Project and production management Intersection: Life-Cycle analysis of on-site and off-site construction

The purpose of this paper is to provide an argument for moving beyond calls for increased construction industry productivity based on the perceived differences between construction projects and manufacture production. Traditionally scholars have claimed that the lack of increased construction industry productivity is attributable to the differences between on-site work and off-site work. However, in 2011 project processes and product outcomes are essential to both. As management theories have become integrated into practice in both industries, the management of both a unique project and product-production have converged. At the same time, almost all construction today utilises both on-site and off-site processes. Therefore, the driver for increased off-site manufacture to ensure increased industry productivity must be reconsidered. One way forward would be to consider issues related to reducing the environmental impacts of construction. That is the aim of this discussion paper. Many researchers have identified difficulties with communication between on-site and off-site production. However, if the focus of productivity gains shifts to measuring environmental impact, based on a Life-Cycle Analysis (LCA), then both the tangible and intangible effects of both on-site and off-site work can be compared. Thus, over-coming identified difficulties with a common language based on LCA could enable co-operative on and off site production. This co-operation could in turn to lead to increased industry productivity. The paper ends by providing a LCA focused research agenda to provide evidence for reconsidering the claim that increasing off-site manufacture will increase construction industry productivity

Use and uptake of web-based therapeutic interventions amongst Indigenous populations in Australia, New Zealand, the United States of America and Canada: a scoping review

Background: Barriers to receiving optimal healthcare exist for Indigenous populations globally for a range of reasons. To overcome such barriers and enable greater access to basic and specialist care, developments in information and communication technologies are being applied. The focus of this scoping review is on web-based therapeutic interventions (WBTI) that aim to provide guidance, support and treatment for health problems. Objectives: This review identifies and describes international scientific evidence on WBTI used by Indigenous peoples in Australia, New Zealand, Canada and USA for managing and treating a broad range of health conditions. Eligibility Criteria: Studies assessing WBTI designed for Indigenous peoples in Australia, Canada, USA and New Zealand, that were published in English, in peer-reviewed literature, from 2006 to 2018 (inclusive), were considered for inclusion in the review. Studies were considered if more than 50% of participants were Indigenous, or if results were reported separately for Indigenous participants. Sources of Evidence: Following a four-step search strategy in consultation with a research librarian, 12 databases were searched with a view to finding both published and unpublished studies. Charting Methods: Data was extracted, synthesised and reported under four main conceptual categories: (1) types of WBTI used, (2) community uptake of WBTI, (3) factors that impact on uptake and (4) conclusions and recommendations for practice. Results: A total of 31 studies met the inclusion criteria. The WBTI used were interactive websites, screening and assessment tools, management and monitoring tools, gamified avatar-based psychological therapy and decision support tools. Other sources reported the use of mobile apps, multimedia messaging or a mixture of intervention tools. Most sources reported moderate uptake and improved health outcomes for Indigenous people. Suggestions to improve uptake included as follows: tailoring content and presentation formats to be culturally relevant and appropriate, customisable and easy to use. Conclusions: Culturally appropriate, evidence-based WBTI have the potential to improve health, overcome treatment barriers and reduce inequalities for Indigenous communities. Access to WBTI, alongside appropriate training, allows health care workers to better support their Indigenous clients. Developing WBTI in partnership with Indigenous communities ensures that these interventions are accepted and promoted by the communities.Rachel Reilly, Jacqueline Stephens, Jasmine Micklem, Catalin Tufanaru, Stephen Harfield, Ike Fisher, Odette Pearson, and James War

Analysis of the uncertainty in microbubble characterization

There is increasing interest in the use of microbubble contrast agents for quantitative imaging applications such as perfusion and blood pressure measurement. The response of a microbubble to ultrasound excitation is, however, extremely sensitive to its size, the properties of its coating and the characteristics of the sound field and surrounding environment. Hence the results of microbubble characterization experiments can be significantly affected by experimental uncertainties, and this can limit their utility in predictive modelling. The aim of this study was to attempt to quantify these uncertainties and their influence upon measured microbubble characteristics. Estimates for the parameters characterizing the microbubble coating were obtained by fitting model data to numerical simulations of microbubble dynamics. The effect of uncertainty in different experimental parameters was gauged by modifying the relevant input values to the fitting process. The results indicate that even the minimum expected uncertainty in, for example, measurements of microbubble radius using conventional optical microscopy, leads to variations in the estimated coating parameters of ~20%. This should be taken into account in designing microbubble characterization experiments and in the use of data obtained from them

The Impact of COVID-19 on UK informant use and management

The effect of COVID-19 on informant use and management, during the peak of the imposed Government lockdown measures was felt across English and Welsh police Dedicated Source Units. Within these restrictions, staff managing informants had to develop and then implement new strategies that delivered safe, yet effective, informant handling capacity and capability. Based on a survey of 205 respondents directly involved in the handling, control or authorisation of informants, this article examined their perceptions of the effect of COVID-19 in this highly specialised policing activity. The research findings revealed five broad themes associated with the impact of COVID-19 on informant management practices: (i) health protection; (ii) governance; (iii) innovation and technology; (iv) recruitment, communication and informant development; and (v) tradecraft and intelligence. The article explored the organisational responses to initiating and maintaining informant-handler relationships and ensuring the flow of intelligence within this unique operational environment. Participants perceived that handler-informant relationships were strengthened, and also indications of a willingness to adapt policy and procedure associated with the informant management cycle: targeting, initial recruitment contact, assessment and evaluation, tasking and deployment and payment of informant rewards. It also highlighted a wider consensus that there was further scope for enhancing resilience to similar future pandemics including the use of enabling technology and responsive policy adaptation

Characteristics of Indigenous primary health care service delivery models: a systematic scoping review

Published online: 25 January 2018Background: Indigenous populations have poorer health outcomes compared to their non-Indigenous counterparts. The evolution of Indigenous primary health care services arose from mainstream health services being unable to adequately meet the needs of Indigenous communities and Indigenous peoples often being excluded and marginalised from mainstream health services. Part of the solution has been to establish Indigenous specific primary health care services, for and managed by Indigenous peoples. There are a number of reasons why Indigenous primary health care services are more likely than mainstream services to improve the health of Indigenous communities. Their success is partly due to the fact that they often provide comprehensive programs that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health. However, there are gaps in the evidence base including the characteristics that contribute to the success of Indigenous primary health care services in providing comprehensive primary health care. This systematic scoping review aims to identify the characteristics of Indigenous primary health care service delivery models. Method: This systematic scoping review was led by an Aboriginal researcher, using the Joanna Briggs Institute Scoping Review Methodology. All published peer-reviewed and grey literature indexed in PubMed, EBSCO CINAHL, Embase, Informit, Mednar, and Trove databases from September 1978 to May 2015 were reviewed for inclusion. Studies were included if they describe the characteristics of service delivery models implemented within an Indigenous primary health care service. Sixty-two studies met the inclusion criteria. Data were extracted and then thematically analysed to identify the characteristics of Indigenous PHC service delivery models. Results: Culture was the most prominent characteristic underpinning all of the other seven characteristics which were identified – accessible health services, community participation, continuous quality improvement, culturally appropriate and skilled workforce, flexible approach to care, holistic health care, and self-determination and empowerment. Conclusion: While the eight characteristics were clearly distinguishable within the review, the interdependence between each characteristic was also evident. These findings were used to develop a new Indigenous PHC Service Delivery Model, which clearly demonstrates some of the unique characteristics of Indigenous specific models.Stephen G. Harfield, Carol Davy, Alexa McArthur, Zachary Munn, Alex Brown and Ngiare Brow

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

Theory of thin-skin eddy-current interaction with surface cracks

Eddy-current non-destructive evaluation is commonly performed at relatively high frequencies at which the skin depths are significantly smaller than the dimensions of a typical crack. A thin-skin analysis of eddy currents is presented in which the electromagnetic fields on the crack faces are described in terms of a potential which obeys a two-dimensional Laplace equation. Solutions of this equation for defects in both magnetic and non-magnetic materials are determined by applying thin-skin boundary conditions at the crack perimeter. The impedance change of an eddy-current coil due to the defect is then calculated by numerical evaluation of one-dimensional integrals over the line of the crack mouth, the impedance integrals having been derived with the aid of a reciprocity relationship. Theoretical predictions are compared with experimental data for long, uniformly deep slots in aluminium and mild steel and good agreement between theory and experiment is obtained