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Background: Children < 5 years living in temporary accommodation (U5TA) are vulnerable to poor health outcomes. Few qualitative studies have examined service provider perspectives in family homelessness; none have focused on U5TA with a cross-sector approach. This study explored professionals’ perspectives of the barriers and facilitators, including pandemic-related challenges, experienced by U5TA in accessing healthcare and optimising health outcomes, and their experiences in delivering services. Methods: Sixteen semi-structured online interviews were conducted. Professionals working in Newham (London) with U5TA families were recruited from non-profit organisations, the health sector, and Local Authority. A thematic analysis was conducted. Findings: Professionals described barriers including poor parental mental health; unsuitable housing; no social support; mistrust of services; immigration administration; and financial insecurity. Digital poverty, language discordance, and the inability to register and track U5TA made them even less visible to services. Professionals tried to mitigate barriers with improved communication, and through community facilitators. Adverse pandemic effects on U5TA health included delay and regression in developmental milestones and behaviours. In-person services were reduced, exacerbating pre-existing barriers. Interpretation: COVID-19 further reduced the ability of professionals to deliver care to U5TA and significantly impacted the lives of U5TA with potential life-long risks. Innovative and tailored cross-sector strategies are needed, including co-production of public health services and policies focusing on early development, mental health support, employment training, and opportunities for parents/carers.

Children’s health can be affected by the interrelated characteristics of the physical and social environment where they live, including housing quality, neighbourhood characteristics and the local community. Following a systems-based approach, this exploratory project sought to understand how the needs and aspirations associated with the home environment can work in synergy with, or be exacerbated by, other aspects of the local area. The study recruited parents of children aged 2–12 years old from two local authorities in England with high levels of child poverty: Tower Hamlets in East London, and Bradford District in West Yorkshire. Thematic analysis of participant interviews highlighted ten themes and opportunities for improvements. The evidence presented in this research emphasises how environmental quality issues within and outside the home, compounded further by delays in repairs and reduction in service standards, as well as affordability issues, are likely to deeply affect the wellbeing of an entire generation of disadvantaged children whose parents can feel disempowered, neglected and often isolated when attempting to tackle various dimensions of inequalities. Interventions which can improve the quality of housing, and access to space and services, are urgently needed, including initiatives to support and empower families and local communities, especially those prioritising opportunities for action.

BACKGROUND: To achieve sustainability, we must consider scalable improvements in student movement behavior in the classroom setting, educational priorities. Flexible learning spaces that employ student‐centered pedagogy and contain a range of furniture and layout options, implemented to improve educational outcomes, may enable unintended health benefits. In this review, we summarize the evidence on the effects of flexible learning spaces on adolescent student movement behaviors and educational outcomes. METHODS: We searched 5 databases, retrieving 5 quantitative and one qualitative article meeting the review criteria. RESULTS: Students in flexible learning spaces spent less time sitting, and more time standing and moving. Students were also more engaged, on‐task, and collaborated and interacted more. Academic results for English, Mathematics and Humanities for those in flexible learning spaces were higher than peers in traditional classrooms. CONCLUSION: Evidence from the reviewed studies suggests that there may be beneficial outcomes across some movement behaviors as well as learning outcomes in classrooms that employ student‐centered pedagogy and use a built environment that facilitates autonomy and choice around where and how to learn. These learning environments present an opportunity for an interdisciplinary approach to address sedentary behavior in classrooms.

Impairment in mental functions attributed to the effects of indoor air quality and thermal conditions has received considerable attention in the past decade, particularly for educational buildings where students’ cognitive performance is essential to foster learning. This study explores the combined effects of indoor temperatures and CO2 levels as markers for ventilation rates on cognitive performance among female students (16– 23 years old) in Saudi Arabia. The longitudinal experiments involved nine conditions combining three CO2 concentration levels (achieved via changes in ventilation) and three temperature levels involving 499 participants, all exposed to the nine conditions. The study implemented a computer- based cognitive performance battery with “9Button” keyboards. Univariable and multivariable multilevel regression models explored the association of indoor temperature and CO2 levels (as markers for ventilation rates) with cognitive performance after adjusting for potential confound-ers. Potential benefits were found on speed and accuracy of tasks of cognitive perfor-mance when indoor temperature was set between 20 and 23ºC and at CO2 levels of 600 ppm compared to higher temperatures and poorer ventilation rates and that both ventilation and thermal environmental control are important and need to be improved for achieving optimum learning conditions. Nevertheless, the results are relevant for short-term exposures lasting no more than 2 h.

In the hot climate of Saudi Arabia, people living year-round in air-conditioned spaces are likely to develop high expectations for homogeneity and cool temperatures, becoming potentially more sensitive if thermal conditions deviate from the comfort zone they expect. This paper presents the results from a field intervention investigating the association between participants’ thermal sensations with cognitive performance in a female university in Saudi Arabia. The climatic context plays a key role in choosing Saudi Arabia, whereas the total reliance on air-conditioners (AC) for cooling is believed to have significant effects on occupants’ perceptions of the comfort temperature. Results reveal discrepancies in the actual thermal sensations between the Saudi and non-Saudi participants which affected their performances. “Cool” and “Slightly Cool” sensations versus neutral were associated with significant lower percentage of errors and significant higher speed for all participants independently of any association with ethnicity and acclimatization. The estimates remained significant even after adjusting for ethnicity and the number of years spent in the country and the set temperature of AC at home. Implications of the study suggest a preference for staying cool when working independently of acclimatization status.

Background: Poor air quality is associated with poor health. Little attention is given to the complex array of environmental exposures and air pollutants that affect mental health during the life course. Aims: We gather interdisciplinary expertise and knowledge across the air pollution and mental health fields. We seek to propose future research priorities and how to address them. Method: Through a rapid narrative review, we summarise the key scientific findings, knowledge gaps and methodological challenges. Results: There is emerging evidence of associations between poor air quality, both indoors and outdoors, and poor mental health more generally, as well as specific mental disorders. Furthermore, pre-existing long-term conditions appear to deteriorate, requiring more healthcare. Evidence of critical periods for exposure among children and adolescents highlights the need for more longitudinal data as the basis of early preventive actions and policies. Particulate matter, including bioaerosols, are implicated, but form part of a complex exposome influenced by geography, deprivation, socioeconomic conditions and biological and individual vulnerabilities. Critical knowledge gaps need to be addressed to design interventions for mitigation and prevention, reflecting ever-changing sources of air pollution. The evidence base can inform and motivate multi-sector and interdisciplinary efforts of researchers, practitioners, policy makers, industry, community groups and campaigners to take informed action. Conclusions: There are knowledge gaps and a need for more research, for example, around bioaerosols exposure, indoor and outdoor pollution, urban design and impact on mental health over the life course. Natural Environment Research Council (NERC): NE/V002171/1; Engineering and Physical Sciences Research Council (EPSRC): EP/V052462/1; EP/W001411/1; EP/T003189/1

Although the built environment (BE) is important for children’s health, there is little consensus about which features are most important due to differences in measurement and outcomes across disciplines. This meta-narrative review was undertaken by a multi-disciplinary team of researchers to summarise ways in which the BE is measured, and how this links to children’s health. A structured search of four databases across the relevant disciplines retrieved 108 relevant references. The most commonly addressed health-related outcomes were active travel, physical activity and play, and obesity. Many studies used objective (GIS and street audits) or standardised subjective (perceived) measurements of the BE. However, there was a wide variety, and sometimes inconsistency, in their definition and use. There were clear associations between the BE and children’s health. Objective physical activity and self-reported active travel, or obesity, were positively associated with higher street connectivity or walkability measures, while self-reported physical activity and play had the strongest association with reduced street connectivity, indicated by quieter, one-way streets. Despite the high heterogeneity found in BE measures and health outcomes, the meta-narrative approach enabled us to identify ten BE categories that are likely to support children’s health and be protective against some non-communicable disease risk factors. Future research should implement consistent BE measures to ensure key features are explored. A systems approach will be particularly relevant for addressing place-based health inequalities, given potential unintended health consequences of making changes to the BE.

Improved housing has the potential to advance health and contribute to the Sustainable Development Goals. Research examining housing, health and energy use in low-income countries is limited; understanding these connections is vital to inform interventions for healthy sustainable human settlements. This paper investigates the low-income setting of Delhi, where rapid urbanisation, a varied climate, high pollution levels, and a wide variation in housing quality could result in significant energy use and health risks. Drawing on approaches from health and the built environment and existing data and literature, a characterisation of energy use and health risks for Delhi’s housing stock is completed. Four broad settlement types were used to classify Delhi housing and energy use calculations and health risk assessment were performed for each variant. Energy use is estimated to be nearly two times higher per household among planned housing compared with other settlement types. Health risks, however, are found to be largest within informal slum settlements, with important contributions from heat and particulate matter across all settlements. This paper highlights intervention priorities and outlines the need for extensive further research, particularly through data gathering, to establish evidence to accelerate achieving healthy, sustainable and equitable housing in Delhi. publishedVersion

The first five years of life are critical for optimal growth, health, and cognitive development. Adverse childhood experiences, including experiencing homelessness, can be a risk factor for multiple health issues and developmental challenges. There is a dearth of data collected with and by families with children under age five living in temporary accommodation due to experiencing homelessness (U5TA) describing indoor environmental barriers that prevent U5TA from achieving and maintaining optimal health. The aim of this study was to address this current gap using a citizen science approach. Fifteen participants, who were mothers of U5TA living in a deprived area of London, and the lead researcher collected data in late 2019/early 2020 using: (I) a housing survey conducted via a mobile app; (II) house visits; and (III) collaborative meetings. Data were analyzed using thematic analysis. Key themes included: overcrowding/shared facilities, dampness/mold growth, poor/inadequate kitchen/toilet facilities, infestations/vermin, structural problems/disrepair, unsafe electrics, excessively cold temperatures, and unsafe surfaces that risk causing trips/falls, with all participants experiencing multiple concurrent indoor environmental barriers. The citizen science approach was successfully used to collect meaningful data demonstrating the need for child-centered housing policies meeting the needs of current and future generations of families living in TA.

Air pollution is the environmental public health problem of our time. The United Nations Convention on the Rights of the Child sets out clear guidance to protecting the rights of children and young people, including a child's right to the best possible health (Article 24) and the right to a good standard of living. Unicef also consider that clean air is a right for all children. The UK Royal Medical Colleges vigorously advocate for a healthy environment at the population level and in local communities, especially where socio-economic circumstances limit the choice of where people can live, and which school children attend. Despite substantial progress in understanding outdoor air pollution, the potential risk to health, especially that of children and young people, from the indoor air has been largely overlooked, yet in modern times, the indoor environment has never been more important as lockdown with the Covi-19 virus pandemic has shown us. Here we provide an abridged version of the RCPCH/RCP Report The inside story: Health effects of indoor air quality on children and young people but without the section on recommendations. The full Report along with recommendations, released on 28 January 2020, can be accessed at https://www.rcpch.ac.uk/resources/inside-story-health-effects-indoor-air-quality-children-young-people. While we recognise that some aspects of this commentary are UK specific, much of the content has wide implications.

The health benefits of regular physical activity are substantial and well-established. However, population activity levels are insufficient to obtain health benefits in the United Kingdom (UK), and strategies to increase activity, particularly in income-deprived communities, are sought. Socioecological models of physical activity posit that activity levels are influenced by social, physical and wider environmental factors. In line with a growing evidence base, there is a need to understand the factors that contribute to an activity-supportive neighbourhood within deprived settings within the UK. This study used photo-elicitation qualitative interviews to explore environmental facilitators and barriers to neighbourhood-based, outdoor physical activity in 23 adults living in two income-deprived neighbourhoods in Glasgow, UK. Data were collected between June and October 2015, and were explored using thematic analysis.\ud \ud Five themes were identified: ‘diversity of destinations in the neighbourhood’, ‘provision of services to support healthy environments’, ‘ownership of public space and facilities to encourage physical activity’, ‘collective control of public space to prevent disorder’ and ‘perceived value of the neighbourhood’. Findings highlighted the close interaction between these themes and more broadly between social and physical facets of neighbourhood environments that were unsupportive of physical activity. Discourse about economic aspects was pervasive and emerged as deeply affecting characteristics of the social and physical environment and upstream influences on physical activity. This study supports evidence that multi-faceted interventions addressing aspects of the social, physical and economic environment may be needed to support outdoor physical activity in deprived communities.

Background In 2019, 585 000 children in England were homeless or at risk of becoming homeless. The pressure of the COVID-19 pandemic on the health-care delivery system has amplified the inequalities faced by marginalised children. Although the UK has had a series of successful health sector reforms, few have designed or implemented strategies that target reach, access, and use of public health services for marginalised children. This project aims to identify such strategies by exploring solutions used in low-income and middle-income countries (LMICs), through reverse-innovation. Methods We undertook a systematic review of the literature published in English from PubMed, MEDLINE, and SCOPUS between Jan 1, 2010, and March 31, 2021. We explored the literature focusing on policy, strategy, intervention, and services, using keywords and Medical Subject Headings corresponding to the target population, and medical, health, and nutrition services including preventive and immunisation services, and outcomes. Our target population included homeless and marginalised children. We defined marginality in terms of social distances following Braun and Gatzweiler (2013). We included in our search homelessness, temporary accommodation (eg, makeshift accommodation, emergency shelter, and feral), the conditions that put a child at risk of homelessness (eg, war, battle, conflict, refugee, displaced, and migrant), and the general conditions of social distances (eg, poverty, and financial catastrophe) that do not belong to discrimination. We used the Arksey O'Malley framework with Levene's extension in the aforementioned databases and Google Scholar to improve inclusivity. The primary outcomes included access, coverage, and utilisation of child health and nutrition services. The impact measurements included morbidity, mortality, and economic outcomes (return on investment, cost, and efficiency). We applied natural language processing for thematic analysis of qualitative evidence. The analysis was assisted by Python (v3.7.12). Findings We found 53 final articles (47 quantitative and six qualitative) from LMICs. Community-focused and financial interventions were successful in different settings. Financial interventions such as user-fee removal increased health care and service use between 15–309%. Cash transfers increased immunisation coverage, financial security, and nutrition. Mobile health services and the individualised tactics of community midwives and volunteers improved the coverage and use of child health and nutrition services. Community-based savings groups, user-fee removal, and cash transfer policies improved access and utilisation. mHealth applications and capacity building of health workforce increased coverage and quality of these services and improved clinic attendance. Interpretation UK policy makers could adapt and adopt targeted and conditional cash transfer policies to provide greater financial security to homeless families and make child health care more affordable and inclusive. Volunteer and mobile-clinic-based community services would increase access and use of these services in the COVID-19 recovery phase. Our review may have missed matured strategies published before 2010. We were unable to estimate a pooled effect. Funding ESRC, UK Research and Innovation rapid response COVID 19.

Economic, physical, built, cultural, learning, social and service environments have a profound effect on lifelong health. However, policy thinking about health research is dominated by the ‘biomedical model’ which promotes medicalisation and an emphasis on diagnosis and treatment at the expense of prevention. Prevention research has tended to focus on ‘downstream’ interventions that rely on individual behaviour change, frequently increasing inequalities. Preventive strategies often focus on isolated leverage points and are scattered across different settings. This paper describes a major new prevention research programme that aims to create City Collaboratory testbeds to support the identification, implementation and evaluation of upstream interventions within a whole system city setting. Prevention of physical and mental ill-health will come from the cumulative effect of multiple system-wide interventions. Rather than scatter these interventions across many settings and evaluate single outcomes, we will test their collective impact across multiple outcomes with the goal of achieving a tipping point for better health. Our focus is on early life (ActEarly) in recognition of childhood and adolescence being such critical periods for influencing lifelong health and wellbeing.

BACKGROUND: Physical activity reduces the risk of morbidity and high sedentary time may be associated with negative health outcomes. The workplace offers an arena to promote physical activity and reduce sedentary time, but existing workplace-based interventions have typically yielded small effects. AIMS: To collate the literature on correlates of occupational physical activity and sedentary behaviour and to inform future novel approaches to workplace-based intervention or policy. METHODS: Systematic literature searches were conducted in December 2014 using multiple databases. Identified papers were screened against an inclusion criterion. Papers were deemed eligible for this review if they included occupational physical activity and sedentary behaviour as an outcome, were quantitative observational studies and included an adult working population. Identified correlates of occupational physical activity and sedentary behaviour were organized into levels of the socioecological model. RESULTS: Forty studies met the inclusion criterion. A higher number of studies included only occupational physical activity, not sedentary time, as an outcome and were carried out in the USA and Australia. The review identified that white-collar workers are at greater risk of low occupational physical activity and high sedentary time. The majority of correlates found to be associated with occupational physical activity and sedentary time were intrapersonal and non-modifiable. CONCLUSIONS: Intervention efforts to increase occupational physical activity and reduce sedentary time may be most effective when targeted at white-collar workers. Research is needed to identify additional modifiable correlates of occupational physical activity and sedentary behaviour, in white-collar workers.

Office-based workers spend a large proportion of the day sitting and tend to have low overall activity levels. Despite some evidence that features of the external physical environment are associated with physical activity, little is known about the influence of the spatial layout of the internal environment on movement, and the majority of data use self-report. This study investigated associations between objectively-measured sitting time and activity levels and the spatial layout of office floors in a sample of UK office-based workers. Participants wore activPAL accelerometers for at least three consecutive workdays. Primary outcomes were steps and proportion of sitting time per working hour. Primary exposures were office spatial layout, which was objectively-measured by deriving key spatial variables: ‘distance from each workstation to key office destinations’, ‘distance from participant’s workstation to all other workstations’, ‘visibility of co-workers’, and workstation ‘closeness’. 131 participants from 10 organisations were included. Fifty-four per cent were female, 81% were white, and the majority had a managerial or professional role (72%) in their organisation. The average proportion of the working hour spent sitting was 0.7 (SD 0.15), participants took on average 444 (SD 210) steps per working hour. Models adjusted for confounders revealed significant negative associations between step count and distance from each workstation to all other office destinations (e.g., B = −4.66, 95% CI: −8.12, −1.12, p &lt, 0.01) and nearest office destinations (e.g., B = −6.45, 95% CI: −11.88, −0.41, p &lt, 0.05) and visibility of workstations when standing (B = −2.35, 95% CI: −3.53, −1.18, p &lt, 0.001). The magnitude of these associations was small. There were no associations between spatial variables and sitting time per work hour. Contrary to our hypothesis, the further participants were from office destinations the less they walked, suggesting that changing the relative distance between workstations and other destinations on the same floor may not be the most fruitful target for promoting walking and reducing sitting in the workplace. However, reported effect sizes were very small and based on cross-sectional analyses. The approaches developed in this study could be applied to other office buildings to establish whether a specific office typology may yield more promising results.

Several industry-led initiatives in various countries demonstrate a new interest in wellbeing and buildings. This paper adopts a scoping review method aiming to establish the most prevalent and insightful definitions and dimensions of wellbeing in buildings applied in the recent published literature. The paper adopts a two-step method for identifying and categorizing the conceptual approaches to wellbeing encountered in the current literature. First, an overview is presented of the term ���wellbeing��� and its development over time. Second, the broad wellbeing categories identified are further refined and complemented via a deductive approach, drawing the final set of conceptual themes informed by the papers reviewed in this study. Nine themes were identified, two of which deductively emerged from the papers included in this study: environmental satisfaction/comfort and cognitive performance/productivity. The findings emphasize the heterogeneity of conceptual approaches to research concerning ���wellbeing in buildings���, an ambiguity between wellbeing outcomes or determinants, and the need for greater clarity on the relative contributions of different wellbeing dimensions to overall individual or population wellbeing. Based on these findings, future work could be carried out to provide guidance on how to evaluate claims of evidence-based building design which foster individual or population wellbeing.

The increasing potential for dramatic climatic changes, the need to protect the future of our energy supply and rising fuel prices, mean that there is an urgent need to reduce energy consumption. This Special Issue of Indoor and Built Environment on ‘People and energy use in the indoor and built environment’ recognises that while buildings account for 32% of total global final energy use, the role of people in buildings’ energy use is often overlooked, despite the fact that ‘buildings don’t use energy: people do.’ The papers in this Special Issue demonstrate a broadening of the social science contribution to understanding energy use in the indoor and built environment. As well as focusing on ‘routine actions’ (or behaviours) using technologies and buildings, many papers presented here focus on ‘one-off actions’ to change technologies or buildings. Several papers go beyond a focus on individual building occupants, to include chains of actors or intermediaries (e.g. landlords) that influence the choice and/or use of technologies or buildings. These papers often also address the processes or chains of actions entailed in introducing new technology or buildings – such as service design or the communication process. Many papers explore the social, economic or technical context for actors and their actions. Most papers explore motivations for actions. Indeed, for many authors in this Special Issue, context is motivation and, combined with existing technologies and buildings, it creates the conditions that virtually require the routine actions that are observed. A few papers report on experiments with relatively ‘deep’ interdisciplinarity; approaches that might help the social and technical sciences learn from each other and so improve our understanding of people and energy use in the indoor and built environment. Three papers focus on the use of technology. Moore et al. note that the installation of heat pumps into homes has traditionally been seen as a purely technical matter, but if heat pumps are not used effectively, they won’t save energy. Examining the installation of domestic heat pumps in UK social housing, they focus on the design of the service to support the user experience of this new technology. Landlords and installers thought heat pumps were too complicated for users and more complicated than necessary. Tenants felt they were given insufficient information on how to use their heat pump, and many lacked confidence using heat pump controls, resulting in feelings of frustration and dependence. However, the authors’ prototype leaflet on using the heat pump controls was not favourably evaluated by users and tenants wanted a personal follow-up visit from the landlord or installer to answer any questions. Belatedly trying to explain how to use a too-complicated technology seems a less-promising approach than developing a technology and its control interface to suit its users. Dimitrokali et al. also examine the use of technology – smart home heating controls. Participants were customers of a UK utility company who volunteered to take part; nearly all were men who felt they had a good understanding of the purpose of smart home heating controls. Participants felt the trial positively changed their heating behaviour but wanted better capacity to control schedules when away from home and personalised tips on how to control their heating. The use of technology is also explored by Watson, focusing on a recently built UK ‘passive design’ office development, featuring a range of natural ventilation technologies and newly inhabited by a tenant organisation. The building was using significantly more energy than predicted, even after a post-occupancy evaluation helped fine-tune the technologies. The author uses social practice theory to understand this ‘performance gap’. Although the material element (technologies) of social practice theory was eventually functioning correctly, this was not the case for the three other elements of the practices framework: embodied habits, engagement (developing shared meaning) and institutionalised knowledge. The habits of building users were deeply

Physical activity levels in children are low and sitting time high, despite the health benefits of regular physical activity and limited sitting. Children spend a large proportion of their time at school, hence school-based interventions targeting physical activity and sitting behaviour may be important. Whilst some aspects of school buildings, their layout and furniture may influence children's physical activity and sitting, these effects could be intertwined with pedagogical approaches. This scoping review aims to identify gaps in the research literature regarding the influence of the indoor school environment on pedagogical approaches and on physical activity and sitting. In primary schools, it was found that physical activity can be integrated into lessons with some benefits on academic behaviour and possibly academic performance. Overall, however, the role of the indoor built environment is poorly investigated, although a handful of studies suggest that a radical change in primary school classrooms may increase physical activity and that stand-biased desks may be promising. This study provides a contribution to the emerging research fields of ‘active design’ from the perspective of indoor school design, highlighting a dearth of research, especially on sitting and for secondary education, and a lack of relevant conceptual frameworks.

Various countries have introduced minimum cooling set-points for air-conditioning either through voluntary or mandatory policies. In the UK, recent recommendations advocate higher summer thermostat settings in offices than formerly, with an indication that 24±2 °C may deliver thermally comfortable environments. However, limited published information exists on the actual summer temperatures maintained in UK air-conditioned offices and on facility managers’ perspectives on imposing limits upon summer set-point (SSP). To address this knowledge gap, an online survey was distributed to facility managers responsible for temperature regulation in UK air-conditioned offices. Over 60% of the respondents report a SSP≤22 °C, indicating potential to raise SSPs. Responses indicate that a recommendation is preferred to a mandatory approach in limiting SSPs, although a mandatory policy is acknowledged as a potentially more effective driver of change. Whilst a mandatory policy on SSP limits may not be welcomed by FMs and would be difficult to enforce, public sector organisations could lead the way in introducing minimum SSPs, as they generally implement higher SSPs than private organisations, are more supportive of such a policy and would accept higher SSPs. Further intervention studies are required to assess the impact on occupants’ expectations and productivity, along with senior management’s perceptions.

Background: Individuals in office-based occupations have low levels of physical activity but there is little research into the socio-ecological correlates of workplace activity. \ud \ud Aims: To identify factors contributing to office-based workers’ perceptions of the office environment and explore cross-sectional relationships between these factors and occupational physical activity and sitting. \ud \ud Methods: Participants in the Active Buildings study reported perceptions of their office environment using the Movement at Work Survey. A principal component analysis (PCA) was conducted on survey items. A sub-sample wore the ActivPAL3TM accelerometer for 3 or more workdays to measure occupational step count, standing, sitting and sit-to-stand transitions. Linear regression analyses assessed relationships between environmental perceptions and activity.\ud \ud Results: There were 433 participants, with accelerometer data available for 115 participants across 11 organisations. The PCA revealed four factors: 1) perceived distance to office destinations, 2) perceived office aesthetics and comfort, 3) perceived office social environment, 4) perceived management discouragement of unscheduled breaks. Younger participants perceived office destinations as being closer to their desk. Younger and female participants perceived more positive office social environments; there were no other socio-demographic differences. Within the sub-sample with accelerometer data, perceived discouragement of breaks by management was related to occupational step count/hour (B=-64.5; 95%CI:-109.7 to -19.2). No other environmental perceptions were related to activity or sitting. \ud \ud Conclusions: Perceived managerial discouragement of breaks could be related to meaningful decreases in occupational step count. Future research should aim to elucidate the role of the workplace socio-cultural environment in occupational walking, with a focus on the role of management.

This Special Issue of Indoor and Built Environment addresses health and wellbeing within the context of the current drive for ‘low-carbon’ buildings – where the term ‘low-carbon’ is used here to include zero or nearly zero carbon/energy approaches. Papers are mainly from invited authors, and a few are extended versions drawn from a relevant Conference of the UK Indoor Environments Group (UKIEG) held in June 2013. All papers were subject to the journal’s peerreview process from authoritative independent experts. Whilst the focus is primarily on the United Kingdom and Europe, and especially on heating-dominated countries, many lessons/issues are also broadly applicable to other climates and regions. This introductory Editorial provides a background overview of the topic, discusses key themes emerging from the papers and argues that the lack in joined-up thinking in the climate change and health policy agendas requires researchers to urgently address one of the main challenges in this field – namely how to ‘sell’ the importance and value of addressing complexity and uncertainty. The intrinsically complex nature of the relationship between health/wellbeing and low-carbon buildings has been discussed for some time in various contexts. Various communities have debated the matter, including the UK Indoor Environments Group (UKIEG), a multidisciplinary network of academic, policy makers and industry concerned with the quality of indoor environments – especially from a health and wellbeing perspective. UKIEG members – some of whom are authors of papers in this Special Issue and have presented at our Conferences – have debated the topic(s) of this Special Issue several times since the UKIEG’s foundation in 2003. These debates have often been accompanied by a great deal of frustration amongst concerns of: (1) a disconnect between the health and the energy/carbon policies; (2) a lack of suitable evidence that current trajectories for low-carbon buildings are sufficiently robust and will provide ‘healthy’ indoor environments (or at least as healthy as current environments). Thus, this Special Issue is timely, not only as a formal contribution to those debates occurring within the UKIEG and other similar groups worldwide, but also because the implementation of the low-carbon buildings agenda is gaining momentum in several countries, both for new builds and retrofits. This means that the question of whether low-carbon buildings are more/ less conducive to health and wellbeing must be addressed urgently. Also, in the past couple of years the first mainstream low-carbon buildings (as opposed to isolated prototypes) have been constructed and inhabited, representing a fantastic opportunity to study the issue in situ. Buildings are responsible for more than 40% of global energy use and one-third of global greenhouse gas emissions both in developed and developing countries. Furthermore, the Building Sector has a large potential for delivering long-term, significant and cost-effective greenhouse gas emission reductions. Consequently, most developed countries and many developing countries have already taken steps to address emissions from the Building Sector, mainly in the form of legislation dictating minimum carbon/ energy standards – especially (but not solely) for new buildings and major renovations. For example, the European Union (EU) ‘Energy Performance of Buildings Directive’ was first published in 2002 (Directive 2002/91/EC), requiring all EU countries to enhance their building regulations and to introduce energy certification schemes for buildings, as well as inspections of boilers and air-conditioners. A further version of the Directive published in 2010 (Directive 2010/31/EU) also included, amongst other things, a move towards new and retrofitted nearly zero energy buildings. As highlighted by several authors in this Issue, the drive for new low-carbon design paradigms

This study investigated the relationships between thermal conditions and perceived learning performance (PLP) by comparing air-conditioned (AC) and fan-assisted naturally ventilated (FANV) environments. The study aimed to provide evidence to support decision-making on the use of fan-assisted natural ventilation in mixed-mode higher education buildings in hot–humid climates. A questionnaire survey on PLP and environmental comfort, including thermal comfort, visual comfort, hearing comfort, perceived air freshness and overall comfort, was conducted in seven typical classrooms. Indoor air temperatures, relative humidity and air velocity in the classrooms were also measured during the period of the survey. When comparing PLP scores between AC and FANV modes, no significant difference was found in PLP of students in the same state of thermal comfort (i.e. neutral and comfortable), except for uncomfortable groups – in which the students in FANV classrooms had significantly lower PLP than those in AC classrooms....

Due to recent studies and government policies, designers and facilities managers are becoming increasingly aware of the role of occupant behaviour in energy conservation in buildings. While the use of post-occupancy surveys and benchmark tools is widespread in the built environment, there is limited research on assessing environmental and energy saving behaviours – particularly in non-domestic buildings. This article focuses on the development and pilot-testing of a novel benchmarking tool for the assessment of behaviour change potential for energy saving in the workplace, with findings from an industrial case study comprising a manufacturing and office environment. Beyond the findings of the case study, the article aims to provide a methodological framework for an easy-to-use benchmarking tool of user-behaviour within the context of energy saving in factories and offices. Practical Implications: This article discusses the development and pilot-testing of a novel questionnaire-based benchmarking tool for the assessment of behaviour change potential for energy saving in office and industrial settings. Its application to a case-study from the manufacturing sector demonstrates that the tool is easy to use, and it provides valuable insights on areas for improvement in energy use within non-domestic buildings, with a focus on user behaviour and management approaches. The tool can be used in applied research, for example in intervention studies for comparison within the same organisation (before and after), and/or for benchmarking against the performance of similar organisations.

Following the Japanese Cool Biz campaign which advocated relaxed dress codes and cooling set-points of 28 °C in air-conditioned public buildings, other countries have introduced similar policies, with temperature limits varying in different countries. In the UK the British Council for Offices suggested that the summer cooling set-points of UK air-conditioned offices should be increased by 2 °C from the previously recommended 22 ± 2 °C. However, these recommendations are largely supported by desk-based analysis rather than using field studies. This paper presents the findings of a blind, controlled intervention study conducted in the summer of 2010 in an office building in London to investigate the effects of increasing the current cooling set-point to 24 °C. The temperature of one floor was changed and compared with a ‘control’ floor where the set-point remained unchanged. The indoor air temperatures were measured at various locations across the floors to monitor the temperatures the occupants were experiencing. The BUS post-occupancy evaluation survey was used to assess occupants’ self-reported comfort and satisfaction, whilst the NEP questionnaire was used to estimate occupants’ environmental attitudes. The findings from statistical analyses of the data collected for all 129 participants suggest that increasing the set-point temperature led to the occupants feeling significantly warmer in comparison with the group at lower temperature settings. Nevertheless, this did not affect the self-reported thermal comfort of the occupants in the intervention group, as depicted by an insignificant difference between the two groups. It was also observed that there is a positive correlation between the occupants’ tolerance of higher indoor air temperatures and their environmental attitudes, indicating that this could play a key role in the acceptance of indoor temperature changes in the UK.

This article discusses the capabilities and the application of an innovative combined hygrothermal and population model to assess the impact of building design and occupant behaviour on house dust mite populations in a mattress. The combined model is the first of its kind able to predict the impact of hourly transient hygrothermal conditions within a 3-dimensional mattress on a population of 'wild' Dermatophagoides pteronyssinus mites. The modelling shows that the current drive for energy efficiency in buildings might lead to an increase in house dust mite infestations in UK dwellings. Further research is needed to accurately determine the size of these effects and to adequately evaluate any trade-offs between energy efficiency measures and health outcomes.

Domestic winter indoor temperatures in the USA, UK and other developed countries appear to be following an upwards trend. This review examines evidence of a causal link between thermal exposures and increases in obesity prevalence, focusing on acute and longer-term biological effects of time spent in thermal comfort compared with mild cold. Reduced exposure to seasonal cold may have a dual effect on energy expenditure, both minimizing the need for physiological thermogenesis and reducing thermogenic capacity. Experimental studies show a graded association between acute mild cold and human energy expenditure over the range of temperatures relevant to indoor heating trends. Meanwhile, recent studies of the role of brown adipose tissue (BAT) in human thermogenesis suggest that increased time spent in conditions of thermal comfort can lead to a loss of BAT and reduced thermogenic capacity. Pathways linking cold exposure and adiposity have not been directly tested in humans. Research in naturalistic and experimental settings is needed to establish effects of changes in thermal exposures on weight, which may raise possibilities for novel public health strategies to address obesity.

The risks associated with climate change, resource scarcity, overreliance on fossil fuels, rising fuel prices and the threats to national securities are all compelling reasons for finding alternative/greener energy sources as well as for reducing our energy consumption. For the demand side, energy efficiency has been the main strategy utilised so far; in buildings, this often means a focus on technologies capable of delivering the same or better levels of comfort, with less energy. In the last decade, however, there has been an increasing awareness that technology and engineering alone do not deliver the expected energy savings, often because of the ‘misuse’ and/or ‘abuse’ of such energy efficient technologies from building users. Hence, greater attention is being paid to occupant behaviour, both in research and policy circles. The role of behaviour and behaviour change within the context of energy reduction can be grouped under two themes/strategies: (1) Ensuring that existing and new energy efficient technologies are adopted, and used appropriately; (2) Exploring to what extent people are willing to ‘conserve energy’ by using less of a product and/or accepting lower comfort levels. These two themes were partly captured in the title of a recent international Conference held in Oxford: Behave 2014 – Paradigm Shift: From Energy Efficiency to Energy Reduction through Social Change. Yet even at this Conference there was a prevalence of papers focused around the energy efficiency paradigm and the question: to what extent people should be nudged, persuaded or coerced into conserving energy? was not, in my view, adequately touched upon or debated. This is perhaps unsurprising, when considering that asking people not to aspire to high comfort levels may be unappealing for policy makers. In fact, many communication and public relations companies specialising in sustainability and climate change highlight the need for ‘positive messages’, avoiding gloomy pictures or end of the world scenarios, focusing instead on positive/happy stories and on what people can do (as opposed to what they should not do) – ideally also referring to additional benefits arising from saving energy. This is a very appealing notion, but also one with hidden complexities. The rebound effect is a fairly well-known potential side-effect of energy efficiency, where the financial savings arising from the new technology/service can incentivise greater use of the technology/service itself (e.g. greater indoor temperatures arising from home insulation), or lead to lower energy prices, which in turn can increase energy use. Whilst the question of whether rebound effects can altogether outweigh any savings arising from energy efficiency is being debated, clearly these effects should be minimised. This, however, can be difficult if the trade-offs between comfort and energy use are not adequately acknowledged. On the contrary, many energy saving interventions are ‘sold’ to the public on the basis of added benefits, such as saving money and greater thermal comfort – as in the case of home insulation measures. Inevitably, these approaches can embed expectations for higher thermal comfort, regardless of the fact that greater levels of comfort, whilst perhaps desirable, may in fact not be needed in some cases. The need to disambiguate the trade-offs between comfort and energy is apparent in the findings of a recent randomised controlled trial aiming to test whether tailored advice from a ‘trusted messenger’ on how to use heating controls can reduce energy consumption. The study, commissioned by the UK’s Department of Energy and Climate Change (DECC), found that the use of in-home advice or informative leaflets within social housing did not significantly