6,291 research outputs found
Proceedings of the 10th International congress on architectural technology (ICAT 2024): architectural technology transformation.
The profession of architectural technology is influential in the transformation of the built environment regionally, nationally, and internationally. The congress provides a platform for industry, educators, researchers, and the next generation of built environment students and professionals to showcase where their influence is transforming the built environment through novel ideas, businesses, leadership, innovation, digital transformation, research and development, and sustainable forward-thinking technological and construction assembly design
A tailored psychological intervention for anxiety and depression management in people with chronic obstructive pulmonary disease: TANDEM RCT and process evaluation
Background: People with chronic obstructive pulmonary disease have high levels of anxiety and depression, which is associated with increased morbidity and poor uptake of effective treatments, such as pulmonary rehabilitation. Cognitive-behavioural therapy improves mental health of people with long-term conditions and could potentially increase uptake of pulmonary rehabilitation, enabling synergies that could enhance the mental health of people with chronic obstructive pulmonary disease. Aim: Our aim was to develop and evaluate the clinical effectiveness and cost effectiveness of a tailored cognitive-behavioural approach intervention, which links into, and optimises the benefits of, routine pulmonary rehabilitation. Design: We carried out a pragmatic multicentre randomised controlled trial using a 1.25 : 1 ratio (intervention : control) with a parallel process evaluation, including assessment of fidelity. Setting: Twelve NHS trusts and five Clinical Commissioning Groups in England were recruited into the study. The intervention was delivered in participant\u27s own home or at a local NHS facility, and by telephone. Participants: Between July 2017 and March 2020 we recruited adults with moderate/very severe chronic obstructive pulmonary disease and mild/moderate anxiety and/or depression, meeting eligibility criteria for assessment for pulmonary rehabilitation. Carers of participants were invited to participate. Intervention: The cognitive-behavioural approach intervention (i.e. six to eight 40- to 60-minute sessions plus telephone support throughout pulmonary rehabilitation) was delivered by 31 trained respiratory healthcare professionals to participants prior to commencing pulmonary rehabilitation. Usual care included routine pulmonary rehabilitation referral. Main outcome measures: Co-primary outcomes were Hospital Anxiety and Depression Scale - anxiety and Hospital Anxiety and Depression Scale - depression at 6 months post randomisation. Secondary outcomes at 6 and 12 months included health-related quality of life, smoking status, uptake of pulmonary rehabilitation and healthcare use. Results: We analysed results from 423 randomised participants (intervention, n = 242; control, n = 181). Forty-three carers participated. Follow-up at 6 and 12 months was 93% and 82%, respectively. Despite good fidelity for intervention delivery, mean between-group differences in Hospital Anxiety and Depression Scale at 6 months ruled out clinically important effects (Hospital Anxiety and Depression Scale - anxiety mean difference -0.60, 95% confidence interval -1.40 to 0.21; Hospital Anxiety and Depression Scale - depression mean difference -0.66, 95% confidence interval -1.39 to 0.07), with similar results at 12 months. There were no between-group differences in any of the secondary outcomes. Sensitivity analyses did not alter these conclusions. More adverse events were reported for intervention participants than for control participants, but none related to the trial. The intervention did not generate quality-of-life improvements to justify the additional cost (adjusted mean difference \ua3770.24, 95% confidence interval -\ua327.91 to \ua31568.39) to the NHS. The intervention was well received and many participants described positive affects on their quality of life. Facilitators highlighted the complexity of participants\u27 lives and considered the intervention to be of potential valuable; however, the intervention would be difficult to integrate within routine clinical services. Our well-powered trial delivered a theoretically designed intervention with good fidelity. The respiratory-experienced facilitators were trained to deliver a low-intensity cognitive-behavioural approach intervention, but high-intensity cognitive-behavioural therapy might have been more effective. Our broad inclusion criteria specified objectively assessed anxiety and/or depression, but participants were likely to favour talking therapies. Randomisation was concealed and blinding of outcome assessment was breached in only 15 participants. Conclusions: The tailored cognitive-behavioural approach intervention delivered with fidelity by trained respiratory healthcare professionals to people with chronic obstructive pulmonary disease was neither clinically effective nor cost-effective. Alternative approaches that are integrated with routine long-term condition care are needed to address the unmet, complex clinical and psychosocial needs of this group of patients. Trial registration: This trial is registered as ISRCTN59537391. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 13/146/02) and is published in full in Health Technology Assessment; Vol. 28, No. 1. See the NIHR Funding and Awards website for further award information.People with long-standing lung problems, such as chronic obstructive pulmonary disease, often also have anxiety and depression, which further reduces their quality of life. Two existing treatments could help. Pulmonary rehabilitation (a programme of exercise and education) improves both the physical and mental health of people with chronic obstructive pulmonary disease. Cognitiveâbehavioural therapy (a talking therapy) may reduce anxiety and depression. The TANDEM [Tailored intervention for Anxiety and Depression Management in chronic obstructive pulmonary disease (COPD)] intervention linked these two treatments by providing talking therapy based on cognitiveâbehavioural therapy during the waiting time following referral for pulmonary rehabilitation. The TANDEM treatment was delivered by respiratory healthcare professionals (e.g. nurses or physiotherapists) trained to deliver the talking therapy in six to eight weekly sessions. The sessions were conducted in the participantâs home (or another convenient location), with brief telephone support during the pulmonary rehabilitation. Of 423 participants recruited to the study, 242 participants received TANDEM talking therapy and 181 participants received usual care (including a referral to pulmonary rehabilitation). We measured mental health, quality of life, social life, attendance at pulmonary rehabilitation and healthcare use in both groups at 6 and 12 months. Forty-three carers joined the study and we assessed their mental well-being. We interviewed patients, carers and health professionals to find out their views and experience of the TANDEM treatment. We also examined whether or not the TANDEM treatment was good value for money. The TANDEM treatment did not improve the mental or the physical health of people with chronic obstructive pulmonary disease. In addition, the TANDEM treatment cost the NHS an extra \ua3770 per patient, which was not good value for money. The TANDEM treatment was well received, and many participants told us how it had helped them. Heath-care professionals noted how participants did not just have chronic obstructive pulmonary disease, but were coping with many physical, mental and social problems. The TANDEM intervention was not effective and, therefore, other strategies will be needed to help people with chronic obstructive pulmonary disease and mental health problems live with their condition
Direct measurement of coating thermal noise in the AEI 10m prototype
A thermal noise interferometer for the characterization of thermal noise in high reflectivity mirrors has been commissioned and first direct measurements of coating thermal noise have been performed. This serves as an important step in the improvement of current and future gravitational wave detectors
Innovation in Energy Security and Long-Term Energy Efficiency â Ą
The sustainable development of our planet depends on the use of energy. The increasing world population inevitably causes an increase in the demand for energy, which, on the one hand, threatens us with the potential to encounter a shortage of energy supply, and, on the other hand, causes the deterioration of the environment. Therefore, our task is to reduce this demand through different innovative solutions (i.e., both technological and social). Social marketing and economic policies can also play their role by affecting the behavior of households and companies and by causing behavioral change oriented to energy stewardship, with an overall switch to renewable energy resources. This reprint provides a platform for the exchange of a wide range of ideas, which, ultimately, would facilitate driving societies toward long-term energy efficiency
Synthetic Aperture Radar (SAR) Meets Deep Learning
This reprint focuses on the application of the combination of synthetic aperture radars and depth learning technology. It aims to further promote the development of SAR image intelligent interpretation technology. A synthetic aperture radar (SAR) is an important active microwave imaging sensor, whose all-day and all-weather working capacity give it an important place in the remote sensing community. Since the United States launched the first SAR satellite, SAR has received much attention in the remote sensing community, e.g., in geological exploration, topographic mapping, disaster forecast, and traffic monitoring. It is valuable and meaningful, therefore, to study SAR-based remote sensing applications. In recent years, deep learning represented by convolution neural networks has promoted significant progress in the computer vision community, e.g., in face recognition, the driverless field and Internet of things (IoT). Deep learning can enable computational models with multiple processing layers to learn data representations with multiple-level abstractions. This can greatly improve the performance of various applications. This reprint provides a platform for researchers to handle the above significant challenges and present their innovative and cutting-edge research results when applying deep learning to SAR in various manuscript types, e.g., articles, letters, reviews and technical reports
âHave patients with chronic skin diseases needs been met?â:A thesis on psoriasis and eczema patient care in dermatology service
Background: Common chronic skin diseases such as eczema and psoriasis usually require long term medical care. They are often associated with psychological and metabolic comorbidities, which can impact on patient quality of life (QOL) and on the self-management of these diseases. Regular assessment of patient needs, comorbidities and feedback is a critical step in the development of decision-analytic models. Currently, no intervention is available to regularly assess such patientsâ needs and comorbidities and support their involvement in the decision-making and self-management of their morbidity and comorbidities. The aim of this research is to involve the patients in decision making of their care and to support their self-management by the use of a paper questionnaire (study tool) at each consultation. Objective: To explore the acceptability and potential of a self-developed paper questionnaire that constituted a study tool for addressing the needs, comorbidities, and feedback of patients with psoriasis and eczema and supporting their involvement in decision making and self-management of their chronic conditions. Method: A mixed method study was conducted and included a postal survey on adult male and female patients with psoriasis and eczema, using the study tool, which is a paper questionnaire and contains the Dermatology Life Quality Index (DLQI) and seven supplementary open-ended questions to capture patientsâ views, feedback, comorbidities, coping status and needs. The survey was followed by semi-structured face-to-face interviews with a sample of the patients who had participated in the survey. The aims of the interviews were two-fold: 1. to gain a deeper understanding of their experience of living with and managing their skin disease; and 2. to gather patient feedback on the service they received as well as their views on using the new study tool or any alternative intervention to address and support their self-management. The final study was a pilot which involved presenting a proposal of an online version of the study tool to a group of healthcare experts asking them to critically review the extent to which the online model responded to patients expressed needs. Results: Of the 114 patients who participated in the postal survey 108 (94.7%) of them expressed physical, metabolic and psychological comorbidities. Stress was identified as the dominant disease-triggering factor in 72 (63%) participants. Thirty-three (28.9%) of participants reported that they could not cope with their chronic illness. Eighteen (15.7%) participants suffered from anxiety, and 12 (10.5%) had depression and suicidal thoughts. Twenty-nine (25%) participants addressed their needs for support at home, and 16 (14%) of them asked for support at work. In the patient feedback section, 21 (18.4%) and 9 (7.8%) participants rated the service they received from their general practitioner (GP) and dermatologist as poor, respectively. In the interviews, all the participants 22 (100%) welcomed the use of the study tool on a regular basis to address their needs, comorbidities and feedback. Nineteen (86.3%) of them suggested that they would prefer using an online version of the tool or patient portal system as a convenient way of remote and interactive communication with the healthcare provider, particularly during the worsening of their skin condition. In the final pilot study, the healthcare experts agreed that the proposed online version of the study tool could be a convenient platform for such patients to support their self-management. They discussed the potential importance of such a tool if it provided them with access to supportive services such as patient information on skin diseases and self-management, access to local mental health service and other relevant psoriasis and eczema patientsâ support groups and charities. Conclusion: This novel mixed method research identified knowledge gaps in managing patients with psoriasis and eczema. It provided a new tool that has the potential to regularly engage and assess patientsâ unmet needs, comorbidities and feedback. The tool can involve patients in decision-making and offers them the autonomy to disclose heterogeneous needs that may support their self-management. All the interviewees welcomed regular use of the study tool and the majority of them suggested that they would prefer using an online version of the tool if it was available. Future research is needed to assess the impact of the study tool in filling important gaps in patient self-management and in health service improvement
Tradition and Innovation in Construction Project Management
This book is a reprint of the Special Issue 'Tradition and Innovation in Construction Project Management' that was published in the journal Buildings
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Shared Leadership in Top Teams. A Study of Nonprofit Federated Board Leadership
This study explores the complex nature of nonprofit board leadership in two boards in one UK charitable federation. It employs a constructionist epistemology and a hybrid analytical approach of thematic analysis, positioning, and leadership differentiated in the interplay between individual action and interdependent leadership. Analysis of three data sources (18 trustee interviews, observation of 3 board meetings, and 39 archival documents) reveal three themes: âapplying accountabilityâ, âengaging with team tensionsâ, and âmanaging resourcesâ. Two storylines also emerge: âseizing a commercial opportunityâ and âdeveloping a new serviceâ. External to these boards, 15 interviews and 3 meetings inform an analytical description of the âcase organisationâ.
Findings from this âinterpretive sensemakingâ case study (Welch et al., 2011) show multiple ways in which leadership occurs. Trusteesâ experience of leadership in talk and in their interactions in negotiation illustrate the kind of leadership agency they adopt when taking responsibility for multiple forms of accountability to clients, tasks, and external entities. Human agency is illuminated in trustees experience of leadership as they act as âinnovative agentsâ and âconstructive integratorsâ. In particular how they balance between innovation and integration. The proposed board leadership framework integrates the individual and team aspects. It conceptually relates the elements of agency as a discursive presentation and the practice of accountability with positioning through which insights make visible the âsharedâ leadership of two teams that constitute trustee boards. This study departs from the positivist orientation of much nonprofit board research to contribute insights of everyday leadership from a rare interpretive perspective. It further contributes to studies and increasing interest in positioning theory, position-oriented analysis, and innovative methodological hybrid analytical approaches. Finally, it contributes to empirical studies of shared leadership (Pearce and Conger, 2003). In particular, the dynamic, temporal, and temporary nature of the concept in ârealâ life settings.
While extant literature of nonprofit board leadership from a positivist orientation offers an important body of work, little attention has been given to how leadership actually occurs in practice. To this end, the theoretical focus of positioning theory helps to illuminate the everyday interactions and discourses through which leadership is enacted
Improving approaches to material inventory management in construction industry in the UK
Materials used in construction constitute a major proportion of the total cost of construction projects. An important factor of great concern that adversely affects construction projects is the location and tracking of materials, which normally come in bulk with minimal identification. There is inadequate integration of modern wireless technologies (such as Radio Frequency Identification (RFID), Personal Digital Assistant (PDA) or Just-in-Time (JIT)) into project management systems for easier and faster materials management and tracking and to overcome human error. This research focuses on improving approaches to material inventory management in the UK construction industry through the formulation of RFID-based materials management tracking process system with projects.
Existing literature review identified many challenges/problems in material inventory management on construction projects, such as supply delays, shortages, price fluctuations, wastage and damage, and insufficient storage space. Six construction projects were selected as exploratory case studies and cross-case analysis was used to investigate approaches to material inventory management practices: problems, implementation of ICT, and the potential for using emerging wireless technologies and systems (such as RFID and PDA) for materials tracking. Findings showed that there were similar problems of storage constraints and logistics with most of the construction projects. The synthesis of good practices required the implementation of RFID-facilitated construction management of materials tracking system to make material handling easier, quicker, more efficient and less paperwork. There was also a recommendation to implement Information and Communication Technology (ICT) tools to integrate plant, labour and materials into one system.
The findings from the cases studies and the literature review were used to formulate a process for real-time material tracking using Radio Frequency Identification (RFID) that can improve material inventory management in the UK construction industry. Testing and validation undertaken assisted in formulating a process that can be useful, functional and acceptable for a possible process systemâs development. Finally, research achievements/contributions to knowledge, and limitations were discussed and some suggestions for further research were outlined
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