New guidance for the use of concrete in maritime engineering

This paper presents an overview of project that aims to deliver an up-to-date, self-supported and decision aiding guidance on the use of concrete for design / construction / repair and maintenance of maritime structures. Some of the key findings relevant to navigation structures are detailed

The value of personalized psychosocial interventions to address behavioral and psychological symptoms in people with dementia living in care home settings: A systematic review

This is the author accepted manuscript. the final version is available from Cambridge University Press via the DOI in this recordBackground: Several important systematic reviews and meta-Analyses focusing on psychosocial interventions have been undertaken in the last decade. However, they have not focused specifically on the treatment of individual behavioral and psychological symptoms of dementia (BPSD) with personalized interventions. This updated systematic review will focus on studies reporting the effect of personalized psychosocial interventions on key BPSD in care homes. Methods: Systematic review of the evidence for psychosocial interventions for BPSD, focusing on papers published between 2000 and 2012. All care home and nursing home studies including individual and cluster randomized controlled trials (RCTs) and pre-/post-Test studies with control conditions were included. Results: 641 studies were identified, of which 40 fulfilled inclusion and exclusion criteria. There was good evidence to support the value of personalized pleasant activities with and without social interaction for the treatment of agitation, and reminiscence therapy to improve mood. The evidence for other therapies was more limited. Conclusions: There is a growing body of evidence indicating specific effects of different personalized psychosocial interventions on individual BPSD and mood outcomes. Copyright © International Psychogeriatric Association 2014

UK sustainable drainage systems: past, present and future

Urban drainage has developed from an engineering discipline, concerned principally with public health and safety outcomes, into a multifaceted vision linking drainage with environmental and wider social and economic imperatives to deliver multifunctional outcomes. UK attention is too often focused on surface water as ‘a problem’, despite international progress and initiatives showing that an ‘opportunity-centred’ approach needs to be taken. Sustainable drainage systems, or ‘Suds’, can, when they are part of an integrated approach to water management, cost-effectively provide many benefits beyond management of water quality and quantity. New tools are available that can design Suds for maximum value to society but this requires greater collaboration across disciplines to seize all of the opportunities available. This paper introduces those tools and a roadmap for their use, including guidance, design objectives and criteria for maximising benefits. These new supporting tools and guidance can help to provide a business case for greater use of Suds in future

Apathy and Its Response to Antipsychotic Review and Nonpharmacological Interventions in People With Dementia Living in Nursing Homes: WHELD, a Factorial Cluster Randomized Controlled Trial

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordObjectives Apathy is common, impactful, and difficult to manage in people with dementia. We evaluated the efficacy of nonpharmacological interventions, exercise, and social interaction, in combination with antipsychotic review, to reduce apathy in people with dementia living in nursing homes in a cluster randomized controlled trial (RCT). Methods Well-being and health for people with dementia (WHELD) program included a 2 × 2 × 2 factorial cluster RCT involving people with dementia living in 16 nursing homes in the United Kingdom. All homes received training in person-centered care, and were randomized to receive antipsychotic review, social interaction, and exercise, either alone or in combinations. Apathy was one of the secondary outcomes of the WHELD trial, and it was measured by the Neuropsychiatric Inventory–nursing home version at baseline and 9 months (n = 273). We used multilevel mixed effects linear regression models to assess the impact of the interventions on apathy. Results Prevalence of apathy was 44.0% (n = 120; 95% confidence interval [CI] 38.1%–49.9%) at baseline. Severity of apathy had significant positive correlations with dementia severity, neuropsychiatric symptoms, depressive symptoms, agitation, and the needs of the people with dementia (P < .001). Antipsychotic review reduced antipsychotic use, but it significantly increased apathy (β = 5.37; SE = 0.91; P < .001). However, antipsychotic review in combination with either social interaction (β = −5.84; SE = 1.15; P < .001) or exercise (β = −7.54; SE = 0.93; P < .001) significantly reduced apathy. Conclusions Antipsychotic review can play a significant role in improving apathy in people with dementia living in nursing homes, when combined with psychosocial interventions such as social interaction and exercise. Guidance must be adapted to reflect this subtlety in care.National Institute for Health Research (NIHR

Comparing cost-effectiveness of surface water flood management interventions in a UK catchment

This is the final published version. Available from Wiley via the DOI in this record.Despite significant consequences caused by recent events, surface water flooding has historically been of lower priority relative to fluvial and coastal risks in UK flood management. Legislation and research proposes a variety of innovative interventions to address this; however, widespread application of these remains a challenge due to a number of institutional, economic, and technical barriers. This research applies a framework capable of fast and high-resolution assessment of intervention cost-effectiveness as an opportunity to improve available evidence and encourage uptake of interventions through analysing permutations of type, scale, and distribution in urban catchments. Fast assessment of many scenarios is achieved using a cellular automata flood model and a simplified representation of interventions. Conventional and green strategies are examined across a range of design standard and high-magnitude rainfall events in an urban catchment. Results indicate high-volume rainwater capture interventions demonstrate a significant reduction in estimated annual damage costs, and localised surface water drainage interventions exhibit high cost-effectiveness for damage reduction. Analysis of performance across a wide range of return periods enhances available evidence for option comparison decision support and provides a basis for future resilience assessment of interventions.Engineering and Physical Sciences Research Council (EPSRC

Delivering green streets: an exploration of changing perceptions and behaviours over time around bioswales in Portland, Oregon

Green Infrastructure (GI) is an increasingly popular means of dealing with flooding and water quality issues worldwide. This study examines public perceptions of, and behaviour around, bioswales, which are a popular GI facility in the United States. Bioswales are highly visible interventions requiring support from residents and policy‐makers to be implemented and maintained appropriately. To understand how the residents' perceptions and attitudes might develop over time, we interviewed residents of Portland, Oregon, living near bioswales installed 1–2, 4–5 and 8–9 years ago, to determine awareness, understanding, and opinions about the devices. We found no consistent patterns across time periods, but did find common issues affecting residents' appreciation and acceptance: environmental attitudes, awareness and understanding of purpose and function, plant choice and maintenance, and mess and littering. It was apparent that increased public engagement, localised maintenance strategies, and possibly even customising facilities to meet residents' needs where feasible, might improve acceptance

Computational fluid dynamics modelling of residence times in vegetated stormwater ponds

Experimental data characterising dispersion within Typha latifolia were previously collected in a laboratory setting. This mixing characterisation was combined with previously proposed computational fluid dynamics modelling approaches to predict residence time distributions for vegetated stormwater treatment pond layouts (including a wetland) derived from Highways England design guidance. The results showed that the presence of vegetation resulted in residence times closer to plug flow, indicating significant improvements in stormwater treatment capability. The new modelling approach reflects changes in residence time due to mixing within the vegetation, but it also suggests that it is more important to include vegetation within the model in the correct location than it is to accurately characterise it. Estimates of hydraulic efficiency suggest that fully vegetated stormwater ponds such as wetlands should function well as a treatment device, but more typical ponds with clear water need to be designed to be between 50% and 100% larger than their nominal residence times would suggest when designed against treatment criteria

Epidemiology of Pain in People With Dementia Living in Care Homes: Longitudinal Course, Prevalence, and Treatment Implications

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordIntroduction Knowledge regarding the longitudinal course, impact, or treatment implications of pain in people with dementia living in care homes is very limited. Methods We investigated the people with dementia living in 67 care homes in London and Buckinghamshire, United Kingdom. Pain, dementia severity, neuropsychiatric symptoms, depression, agitation, and quality-of-life were measured using appropriate instruments at baseline (N = 967) and after 9 months (n = 629). Results Baseline prevalence of pain was 35.3% (95% CI 32.3–38.3). Pain severity was significantly correlated with dementia severity, neuropsychiatric symptoms, depression, agitation, and quality of life at both time points. Regular treatment with analgesics significantly reduced pain severity. Pain was significantly associated with more antipsychotic prescriptions. Pain was significantly associated (OR 1.48; 95% CI 1.18–1.85) with all-cause mortality during follow-up. Conclusions Pain is an important determinant of neuropsychiatric symptoms, mortality, quality-of-life, and antipsychotic prescriptions. Improved identification, monitoring, and treatment of pain are urgent priorities to improve the health and quality-of-life for people with dementia.National Institute for Health Research (NIHR

Integrating Integrated Water Management

© 2014, Thomas Telford Services Ltd. All rights reserved. The water cycle is a contiguous system interconnected with human activities. Management has tended to be fragmented across anthropocentrically defined disciplines, potentially generating unintended negative consequences. The ecosystem approach and the ecosystem services framework emphasise interlinked, albeit often overlooked, benefits that the natural environment provides for people. This enables recognition and avoidance of potential ‘negative externalities’, identification of solutions optimising benefits across multiple services, and participation of wider constituencies of stakeholders. Systemic, outcome-based approaches are inherently economically efficient, yielding greater cumulative benefits for lower transaction costs by working with natural processes. The ecosystem approach establishes geographical and socio-economic contexts for management ecosystem service outcomes, providing a broader context in which to nest established water resource management methods. The ecosystem approach can also be applied at different scales and to diverse societal activities, internalising into them the value of natural processes. It is amenable to integration into catchment-scale considerations, yet does not present these activities as subsidiary to river basin planning. The addition of ecosystem services for options appraisal in preexisting decision-support tools adapts them to better address multi-benefit goals. Shifts are required in the policy and economic environment, but engineers have an important role in promoting, applying and innovating multibenefit solutions