A review of nondestructive examination methods for new-building ships undergoing classification society survey

Classification societies require ship manufacturers to perform nondestructive examination (NDE) of ship weldments to ensure the welding quality of new-building ships. Ships can contain hundreds of kilometers of weld lines and 100% inspection of all welded connections is not feasible. Hence, a limited number of weldments are specified by rules of classification societies to be inspected on a sampling basis. There is a variation between the rules and guidelines used by different classification societies in terms of both philosophy and implementation which results in significant discrepancy in the prescribed checkpoints, numbers, and their locations. In this article, relevant sections of the rules of mainstream International Association of Classification Societies members are studied and potential ways of improving them are discussed. The authors have endeavored to make this study as comprehensive as much as possible. However, given the challenges of covering every single aspect and variable related to NDE in the classification societies’ rules and guidelines reviewed here, the authors can only attempt to cover the key features

Attitudinal predictors of older peoples' and caregivers' desire to deprescribe in hospital

Background Deprescribing is a partnership between practitioners, patients and caregivers. External characteristics including age, comorbidities and polypharmacy are poor predictors of attitude towards deprescribing. This hospital-based study aimed to describe the desire of patients and caregivers to be involved in medicine decision-making, and identify attitudinal predictors of desire to try stopping a medicine. Methods Patients and caregivers recruited from seven Older People’s Medicine wards across two UK hospitals completed the revised Patients’Attitudes Towards Deprescribing (rPATD) questionnaire. Patients prescribed polypharmacy and caregivers involved in medication decision-making of such patients were eligible. A target of 150 patients and caregivers provided a 95% confidence interval of ±11.0% or smaller around rPATD item agreement. Descriptive statistics characterised participants and rPATD responses. Responses to items regarding desire to be involved in medication decision-making and desire to try stopping a medicine were used to address the aims. Binary logistic regression provided the adjusted odds ratios (OR) for predictors of desire to try stopping a medicine. Results Patient participants (N=75) were a median (IQ) 87.0 (83.0, 90.0) years old and the median (IQ) number of pre-admission medication was 8.0 (6.0, 10.0). Caregiver participants (N=76) were a median (IQ) 70.0 (57.0, 83.0) years old and the majority were a spouse (63.2%). For patients and caregivers respectively, the following were reported: 58.7% and 65.8% wanted to be involved in medication decision-making; 29.3% and 43.5% reported a desire to try stopping a medicine. Attitudinal predictors of low desire to try stopping a medicine for patients and caregivers are a perception that there are no unnecessary prescribed medicines [OR=0.179 (patients) and 0.044 (caregivers)] and no desire for dose reduction [OR=0.199 (patients) and 0.024 (caregivers)]. A perception of not being prescribed too many medicines also predicted low patient desire to try stopping a medicine [OR=0.195]. Conclusion A substantial proportion of patients and caregivers did not want to be involved medication decision-making, however this should not result in practitioners dismissing deprescribing opportunities. The three diagnostic indicators for establishing desire to try stopping a medicine are perceived necessity of the medicine, appropriateness of the number prescribed medications and a desire for dose reduction

Weld defect frequency, size statistics and probabilistic models for ship structures

Ships undergo cyclic loading which combined with weld defects can cause fatigue failure. Remaining fatigue life of structures containing defects can be estimated using the defect size. The defect data for ships is non-existent in literature or belong to old offshore structures. In this research, the data collected from two ships are presented. The statistical analysis of the data shows that the Hybrid Laser Welding has lower defect rates than other common arc welding processes indicating that less quality control inspection may be allowed. The defect length values from the studied ships were smaller than those from offshore structures

Using accelerometry to classify physical activity intensity in older adults:What is the optimal wear-site?

This study aimed to determine the optimal accelerometer wear-site specific cut-points for discrimination of the sedentary time, light physical activity and moderate-to-vigorous physical activity (MVPA) in older adults. Twenty-three adults (14 females) aged 55-77 years wore a GENEActiv accelerometer on their non-dominant wrist, dominant wrist, waist and dominant ankle whilst undertaking eight, five-minute bouts of activity: lay supine, seated reading, slow walking, medium walking, fast walking, folding laundry, sweeping and stationary cycling. VO2 was assessed concurrently using indirect calorimetry. Receiver-operating-characteristic (ROC) analyses were used to derive wear-site specific cut-points for classifying intensity. Indirect calorimetry indicated that being lay supine and seated reading were classified as sedentary (3 METs). Areas under ROC curves indicated that the classification of sedentary activity was good for the non-dominant wrist and excellent for all other wear sites. Classification of MVPA was excellent for the waist and ankle, good for the waist and poor for the dominant and non-dominant wrists. Overall, the ankle location performed better than in other locations. Ankle-worn accelerometry appears to provide the most suitable wear-site to discriminate between sedentary time and MVPA in older adults

Consequences of intensive forest harvesting on the recovery of Swedish lakes from acidification and on critical load exceedances

Across much of the northern hemisphere, lakes are at risk of re-acidification due to incomplete recovery from historical acidification and pressures associated with more intensive forest biomass harvesting. Critical load (CL) calculations aimed at estimating the amount of pollutants an ecosystem can receive without suffering adverse consequences are dependent on these factors. Here, we present a modelling study of the potential effects of intensified forest harvesting on re-acidification of a set of 3239 Swedish lakes based on scenarios with varying intensities of forest biomass harvest and acid deposition. There is some evidence that forestry would have caused a certain level of acidification even if deposition remained at 1860 levels. We show that all plausible harvest scenarios delay recovery due to increased rates of base cation removal. Scenario results were used to estimate critical loads for the entire population of lakes in Sweden. The forestry intensity included in critical load calculations is a political decision. After scaling calculations to the national level, it was apparent that a high but plausible forest harvest intensity would lead to an increase in the area of CL exceedances and that even after significant reductions in forest harvest intensity, there would still be areas with CL exceedances. Our results show that forest harvest intensity and regional environmental change must be carefully considered in future CL calculations

Deprescribing admission medication at a UK teaching hospital; a report on quantity and nature of activity

Background: Deprescribing medication may be in response to an adverse clinical trigger (reactive) or if future gains are unlikely to outweigh future harms (proactive). A hospital admission may present an opportunity for deprescribing, however current practice is poorly understood. Objective: To quantify and describe the nature of deprescribing in a UK teaching hospital. Method: Prescribing and discontinuation data for admission medication from a hospital’s electronic prescribing system were extracted over 4 weeks. The rationale for discontinuation of a random sample of 200 was determined using medical records. This informed categorisation of deprescribing activity by clinicians into ‘proactive’ or ‘reactive’. Data were extrapolated to estimate the proportion of admission medications deprescribed and the proportion which were reactive and proactive. Results: From 24,552 admission medicines, 977 discontinuations were recorded. Of the 200 discontinuations sampled for review, only 44 (22.0%) were confirmed deprescribing activities; categorised into 7 (15.9%) proactive and 37 (84.1%) reactive. Extrapolation yielded 0.6% (95% CI 0.5–0.7%) of all admission medications deprescribed. Conclusion: Limited deprescribing activity, dominated by reactive behaviour was identified, suggesting prescribers require a clinical trigger to prompt deprescribing. There may be scope for increasing proactive deprescribing in hospital, however the extent to which this is feasible is unknown

Application of probabilistic fracture mechanics in risk based non destructive examination of new building ships

Risk based methods can be used to optimise None Destructive Examination (NDE) planning of new building ship hull structures. A key step in this method is estimation of failure probability of fabrication weld defects under fatigue loading. This is achieved through probabilistic fatigue and fracture mechanics assessment. In this paper probabilistic fatigue and fracture mechanics analysis of a butt weld for a ship deck plate is presented

Development of expertise in elite and sub-elite British rugby league players: A comparison of practice experiences

Previous studies have investigated how individuals reach an expert level by counting the number of hours engaged in specific practice types. Here we sought to understand and compare the microstructure (e.g. practice tasks undertaken) of these practice hours experienced by elite and sub-elite British rugby league players. Semi-structured interviews explored the practice experiences of eight international and eight domestic level players. A two-staged thematic analysis was used to interpret the data. The analysis revealed that both player groups experienced a rich and narrow landscape of affordances and were exposed to early diversification of sports experiences during childhood. Differences were identified in domestic level players’ experiences of amateur and professional sports, where episodes of negative developmental environments were reported. International players’ practice experiences revealed differences in their professional careers, where exposure to scenario-based practice and dynamic learning environments were reported. The findings suggest that insights from ecological dynamics provide a suitable theoretical framework to guide coaches in the design of practice environments that should consider the physical, psychological, emotional and social dimensions of expertise acquisition

Development of a hospital Deprescribing Implementation Framework : a focus group study with geriatricians and pharmacists

Background: over 50% of older people in hospital are prescribed a pre-admission medicine that is potentially inappropriate; however, deprescribing by geriatricians and pharmacists is limited. This study aimed to characterise geriatricians’ and pharmacists’ barriers and enablers to deprescribing in hospital. It also intended to develop a framework of intervention components to facilitate implementation of hospital deprescribing. Methods: fifty-four geriatricians and pharmacists representing four UK hospitals attended eight focus groups. We designed a topic guide to invite discussions about barriers and enablers to deprescribing. After thematic analysis, themes were mapped to the theoretical domains framework (TDF), enabling prioritisation of domains for behaviour change. We then identified evidence-based intervention components for changing behaviour within prioritised TDF domains. Results: geriatricians and pharmacists described several deprescribing enablers in the hospital setting including alignment with their role and generalist knowledge, and routine patient monitoring. Five prioritised TDF domains represent the key barriers and enabler: patient and caregiver attachment to medication (social influence); perceptions that deprescribing is riskier than continuing to prescribe (beliefs about consequences); pharmacists’ working patterns limiting capacity to support deprescribing (environmental context and resources); deprescribing being a low hospital priority (goals) and incentives to deprescribe (reinforcement). Prioritised TDF domains aligned with 44 evidence-based intervention components to address the barriers and enabler to hospital deprescribing. Conclusion: the behavioural determinants and their associated intervention components provide a hospital deprescribing implementation framework (hDIF). Intervention components should be selected from the hDIF to provide a theory and evidence-based intervention tailored to hospital contexts