An exploration of the impact of the Green-Schools programme on the development of sustainable behaviours in the home

Concern for the sustainability of our planet is widespread. The ever-increasing economic activity and large scale industralisation our consumer society requires has increased concerns among academics, politicians, and consumers alike on natural resource depletion, waste management, dangers of toxic chemicals, and climate change. Human consumption is causing major issues for the space we inhabit. Much work has been done over the past four decades to remedy human impact on our environment at corporate, policy and consumer level. But concerns on our ability to progress the sustainability agenda remain. Consumer behaviour plays a pivotal role in sustainable development. In light of this, we need to explore and understand the ways in which consumption occurs in consumers lives, with an aim to changing behaviours that do not support the natural environment. Questions on how to change consumer behaviour dominate much of the literature on sustainable consumption, but substantial behaviour change among individuals has not occurred as predicted. Some focus has shifted to look at upstream interventions, such as education. The Green-Schools Programme (known internationally as Eco-Schools) is one such intervention. The aim of this thesis was to explore consumption in the context of the Green-Schools Programme. The main research question asks: in the context of the Green-Schools, how are sustainable behaviour practices developed in the home? The findings presented in this thesis show that sustainable behaviour has developed in the home from both internal and external factors, the Green-Schools effect being one such factor; the programme does influence behaviour in the home context to some degree. One of the main findings of this research indicates that schoolchildren are imparting ‘positive pester power’ on household behaviour practices and the majority of households are passively practicing sustainable consumption. These findings contribute to knowledge on sustainable consumption in the home context.

Development of an intervention to support medication management in patients with multimorbidity in primary care

The overarching aim of this thesis was to develop an intervention to support patient-centred prescribing in the context of multimorbidity in primary care. Methods A range of research methods were used to address different components of the Medical Research Council, UK (MRC) guidance on the development and evaluation of complex interventions in health care. The existing evidence on GPs’ perceptions of the management of multimorbidity was systematically reviewed. In qualitative interviews, chart-stimulated recall was used to explore the challenges experienced by GPs when prescribing for multimorbid patients. In a cross-sectional study, the psychosocial issues that complicate the management of multimorbidity were examined. To develop the complex intervention, the Behaviour Change Wheel (BCW) was used to integrate behavioural theory with the findings of these three studies. A feasibility study of the new intervention was then conducted with GPs. Results The systematic review revealed four domains of clinical practice where GPs experienced difficulties in multimorbidity. The qualitative interview study showed that GPs responded to these difficulties by ‘satisficing’. In multimorbid patients perceived as stable, GPs preferred to ‘maintain the status quo’ rather than actively change medications. In the cross-sectional study, the significant association between multimorbidity and negative psychosocial factors was shown. These findings informed the development of the ‘Multimorbidity Collaborative Medication Review and Decision-making’ (MY COMRADE) intervention. The intervention involves peer support: two GPs review the medications prescribed to a complex multimorbid patient together. In the feasibility study, GPs reported that the intervention was appropriate for the context of general practice; was widely applicable to their patients with multimorbidity; and recommendations for optimising medications arose from all collaborative reviews. Conclusion Applying theory to empirical data has led to an intervention that is implementable in clinical practice, and has the potential to positively change GPs’ behaviour in the management of medications for patients with multimorbidity.

Selection of a network of large lakes and reservoirs suitable for global environmental change analysis using Earth Observation

The GloboLakes project, a global observatory of lake responses to environmental change, aims to exploit current satellite missions and long remote-sensing archives to synoptically study multiple lake ecosystems, assess their current condition, reconstruct past trends to system trajectories, and assess lake sensitivity to multiple drivers of change. Here we describe the selection protocol for including lakes in the global observatory based upon remote-sensing techniques and an initial pool of the largest 3721 lakes and reservoirs in the world, as listed in the Global Lakes and Wetlands Database. An 18-year-long archive of satellite data was used to create spatial and temporal filters for the identification of waterbodies that are appropriate for remote-sensing methods. Further criteria were applied and tested to ensure the candidate sites span a wide range of ecological settings and characteristics; a total 960 lakes, lagoons, and reservoirs were selected. The methodology proposed here is applicable to new generation satellites, such as the European Space Agency Sentinel-series.

Assessing the utility of geospatial technologies to investigate environmental change within lake systems

Over 50% of the world's population live within 3. km of rivers and lakes highlighting the on-going importance of freshwater resources to human health and societal well-being. Whilst covering c. 3.5% of the Earth's non-glaciated land mass, trends in the environmental quality of the world's standing waters (natural lakes and reservoirs) are poorly understood, at least in comparison with rivers, and so evaluation of their current condition and sensitivity to change are global priorities. Here it is argued that a geospatial approach harnessing existing global datasets, along with new generation remote sensing products, offers the basis to characterise trajectories of change in lake properties e.g., water quality, physical structure, hydrological regime and ecological behaviour. This approach furthermore provides the evidence base to understand the relative importance of climatic forcing and/or changing catchment processes, e.g. land cover and soil moisture data, which coupled with climate data provide the basis to model regional water balance and runoff estimates over time. Using examples derived primarily from the Danube Basin but also other parts of the World, we demonstrate the power of the approach and its utility to assess the sensitivity of lake systems to environmental change, and hence better manage these key resources in the future.

Athletic groin pain (part 2): a prospective cohort study on the biomechanical evaluation of change of direction identifies three clusters of movement patterns

Background: Athletic groin pain (AGP) is prevalent in sports involving repeated accelerations, decelerations, kicking and change-of-direction movements. Clinical and radiological examinations lack the ability to assess pathomechanics of AGP, but three-dimensional biomechanical movement analysis may be an important innovation. Aim: The primary aim was to describe and analyse movements used by patients with AGP during a maximum effort change-of-direction task. The secondary aim was to determine if specific anatomical diagnoses were related to a distinct movement strategy. Methods: 322 athletes with a current symptom of chronic AGP participated. Structured and standardised clinical assessments and radiological examinations were performed on all participants. Additionally, each participant performed multiple repetitions of a planned maximum effort change-of-direction task during which whole body kinematics were recorded. Kinematic and kinetic data were examined using continuous waveform analysis techniques in combination with a subgroup design that used gap statistic and hierarchical clustering. Results: Three subgroups (clusters) were identified. Kinematic and kinetic measures of the clusters differed strongly in patterns observed in thorax, pelvis, hip, knee and ankle. Cluster 1 (40%) was characterised by increased ankle eversion, external rotation and knee internal rotation and greater knee work. Cluster 2 (15%) was characterised by increased hip flexion, pelvis contralateral drop, thorax tilt and increased hip work. Cluster 3 (45%) was characterised by high ankle dorsiflexion, thorax contralateral drop, ankle work and prolonged ground contact time. No correlation was observed between movement clusters and clinically palpated location of the participant's pain. Conclusions: We identified three distinct movement strategies among athletes with long-standing groin pain during a maximum effort change-of-direction task. These movement strategies were not related to clinical assessment findings but highlighted targets for rehabilitation in response to possible propagative mechanisms. Trial registration number NCT02437942, pre results.

Modelling and predictive control techniques for building heating systems

Model predictive control (MPC) has often been referred to in literature as a potential method for more efficient control of building heating systems. Though a significant performance improvement can be achieved with an MPC strategy, the complexity introduced to the commissioning of the system is often prohibitive. Models are required which can capture the thermodynamic properties of the building with sufficient accuracy for meaningful predictions to be made. Furthermore, a large number of tuning weights may need to be determined to achieve a desired performance. For MPC to become a practicable alternative, these issues must be addressed. Acknowledging the impact of the external environment as well as the interaction of occupants on the thermal behaviour of the building, in this work, techniques have been developed for deriving building models from data in which large, unmeasured disturbances are present. A spatio-temporal filtering process was introduced to determine estimates of the disturbances from measured data, which were then incorporated with metaheuristic search techniques to derive high-order simulation models, capable of replicating the thermal dynamics of a building. While a high-order simulation model allowed for control strategies to be analysed and compared, low-order models were required for use within the MPC strategy itself. The disturbance estimation techniques were adapted for use with system-identification methods to derive such models. MPC formulations were then derived to enable a more straightforward commissioning process and implemented in a validated simulation platform. A prioritised-objective strategy was developed which allowed for the tuning parameters typically associated with an MPC cost function to be omitted from the formulation by separation of the conflicting requirements of comfort satisfaction and energy reduction within a lexicographic framework. The improved ability of the formulation to be set-up and reconfigured in faulted conditions was shown.