Leveraging Lean in construction: A case study of a BIM-based HVAC manufacturing process

The impetus towards efficiency in the AECO (Architecture, Engineering, Construction & Operations) sector is driving the implementation of Lean practices. BIM technologies and BIM processes provide methods by which this can be achieved. Major clients of building services contractors have begun to mandate the use of BIM and some are using BIM preparedness/experience as pre-tender qualification criteria. In this case study, an initial review has been conducted of the achievements of a major Irish M&E contractor in implementing BIM. The firm purpose-built a facility for the off-site manufacture of building services components. The operations of the plant are efficient and qualityassured through the use of an appropriately skilled workforce at all stages of manufacture, and tracking software that has developed as the knowledge of the contractor grew. Standardised processes have been developed which have resulted in greater efficiencies and lower costs for the contractor as a result of fewer requirements for onsite modifications (such as those caused by clashes), less waste, and greater flexibility. Despite some initial objections, the employees of the company are now more satisfied with their working conditions and are, as a result, more productive. Through investment in BIM-based, Lean processes, the contractor can now better compete when tenerding for large-scale projects in Ireland and worldwide, including the rapidly-increasing number where BIM experience and preparedness is mandated

The Public Health Response to COVID-19 in the Northeast Region of Missouri

The Public Health Response to COVID-19 in the Northeast Region of Missouri documents efforts by Northeast Missouri’s local public health agencies along with other stakeholders to leverage their partnerships, resources, and expertise to respond to COVID-19. Along with professional stakeholder accounts, the report includes residents’ perspectives and experiences during the COVID-19 response. Professional and resident findings helped identify lessons that could strengthen the public health system’s ability to continue responding to COVID-19 and face future crisis with greater resources, coordination, equitable strategies, modernized infrastructure and public trust. The findings in this report center on the period of the pandemic from March 2020 through May 2021, before the proliferation of the Delta and Omicron variants. The Public Health Response to COVID-19 in the Northeast Region of Missouri along with The Public Health Response to COVID-19 in the Southwest Region of Missouri and The Public Health Response to COVID-19 in the St. Louis Region of Missouri are part of a series of regional reports that were used to inform the state-level recommendations in the report Missouri’s Public Health Response to COVID-19: Key Findings and Recommendations for State Action and Investment

Ecological Factors and Childhood Eating Behaviours at 5 Years of Age: findings from the ROLO longitudinal birth cohort study

Individual differences in children eating behaviours have been linked with childhood overweight and obesity. The determinants of childhood eating behaviours are influenced by a complex combination of hereditary and ecological factors. This study examines if key ecological predictors of childhood overweight; maternal socio-economic status (SES), children’s screen time, and childcare arrangements, are associated with eating behaviours in children aged 5-years-old

Strategies to improve retention in randomised trials

Acknowledgements We thank Jayne Tierney, Sally Stenning, Seeromanie Harding, Sarah Meredith, and Irwin Nazareth for their contributions to earlier versions of this review. We also thank all authors of included published studies who provided additional or unreported data and Principal investigators for data on studies in progress or completed and unpublished. This update was funded by a National Institute for Health Research (NIHR) Incentive Award Scheme 2019 Reference 130660. The Health Services Research Unit, University of Aberdeen receives core funding from the Chief Scientist Office of the Scottish Government Health Directorates. The views expressed in this review are those of the authors and do not necessarily reflect those of the NIHR, the Department of Health and Social Care or these other funders. Sources of support Internal sources: No sources of support supplied External sources: National Institue for Health Research Incentive Award, UK; This update was funded by a National Institue for Health Research Incentive Award [NIHR IA 130660].Peer reviewedPublisher PD

Sleep duration and eating behaviours are associated with body composition in 5-year-old children: findings from the ROLO longitudinal birth cohort study

Inadequate sleep and poor eating behaviours are associated with higher risk of childhood overweight and obesity. Less is known about the influence sleep has on eating behaviours and consequently body composition. Furthermore, whether associations differ in boys and girls has not been investigated extensively. We investigate associations between sleep, eating behaviours and body composition in cross-sectional analysis of 5-year-old children. Weight, height, BMI, mid upper arm circumference (MUAC), abdominal circumference (AC) and skinfold measurements were obtained. Maternal reported information on child’s eating behaviour and sleep habits were collected using validated questionnaires. Multiple linear regression examined associations between sleep, eating behaviours and body composition. Sleep duration was negatively associated with BMI, with 1-h greater sleep duration associated with 0·24 kg/m2 (B = 0·24, CI −0·42, −0·03, P = 0·026) lower BMI and 0·21 cm lower (B = –0·21, CI −0·41, −0·02, P = 0·035) MUAC. When stratified by sex, girls showed stronger inverse associations between sleep duration (h) and BMI (kg/m2) (B = –0·32; CI −0·60, −0·04, P = 0·024), MUAC (cm) (B = –0·29; CI −0·58, 0·000, P = 0·05) and AC (cm) (B = –1·10; CI −1·85, −0·21, P = 0·014) than boys. Positive associations for ‘Enjoys Food’ and ‘Food Responsiveness’ with BMI, MUAC and AC were observed in girls only. Inverse associations between sleep duration and ‘Emotional Undereating’ and ‘Food Fussiness’ were observed in both sexes, although stronger in boys. Sleep duration did not mediate the relationship between eating behaviours and BMI. Further exploration is required to understand how sleep impacts eating behaviours and consequently body composition and how sex influences this relationship