Assessing the Impact of Infrastructure Projects on Global Sustainable Development Goals

While sustainability of civil infrastructure is critical to professionals, project owners, regulators, funding agencies and the public, little is done to link individual project sustainability to the United Nation’s 17 global sustainable development goals for 2030. This paper provides some answers but also exposes many questions that need resolution by the infrastructure sector. Using empirical evidence, the authors have identified a ‘golden thread’ between best-practice sustainability-reporting frameworks at project level with those at organisational level. In doing so, they find there is sufficient linkage to embed sustainable-development-goal impact targets into the design stage of an infrastructure project. This would provide a more robust investment appraisal at the project design phase, helping to define project success more widely across the triple bottom line of economic, social and environmental outcomes and associated impact

Measuring practice leadership in supported accommodation services for people with intellectual disability: Comparing staff-rated and observational measures

Background Studies incorporating staff-rated or observational measures of practice leadership have shown that where practice leadership is stronger, active support is better implemented. The study aim was to compare measures of practice leadership used in previous research to determine the extent of their correspondence. Method A subset of data from a longitudinal study regarding 29 front-line managers working across 36 supported accommodation services in Australia was used. An observed measure of practice leadership, based on an interview and observation of a front-line manager, was compared with ratings of practice leadership completed by staff. The quality of active support was rated after a 2-hour structured observation. Results Correlations between staff-rated and observed measures were non-significant. Only the observed measure was correlated with the quality of active support. Conclusions This study provides evidence to support using an observational measure of practice leadership rather than reliance on staff ratings

Time taken by individuals with respiratory symptoms to present to primary care: a descriptive study of assessments at Australian General Practitioner-led respiratory clinics

Effective control of coronavirus disease 2019 (COVID-19) has been challenging, in part due to significant asymptomatic and pre-symptomatic transmission of disease. Reducing the time between symptom onset and COVID-19 testing and isolation allows enhanced outbreak control. The purpose of this study is to describe the time taken by participants to present to general practitioner-led (GP) respiratory clinics for assessment following the development of symptoms, and to explore associations between demographic and geographic characteristics and the time to presentation. A total of 314,148 participants, who were assessed in GP respiratory clinics between 1 February and 31 August 2021, were included in the analysis. The median age of participants at presentation was 33 years (interquartile range, IQR: 15–49). The median time from development of symptoms to presentation for assessment at GP respiratory clinics was 2 days (IQR: 1–3). Participants were more likely to present within one day of symptom onset if they were aged between 15 and 64 years (43.4%), lived in urban areas (40.9%) or were non-Indigenous (40.2%). Participants in New South Wales and Victoria had twice the odds (OR 2.01; 95% confidence interval (CI): 1.95, 2.08) of presenting at a GP respiratory clinic within one day of symptom onset in August 2021, when there was a COVID-19 outbreak in those states, than they did in March 2021, when there was no COVID-19 outbreak in Australia. The number of days from symptom onset to presentation at a GP respiratory clinic was strongly associated with the presence of a COVID-19 outbreak. Participant age, location of the clinic, and Indigenous status of participants were also associated with the time to presentation. This study highlights the importance of recognising COVID-19 as a potential cause of symptoms, as well as the importance of providing easily accessible, and culturally appropriate, testing facilities for the population

Assessing the impact of infrastructure projects on global sustainable development goals

While the sustainability of civil infrastructure is critical to professionals, project owners, regulators, funding agencies and the public, little is done to link individual project sustainability to the UN’s 17 global sustainable development goals for 2030. This paper not only provides some answers, but also exposes many questions that need resolution by the infrastructure sector. Using empirical evidence, the authors have identified a ‘golden thread’ between best-practice sustainability-reporting frameworks at the project level and those at the organisational level. In doing so, they have found that there is sufficient linkage to embed sustainable-development-goal impact targets into the design stage of an infrastructure project. This would provide a more robust investment appraisal at the project design phase, helping define project success more widely across the triple bottom line of economic, social and environmental outcomes and associated impact

Polydopamine-lysophosphatidate-functionalised titanium: A novel hybrid surface finish for bone regenerative applications

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Aseptic loosening of total joint replacements (TJRs) continues to be the main cause of implant failures. The socioeconomic impact of surgical revisions is hugely significant; in the United Kingdom alone, it is estimated that £135m is spent annually on revision arthroplasties. Enhancing the longevity of titanium implants will help reduce the incidence and overall cost of failed devices. In realising the development of a superior titanium (Ti) technology, we took inspiration from the growing interest in reactive polydopamine thin films for biomaterial surface functionalisations. Adopting a “one-pot” approach, we exposed medical-grade titanium to a mildly alkaline solution of dopamine hydrochloride (DHC) supplemented with (3S)1-fluoro-3-hydroxy-4-(oleoyloxy)butyl-1-phosphonate (FHBP), a phosphatase-resistant analogue of lysophosphatidic acid (LPA). Importantly, LPA and selected LPA analogues like FHBP synergistically cooperate with calcitriol to promote human osteoblast formation and maturation. Herein, we provide evidence that simply immersing Ti in aqueous solutions of DHC-FHBP afforded a surface that was superior to FHBP-Ti at enhancing osteoblast maturation. The facile step we have taken to modify Ti and the biological performance of the final surface finish are appealing properties that may attract the attention of implant manufacturers in the future

InGaAs spin light emitting diodes measured in the Faraday and oblique Hanle geometries

InGaAs quantum well light emitting diodes (LED) with spin-injecting, epitaxial Fe contacts were fabricated using an in situ wafer transfer process where the semiconductor wafer was transferred under ultrahigh vacuum (UHV) conditions to a metals growth chamber to achieve a high quality interface between the two materials. The spin LED devices were measured optically with applied magnetic fields in either the Faraday or the oblique Hanle geometries in two experimental set-ups. Optical polarizations efficiencies of 4.5% in the Faraday geometry and 1.5% in the Hanle geometry are shown to be equivalent. The polarization efficiency of the electroluminescence is seen to decay as the temperature increases although the spin lifetime remains constant due to the influence of the D'yakonov–Perel' spin scattering mechanism in the quantum well.RM would like to acknowledge support from the EPSRC.This is the final version of the article. It first appeared from the Institute of Physics via https://doi.org/10.1088/0022-3727/49/16/16510

Using domiciliary non-invasive ventilator data downloads to inform clinical decision-making to optimise ventilation delivery and patient compliance

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Introduction Ventilation parameter data from patients receiving home mechanical ventilation can be collected via secure data cards and modem technology. This can then be reviewed by clinicians and ventilator prescriptions adjusted. Typically available measures include tidal volume (V T ), leak, respiratory rate, minute ventilation, patient triggered breaths, achieved pressures and patient compliance. This study aimed to assess the potential impact of ventilator data downloads on management of patients requiring home non-invasive ventilation (NIV). Methods A longitudinal within-group design with repeated measurements was used. Baseline ventilator data were downloaded, reviewed and adjustments made to optimise ventilation. Leak, V T and compliance data were collected for comparison at the first review and 3-7 weeks later. Ventilator data were monitored and amended remotely via a modem by a consultant physiotherapist between the first review and second appointment. Results Analysis of data from 52 patients showed increased patient compliance (% days used > 4 hours) from 90% to 96% (p=0.007), increased usage from 6.53 to 6.94 hours (p=0.211) and a change in V T (9.4 vs 8.7 mL/kg/ideal body weight, p=0.022). There was no change in leak following review of NIV prescriptions (mean (SD): 43 (23.4) L/min vs 45 (19.9)L/min, p=0.272). Conclusion Ventilator data downloads, via early remote assessment, can help optimise patient ventilation through identification of modifiable factors, in particular interface leak and ventilator prescriptions. However, a prospective study is required to assess whether using ventilator data downloads provides value in terms of patient outcomes and cost-effectiveness. The presented data will help to inform the design of such a study

Interactions between downslope flows and a developing cold-air pool

A numerical model has been used to characterize the development of a region of enhanced cooling in an alpine valley with a width of order (Formula presented.) km, under decoupled stable conditions. The region of enhanced cooling develops largely as a region of relatively dry air which partitions the valley atmosphere dynamics into two volumes, with airflow partially trapped within the valley by a developing elevated inversion. Complex interactions between the region of enhanced cooling and the downslope flows are quantified. The cooling within the region of enhanced cooling and the elevated inversion is almost equally partitioned between radiative and dynamic effects. By the end of the simulation, the different valley atmospheric regions approach a state of thermal equilibrium with one another, though this cannot be said of the valley atmosphere and its external environment.Peer reviewe

Improved Biomedical and Psychological Outcomes 1 Year After Structured Education in Flexible Insulin Therapy for People With Type 1 Diabetes: The U.K. DAFNE experience

OBJECTIVEdDAFNE (Dose Adjustment For Normal Eating), a structured education program in flexible insulin therapy, has been widely adopted in the U.K. after validation in a randomized trial. To determine benefits in routine practice, we collected biomedical and psychological data from all participants attending during a 12-month period. RESEARCH DESIGN AND METHODSdHbA1c, weight, self-reported hypoglycemia awareness, severe hypoglycemia frequency, PAID (Problem Areas In Diabetes), HADS (Hospital Anxiety and Depression Scale), and EuroQol Group 5-Dimension Self-Report Questionnaire scores were recorded prior to DAFNE and after 1 year. RESULTSdComplete baseline and follow-up HbA1c data were available for 639 (54.9%) of 1,163 attendees. HbA1c fell from 8.51 6 1.41 (mean 6 SD) to 8.24 6 1.29% (difference 0.27 [95% CI 0.16–0.38]; P , 0.001), with a greater mean fall of 0.44% from baseline HbA1c .8.5%. Severe hypoglycemia rate fell from 1.7 6 8.5 to 0.6 6 3.7 episodes per person per year (1.1 [0.7– 1.4]) and hypoglycemia recognition improved in 43% of those reporting unawareness. Baseline psychological distress was evident, with a PAID score of 25.2 and HADS scores of 5.3 (anxiety) and 4.8 (depression), falling to 16.7 (8.5 [6.6–10.4]), 4.6 (0.7 [0.4–1.0]), and 4.2 (0.6 [0.3–0.8]), respectively (all P , 0.001 at 1 year). Clinically relevant anxiety and depression (HADS $8) fell from 24.4 to 18.0% and 20.9 to 15.5%, respectively. CONCLUSIONSdA structured education program delivered in routine clinical practice not only improves HbA1c while reducing severe hypoglycemia rate and restoring hypoglycemia awareness but also reduces psychological distress and improves perceived well-being