A growing number of patients are presenting to NHS hospitals with post-operative complications following cosmetic surgery and non-surgical procedures performed in the UK. A retrospective cross-sectional review of electronic records in patients presenting with cosmetic surgery/procedure complications was conducted at a London hospital across 17 months, and a patient survey was used to establish motivations for treatment. 96% of surgical patients presenting with complications had their procedure performed abroad, with the majority performed in Turkey (73%). 67% of non-surgical patients had their procedure performed in the UK; 22% were BBLs. Total cost of complications was estimated at £110,690.00. Cheaper cost was the motivating factor for four of seven respondents to the survey in seeking procedures abroad. Going forward it is important to educate the public on the dangers of cosmetic tourism, and we urge the government to bring about legislative change to improve regulation in a highly unregulated non-surgical market within the UK.

The planktonic copepod, Calanus finmarchicus, plays a pivotal role in the Gulf of Maine (GoM) pelagic food web as a primary food source for many species, including the critically endangered North Atlantic right whale (NARW). Thus, observing C. finmarchicus on a Gulf-wide scale via satellite could be beneficial for understanding changes in the migration patterns of the NARW. This study investigated the application of ocean color remote sensing to detect the surface population levels of C. finmarchicus in the GoM. Using remote sensing reflectance data from the MODIS Aqua sensor, we processed enhanced RGB (eRGB) imagery to detect and quantify the presence of C. finmarchicus, which is identifiable by its red astaxanthin pigment. This study employed a refined approach from the method originally developed off the coast of Norway, which integrates eRGB imagery and radiative transfer modeling to generate optical anomaly maps that are used for quantifying surface C. finmarchicus concentrations in the GoM. We detected surface swarms of C. finmarchicus in the ocean color imagery and estimated their concentrations. However, due to the method’s reliance on astaxanthin/red pigment-based detection, other astaxanthin-rich red/brown plankton were misidentified as C. finmarchicus. While the approach presented is effective for identifying astaxanthin anomalies in ocean color and holds potential for quantifying the surface populations of C. finmarchicus, it requires local knowledge to accurately quantify the C. finmarchicus abundances.

Autonomous underwater vehicles provide water column observations of phytoplankton biomass using chlorophyll a (Chl a) fluorometers. However, under high incident light, phytoplankton fluorescence yield decreases in a process known as non-photochemical quenching, resulting in a reduced Chl a fluorescence signal. Methods have been developed to identify and remove the quenched signal from observations by autonomous underwater vehicles. These existing methods rely on assumptions of the homogeneity of the system, both in terms of time (i.e., between day and night observations) and space (i.e., within the water column or between neighboring profiles). These assumptions are not valid in shallow shelf seas or when sampling across different water masses. Thus, we evaluate six new quenching correction methods based on an existing ocean-based method, but adapted for a continental shelf sea environment where the water mass changes between night and day observations. We have included two main changes to the existing method. First, we interpolate the unquenched, nighttime signal across the daytime observations and use this as a reference for correcting the quenched, daytime signal. Second, we explore the inclusion of a fluorescence quenching depth limit. By interpolating nighttime observations across daytime periods, the diel changes in non-photochemical quenching were separated from the phytoplankton population changes. The proposed methods all show improved performance compared to existing approach. The methods presented here, and the approach used to evaluate them, are applicable in other shelf sea environments, enabling studies using autonomous Chl a fluorescence data across shelf sea ecosystems.

Policy entrepreneurship theory seeks to explain how actors, institutions, actions and interactions influence policy makers and policy outcomes; however, the role of citizens in this process remains largely unarticulated. Adopting a conception of policy entrepreneurship as a (distributed) pattern of agency rather than the actions of an individual, we analyse the development of local government climate emergency declarations (CEDs) (many of which visibly involved citizen advocacy). This analysis expands on the role of citizens in policy change and provides evidence of how citizen entrepreneurs interact collaboratively with more traditional forms of policy elites, in this case local elected representatives. Since 2018 hundreds of local governments in the United Kingdom (UK) have issued CEDs in a surge of expressions of local climate ambition. Whilst CEDs have attracted attention from scholars, the underlying dynamics and politics which drove the adoption of these policies, including the role played by citizens, remain unexplored in the literature. Interviews with councillors, council officers, and citizens reveal that citizens carry out a range of activities related to policy entrepreneurship, including problem framing, identifying solutions, networking and building coalitions, and seeking attention and opportunities. We find that they carry out these activities collectively with other citizens and collaboratively with elected representatives; whilst precise coalition-internal dynamics vary, citizens frequently exploit opportunities to demonstrate the strength and breadth of public support for their cause.

FAQ 13.1:What roles do national play in climate mitigation, and how can they be effective? 1413 FAQ 13.2:What policies and strategies

The Gulf of Maine North Atlantic Time Series (GNATS) has been run since 1998, across the Gulf of Maine (GoM), between Maine and Nova Scotia. GNATS goals are to provide ocean color satellite validation and to examine change in this coastal ecosystem. We have sampled hydrographical, biological, chemical, biogeochemical, and bio-optical variables. After 2008, warm water intrusions (likely North Atlantic Slope Water [NASW]) were observed in the eastern GoM at 50-180 m depths. Shallow waters (<50 m) significantly warmed in winter, summer, and fall but cooled during spring. Surface salinity and density of the GoM also significantly increased over the 20 years. Phytoplankton standing stock and primary production showed highly-significant decreases during the period. Concentrations of phosphate increased, silicate decreased, residual nitrate [N*; nitrate-silicate] increased, and the ratio of dissolved inorganic nitrogen:phosphate decreased, suggesting increasing nitrogen limitation. Dissolved organic carbon (DOC) and its optical indices generally increased over two decades, suggesting changes to the DOC cycle. Surface seawater carbonate chemistry showed winter periods where the aragonite saturation (Ωar) dropped below 1.6 gulf-wide due to upward winter mixing of cool, corrosive water. However, associated with increased average GoM temperatures, Ωar has significantly increased. These results reinforce the hypothesis that the observed decrease in surface GoM primary production resulted from a switch from Labrador Sea Water to NASW entering the GoM. A multifactor analysis shows that decreasing GoM primary production is most significantly correlated to decreases in chlorophyll and particulate organic carbon plus increases in N* and temperature.

The UK’s energy transition path has been shaped by a legacy of fossil fuel use across electricity generation, transport and heat, but also by the institutions and ideas that make up the governance of energy. Some important elements, such as a market-led policy paradigm and the delegation of regulation to arm’s-length bodies, are the result of privatization in the 1980s. Others, such as a heavily centralized, supply-led power sector and a resilient nuclear lobby, are continuities from an earlier period. This governance system, strongly concentrated within central government, was challenged in a major way in the 2000s by a wave of concern about climate change. This driver has meant that the UK energy transition has been primarily about emissions reduction, rather than specific technologies such as renewable energy, whose expansion in the UK has largely been the result of European-level policy. With a preference for incentive-based and internalizing instruments over direct regulation arising from the market-led paradigm, the UK has managed to bring about a major decline in power sector emissions and some increase in renewable energy, especially in electricity generation, while at the same time trying to support a program of new nuclear build. However, as the country now enters the next phase of transition, involving integration of intermittent renewables into electricity sector systems and institutions, and of transport and heat into electricity, the coherence of policy, clarity of direction, and coordination of regulatory change are all open to question.

Energy systems around the world are in a riveting development. A significant increase of wind energy is expected globally, and the technology will start to play a new role—that of a dominant market player as a backbone of the overall energy system. Wind energy development has always been strongly policy-driven, and we expect this to continue in the future. Policies employed for wind energy range from basic R&D to direct investment support, and include fiscal incentives, production-based support, public finance mechanisms and regulations. Sharp cost declines will diminish the need for production-based support payments for wind energy in some countries, but this does not mean that policy challenges around wind energy will disappear or even reduce—they merely change their nature as compared to the earlier days of technology introduction. Long-term, adequate and consistent policies that flexibly adjust to new circumstances will be crucial to attract future private investment in the technology. Policy frameworks need to be systematically developed to reduce risks and enable stable returns. A mix of policy instruments will be required, targeting not only the deployment of wind energy itself, but also the whole energy system and market designs, supplementary technologies and infrastructure, as well as an enabling environment.

The design of electricity markets determines the technologies, services and modes of operation that can access value, consequently shaping current and future electricity landscapes. This paper highlights that the efficacy of Great Britain's electricity market design in facilitating net zero is inadequate and must be reconfigured. The rules of the current electricity market design are remnants of an electricity sector dominated by large-scale, centralised, fossil fuel technologies. Therefore, routes to market for the provision of necessary services to support net zero, not least flexibility, are largely inaccessible for distributed energy resources and, despite their benefits to the system, are thus undervalued. Based upon a review and consolidation of 30 proposed electricity market designs from liberalised electricity sectors, this paper proposes a new electricity market design for Great Britain. This design is presented alongside a new institutional framework to aid in the efficient operation of the market. Specifically, this paper proposes a new local balancing and coordinating market located at each grid supply point (the transmission and distribution interface). This is realised through the implementation of a distributed locational marginal pricing structure which is governed by the evolution of the current distributed network operator, known as the distributed service provider (DSP). The DSP also operates a local balancing and ancillary market for their geographical area. The wholesale market is reconfigured to coordinate with these new local markets and to harmonise the actors across the distribution and transmission network.

There are multiple ways to meet the 2°C reduction target of the Paris Agreement and to reach a ‘deep decarbonisation’ of our economies, including a reduction of primary energy consumption, the use of low-emission generation technologies such as nuclear power, or the use of carbon capture and storage. However, the most likely and cost-effective path of decarbonisation is that of renewables supplying the majority of electricity, if not the entirety (GEA 2012; IPCC 2015; Greenpeace 2015) alongside significant energy efficiency measures, whether minimising energy use in buildings through retrofit programmes or via the markets, ensuring the demand side is as valuable as the supply side. That will require not only new policies and significant changes in incentive schemes for generators and the associated grid infrastructure, but also a more

“Everyone knows that renewable energy’s time has come. An increasingly important issue relates to decentralised resources, and how to use them most efficiently. Governance frameworks and developing new business models are important for both. This book uniquely takes a global view of these intertwined issues, and is a fascinating read for anyone interested in the acceleration of GHG reduction and in coordination factors for a cost effective energy policy.”— Dan Kammen, Professor and Chair, Energy and Resources Group, UC Berkeley, Former Science Envoy, US Department of State Dectralised Eergy – a Gobal Game Cnger Brger, Frggatt, Mchell nd Wnmann (ds.) Decentralised Energy a Global Game Changer

The three phases of the energy transformation -combining governance and business model innovationThis chapter merges the findings of the two preceding chapters -on the importance of governance and the simultaneous development of business models -in moving from the conventional, fossil fuel-based energy system to one that is decentralised, renewable and based on energy efficiency.It highlights characteristics of three distinct phases during that transition and concludes that it is vital to align governance (policies, network rules, market rules, institutions etc.) with flexible system operation to achieve a smooth transition.In the context of developing countries with incomplete grid infrastructure, regulatory incentives and business initiatives may lead to a leapfrogging effect from Phase I to Phase III, though.

The current transformation of energy systems around the world is fundamentally a policy-driven process, unlike previous socio-technical transitions. This article focuses on the challenges of constructing forward-looking policies for sustainable energy transitions in the presence of powerful incumbent interests, through an in-depth study of how the emerging option of demand-side response (DSR) was incorporated into the Capacity Market (CM) for electricity in Great Britain over the period 2010 to 2014. Drawing on extensive documentation related to the development of the CM rules and interviews with participants and close observers of the process, the paper provides an unusually detailed assessment of the influence of companies with large electricity generation assets. The evidence presented supports the hypotheses that these companies had influence through deploying public facing strategies, that they had been able to draw on close networks of contacts and networks with senior policy makers, and that the latter had internalised the ideas and interests of the former. Despite counter-lobbying by DSR firms and non-governmental organisations, institutional arrangements gave major generators an advantage in terms of access. The paper concludes by recommending the establishment of independent bodies to propose policies and monitor the process of their development during energy system transformations.

Energy systems are changing all over the world.In the United States of America (USA), the different states follow very different energy policies.Some are at the forefront of global energy policy thinking, including California (CA) and New York state (NYS).However, CA and NYS, whilst both progressive in terms of greenhouse gas (GHG) reduction policies, have very different principles underlying their energy system governance 29 and therefore implement their energy policies in very different ways.CA is one of the world's earliest movers in terms of energy system transformation and, on most metrics, outperforms NYS.However, NYS in 2014 put in place the New York Reforming the Energy Vision (NY REV), and although it is too early to judge how successful it is, it has introduced new ideas and arguments about the necessary governance constituents for energy system transformation, and is acting as a first mover in certain significant ways. 28Work undertaken as a result of the UK EPSRC IGov Research award http://projects.exeter.ac.uk/igov/; and thanks to Carl Linvill of RAP, and Rudi Stegemoeller, ex

•We apply financial risk, transaction cost, innovation and social welfare considerations to sustainability transitions.•We analyze optimal choice between price and quantity instruments for support of emerging technologies.•The dynamic nature of risk implies changes in optimal instrument choice during sustainability transition process.•Price instruments seem optimal at first, then quantity control could take over with flattening marginal costs.•Solar PV in Germany as case, where auctions (a form of quantity control) succeeded feed-in tariffs (price instrument).

(1) The increasing competitiveness of renewable energy generation in liberalised markets – meeting grid parity and heading towards energy system parity: renewable energies have attracted major investments in industrialised countries with an established and reliable energy system. As costs have fallen, the motivation to install solar and wind power units in these countries has shifted from publicly sponsored incentive schemes to grid parity and attractive financing models even without subsidies and government aid. (2) The global spread of decentralised energy generation: since 2010, cumulative investment in distributed capacity has been around US$400 billion, moving energy supply onto rooftops and smaller acreages. Not only is this provision of services, but in countries such as Germany, Italy, or Australia community-owned initiatives have also become engaged in ownership or operation of grid infrastructure. (3) Decentralised storage gaining importance: storage via batteries is a key technology to increase flexibility and adapt the energy supply system to intermittent renewable generation. Advances in storage

In 2014, the European Council set energy and climate targets for 2030 that will have far-reaching implications for the decarbonisation of Europe's economy as well as the nature and success of the energy integration project, the Energy Union. The targets mark a qualitative shift towards a more technology-neutral EU climate and energy policy than represented in targets for 2020, decided in 2007. Existing explanations emphasise the role of non-state actors but do not fully account for the muted advocacy for a multiple targets approach. This article examines the alternative explanatory power of the concepts of problem surfing and spillover, taken from the multiple streams approach, for interpreting the inability of multiple targets advocates to make a real impact on the policy agenda. Findings suggest that the problematisation of the EU's 'flagship' instrument, the EU-ETS, by policy entrepreneurs and subsequent structural internal alignment of the policy community offer a complementary explanation.