Network FOuNTAIN a CDBB network: For ONTologies and information maNagement in digital built Britain. Final report.

Network FOuNTAIN is the Network For ONTologies And Information maNagement in Digital Built Britain. The Network is supported by the Centre for Digital Built Britain. The vision of the Network is for all stakeholders in Digital Built Britain (DBB) to be able to meet their information needs. With the establishment of concepts such as Building Information Modelling (BIM) and Common Data Environments (CDE), built environment design, construction and operation are becoming increasingly information-intensive. The Network undertook five workshop activities between July and December 2018. This report summarises the proceedings of these workshops, and in particular establishes future capabilities needed to realise the vision of DBB

Potential immunological consequences of pharmacological suppression of gastric acid production in patients with multiple sclerosis

Corticosteroids are standard treatment for patients with multiple sclerosis experiencing acute relapse. Because dyspeptic pain is a common side effect of this intervention, patients can be given a histamine receptor-2 antagonist, proton pump inhibitor or antacid to prevent or ameliorate this disturbance. Additionally, patients with multiple sclerosis may be taking these medications independent of corticosteroid treatment. Interventions for gastric disturbances can influence the activation state of the immune system, a principal mediator of pathology in multiple sclerosis. Although histamine release promotes inflammation, activation of the histamine receptor-2 can suppress a proinflammatory immune response, and blocking histamine receptor-2 with an antagonist could shift the balance more towards immune stimulation. Studies utilizing an animal model of multiple sclerosis indicate that histamine receptor-2 antagonists potentially augment disease activity in patients with multiple sclerosis. In contrast, proton pump inhibitors appear to favor immune suppression, but have not been studied in models of multiple sclerosis. Antacids, histamine receptor-2 antagonists and proton pump inhibitors also could alter the intestinal microflora, which may indirectly lead to immune stimulation. Additionally, elevated gastric pH can promote the vitamin B12 deficiency that patients with multiple sclerosis are at risk of developing. Here, we review possible roles of gastric acid inhibitors on immunopathogenic mechanisms associated with multiple sclerosis

ICT-enabled collaborative working methodologies in construction

Since the turn of the new millennium the UK construction industry has witnessed the naissance of a new paradigm known as ICT-enabled collaborative working. Advocates of this new approach believe that the adoption of ICTs will lead to better project information exchange, communications, integrated processes and therefore more efficient collaborative working. It is expected that ICT-enabled collaborative working will not only overcome the industry’s many inherent problems, such as its adversarial and fragmented nature, but that it will also facilitate benefits for all involved. This supposition is based upon the recognition that its exploitation has proven successful at transforming other industries. The EngD thesis pertains to a four-year study on two methodologies currently applied under the concept of ICT-enabled collaborative working, ‘Collaborative Prototyping’ (CP) and the use of ‘Construction Project Extranets’ (CPE). The research project utilised literature reviews, case studies, project observations, active involvement, surveys, interviews and workshops to develop expertise and knowledge within the subject area. It shows that a large disparity exists between the use of a shared 3D model and the use of CPEs to promote collaborative working. Conversely, whilst CPEs have become the de facto ICT-enabled approach to seeking improvements in project efficiency (due to their potential to enhance communications, integration and collaboration) they are not being utilised effectively. This was attributed to the use of inadequate procedures that fail to provide proper consideration of all the necessary issues to ensure successful implementation, application and management of the CPE. As a result, project teams are failing to ascertain the full potential benefits offered by such collaboration tools. The research demonstrates that to overcome this, project teams require the development of an industry best-fit framework that defines proficient procedures. It highlights the main factors for inclusion within a protocol. Furthermore, it provides a simple form to promote greater awareness of the key factors that impinge on the successful application of CPE. The thesis concludes by outlining a number of recommendations for consideration by the industry, along with requirements for future work

Considerations for the safe prescribing and use of COX-2-specific inhibitors

The majority of the "Australian COX-2-Specific Inhibitor (CSI) Prescribing Group" endorse the following points: CSIs are equivalent to non-steroidal anti-inflammatory drugs (NSAIDs) as anti-inflammatory agents. CSIs and NSAIDs modify symptoms but do not after the course of musculoskeletal disease. CSIs do not eliminate the occurrence of ulcers or their serious complications, but are associated with considerably fewer peptic ulcers, slightly fewer upper GI symptoms and, according to published reports, fewer serious upper GI complications, notably bleeding, than NSAIDs. CSIs and NSAIDs have similar effects on renal function and blood pressure. Whether any CSI poses a risk to cardiovascular safety remains subject to debate. Comorbidities and coprescribed drugs must be considered before initiating CSI (or NSAID) therapy. Patients prescribed CSIs (or NSAIDs) should be reviewed within the first few weeks of therapy to assess effectiveness, identify adverse effects and determine the need for ongoing therapy

How is recovery from low back pain measured? A systematic review of the literature

Recovery is commonly used as an outcome measure in low back pain (LBP) research. There is, however, no accepted definition of what recovery involves or guidance as to how it should be measured. The objective of the study was designed to appraise the LBP literature from the last 10 years to review the methods used to measure recovery. The research design includes electronic searches of Medline, EMBASE, CINAHL, Cochrane database of clinical trials and PEDro from the beginning of 1999 to December 2008. All prospective studies of subjects with non-specific LBP that measured recovery as an outcome were included. The way in which recovery was measured was extracted and categorised according to the domain used to assess recovery. Eighty-two included studies used 66 different measures of recovery. Fifty-nine of the measures did not appear in more than one study. Seventeen measures used pain as a proxy for recovery, seven used disability or function and seventeen were based on a combination of two or more constructs. There were nine single-item recovery rating scales. Eleven studies used a global change scale that included an anchor of ‘completely recovered’. Three measures used return to work as the recovery criterion, two used time to insurance claim closure and six used physical performance. In conclusion, almost every study that measured recovery from LBP in the last 10 years did so differently. This lack of consistency makes interpretation and comparison of the LBP literature problematic. It is likely that the failure to use a standardised measure of recovery is due to the absence of an established definition, and highlights the need for such a definition in back pain research