that could otherwise be avoided. Even though compliance with food safety regulation is burdensome, the cost of non-compliance will also be significant to enterprises. The findings also show that there is no significant effect of size of enterprise on the drivers, benefits and challenges to compliance with food safety regulation. [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]

Abstract: Explicit health care rationing or priority-setting is the use of institutional procedures for the systematic allocation of resources within health care systems. With the establishment of priority setting systems in various countries in the past two decades, research has been conducted on their principles, methods and institutional aspects. This paper draws on the sociology of science and technology to propose an uncertainty-focused conceptual model of the relationship between knowledge practises and political processes in health care rationing. Taking a case-study approach, the paper explores the public controversy about whether dementia drugs should be available on the UK National Health Service. It shows how three aspects of the controversy – loose institutional framing, open membership and hybrid knowledge – worked together to enable the use of a ‘pragmatic balance’ between rules and cases. Placing this outcome within the space of possibilities suggested by the model, the paper suggests that accepting and fostering the exploration of uncertainty at the core of health care priority setting systems should provide those systems with increased social robustness. [Copyright &y& Elsevier]

Abstract: This paper contributes to research on women’s health by challenging the ‘common belief’ that pregnant employees are prone to take sick leave. Conversely, it shows how some pregnant employees are so determined to appear ‘well’ that they remain at work when they are ill. The paper coins the phrase ‘pregnant presenteeism’ to describe pregnant employees who resist taking sick leave. The paper first acknowledges previous studies which show how employers associate pregnancy with incompetence and sickness absence. It then examines why (in contrast to employers’ assumptions), some pregnant employees remain at work when they are ill. It does this through a qualitative study of 15 employed mothers in the UK, each of whom was working in a managerial/professional role at the time of her interview. Of these 15 women, three remained at work during pregnancy despite serious health problems. In order to understand the experiences of these ‘pregnant presentees’, the paper draws upon concept of a ‘binary opposition’ which articulates the tendency within medicine to polarize women’s and men’s health as if at opposite ends of a scale, with women’s health classified as ‘poor’ and men’s health as ‘good’. The paper argues that the conceptual principles of ‘binary opposition’ spill over into workplace contexts especially in relation to pregnancy. It then proposes that some employed pregnant women deny their own ill health due to fear of being identified with the female, ‘poor health’ end of the binary opposition scale. It articulates such denial as a potentially serious health issue for pregnant workers. The paper develops new and more explicit links between ‘socio-cultural’ feminist studies on the employed maternal body, and health research. [Copyright &y& Elsevier]

Abstract: It has been suggested that as many as 23,000 in-hospital cardiac arrests in the UK could be prevented with earlier detection and intervention (). Cases of ‘failure to rescue’ are often linked with difficulties relaying and interpreting information across occupational and professional boundaries. Standardised communication protocols have been recommended as a means of enabling the transmission of concise, salient information, licensing and empowering the individual to overcome established hierarchies in speaking out and asking for help. This paper critically examines the current discourse around such protocols. We find that there is a paucity of evidence regarding the complex relationship between social contexts, individual applications of these protocols and short- and long-term impact on safety and ‘failure to rescue’ rates. The paper highlights the complexities of the underlying power dynamics that are located within gendered and occupational hierarchies and explores the role of standardised communication protocols as a potential boundary object. The paper discusses the potential for these protocols to inter-relate and act as a mediating boundary object between nursing and medical staff, enabling understanding and sharing of cultural context. [Copyright &y& Elsevier]

Abstract: This paper presents an ethnographic account of the implementation of Lean service redesign methodologies in one UK NHS hospital operating department. It is suggested that this popular management ‘technology’, with its emphasis on creating value streams and reducing waste, has the potential to transform the social organisation of healthcare work. The paper locates Lean healthcare within wider debates related to the standardisation of clinical practice, the re-configuration of occupational boundaries and the stratification of clinical communities. Drawing on the ‘technologies-in-practice’ perspective the study is attentive to the interaction of both the intent to transform work and the response of clinicians to this intent as an ongoing and situated social practice. In developing this analysis this article explores three dimensions of social practice to consider the way Lean is interpreted and articulated (rhetoric), enacted in social practice (ritual), and experienced in the context of prevailing lines of power (resistance). Through these interlinked analytical lenses the paper suggests the interaction of Lean and clinical practice remains contingent and open to negotiation. In particular, Lean follows in a line of service improvements that bring to the fore tensions between clinicians and service leaders around the social organisation of healthcare work. The paper concludes that Lean might not be the easy remedy for making both efficiency and effectiveness improvements in healthcare. [Copyright &y& Elsevier]