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Collaborative care model versus usual care for the management of musculoskeletal and co-existing mental health conditions: a randomised feasibility mixed-methods study.
Get PDFThis study aimed to assess the feasibility of a future trial comparing the collaborative care model with usual care for patients with musculoskeletal conditions and co-existing symptoms of anxiety and depression. A single-centre, parallel-arm, one-to-one, randomised controlled trial design using a mixed-methods approach was used. semistructured interviews and focus groups were conducted post intervention with all participants and staff respectively to explore acceptability towards the model and identify recommendations for improvements. An orthopaedic rehabilitation outpatient tertiary hospital. Adult patients with musculoskeletal conditions and co-existing moderate or severe symptoms of anxiety and depression attending outpatient therapy appointments. The collaborative care model consisted of a tailored management programme to facilitate the integration of care provided by physical and mental healthcare professionals. A case manager screened and coordinated targeted mental health support for participants. Participants allocated to usual care had no support from the case manager. Feasibility indicators (rates of recruitment, randomisation and retention), acceptability of clinical outcome measures, usage of additional resources and cost of intervention implementation. Of the 89 patients who provided consent to take part, 40 participants who matched the eligibility criteria were randomised to either the intervention (n=20) or usual care arm (n=20). Overall adherence to the intervention was 58.82%, while the withdrawal rate was 37.5% at 6 months. All of the 27 participants who were retained completed self-reported outcomes. Qualitative data highlighted that integrated mental health support was favourably perceived. In addition to prenegotiating protected psychology time, the need for operationalised communication between the case manager and clinicians was identified as a recommendation for a future trial. The trial and intervention were acceptable to patients and healthcare professionals. While the findings demonstrate the feasibility of trial recruitment, a future trial will require optimised retention strategies to improve adherence and withdrawal rates. NCT05018039. [Abstract copyright: © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
A pragmatic trial of an Artificial intelligence DRiven appOInTment maNagEment SyStem (ADROITNESS) in NHS outpatient departments: WP3 REPORT
No full textDrDoctor is an artificial intelligence system that seeks to predict the probability of outpatient not attending their appointment (phase 1) predicting linked clinics (phase2a) and predicting out of sequence linked appointments (phase 2b).
LSBU were commissioned by NHS England to evaluate the use of the DrDoctor system in two NHS trusts to see if it is accurate, safe, effective provides value and explore person centred aspects (phase 1) and due to time constrainst resulting from DrDoctor delays in development consider the only the processes adopted (for phases 2a and 2b).
A summary of phase 1 work stream 3 How effective is the DrDoctor AI system? covering rationale, objectives, hypotheses, methods and results for this work strea
Critical Success Factors for Cost Overrun Minimization in Public Construction Projects in Developing Countries: The Case of Ghana
Get PDFPurpose: It is widely accepted that one criterion for determining if a construction project is successful is whether it is completed within the expected budget. There have been advancements in the management of building projects throughout time; but, cost overruns remain a key concern in the construction sector internationally, particularly in emerging economies like Ghana. The study aims to answer the question, “What are the critical success factors that can assist reduce cost overruns in public-sector infrastructure projects in the Ghanaian construction industry?”
Methodology: The study used a quantitative survey method. Questionnaire was pre-tested by interviewing 15 contractors to ascertain the validity of the content. Factor analysis and multiple regression were adopted to analyse the data.
Findings: The study discovered that the critical factors that can reduce cost overruns in construction projects in Ghana are directly linked to five themes: early contractor involvement in the project planning stage, adequate funding, good project team relations, competent managers/supervisors, and project participant incentives/bonuses. This study identifies indestructible empirically measurable important success criteria for reducing cost overruns in public building projects in Ghana.
Practical implication: When well thought through from the project initiation stage to completion, these critical successes can also be used to deal with damaging economic effects such as allocative inefficiency of scarce resources, further delays, contractual disputes, claims and litigation, project failure, and total abandonment.
Originality: The uniqueness of this research resides in the fact that it is a first-of-its-kind investigation of the critical success factors for reducing cost overruns in public building projects in developing countries
Evaluation of Mental Health First Aid within a workplace context.
Get PDFBackground: Evidence suggests that Mental Health First Aid (MHFA) benefits organisations and employees. However, there has been no systematic investigation of the impact of MHFA on direct recipients and the organisations that adopt MHFA. Aims of thesis: The thesis aims to [1] evaluate the effectiveness of MHFA on help-seeking behaviour amongst employees and direct recipients, [2] explore participants’ experience and the impact of MHFA on workplace culture and relationships, [3] understand the active ingredients and mechanisms of action in MHFA that improves help-seeking behaviour for mental health difficulties. Methods Design: An embedded mixed methods design comprising a two-arm clustered Randomised Controlled Trial (RCT) comparing MHFA and usual practice, a qualitative evaluation, and theoretical mapping of MHFA onto the Behavioural Change Wheel (BCW). Sample: The participants were mental health first-aiders and other employees who have received MHFA directly or indirectly, working in randomly allocated UK clusters. Measures: Standard measures of participants’ help-seeking behaviour, helpseeking intentions, mental health and well-being, self-efficacy levels, and use of health and social services were used to assess the impact of MHFA. Procedure: Employees within these organisations were assessed via online completion of measures at baseline and 6 months post-intervention. A purposive selection of participants was interviewed. In addition, a consensus approach was taken to retrospectively map the MHFA intervention to the associated elements of the BCW. Results & Discussions: The study found that MHFA does not encourage formal help-seeking behaviour and identifies contributing factors to a preference for informal help-seeking avenues outside the workplace through qualitative interviews. Also, the thesis identified key components of health behaviour change, such as problem-solving, action planning, and social support as active ingredients in MHFA. However, there were inconsistencies in the practical 2 application of the MHFA interventions. The study suggests that more research is needed to determine the effectiveness of MHFA interventions on direct recipients and to explore the factors that contribute to mental health help-seeking. Utilising the COM-B model and TDF in future studies can help identify the changes required to facilitate actual help-seeking behaviour in a bid to improve MHFA intervention
Content/Form: A Peer-reviewed Newspaper
Get PDFThis publication explores content as inseparable from the forms and formats through which it is rendered. If our attachment to all forms and formats – served to us by big tech – limit the space for political possibility and collective action, then we ask what alternatives might be envisioned, including for research itself? What does research do in the world? Perhaps what is missing is a stronger account of the structures that render our research experiences, that produce new imaginaries, new spatial and temporal forms? [...] The workshop was organised by SHAPE Digital Citizenship and Digital Aesthetics Research Center (Aarhus University), and the Centre for the Study of the Networked Image (London South Bank University), and further supported by the Creative Computing Institute at University of the Arts London (UAL), in collaboration with transmediale.
CONTRIBUTORS: Anya Shchetvina, Asker Bryld Staunæs, Batool Desouky, Bilyana Palankasova, Christian Ulrik Andersen, Denise Helene Sumi, Duncan Paterson, Edoardo Biscossi, Emilie Sin Yi Choi, Esther Rizo-Casado, Geoff Cox, George Simms, Katie Tindle, Kendal Beynon, Luca Cacini, Maja Bak Herrie, Manetta Berends, Mariana Marangoni, Marie Naja Lauritzen Dias, Mara Karagianni, Martyna Marciniak, Mateus Domingos, ooooo, Pablo Velasco, Pierre Depaz, Rachel Falconer, Rebecca Aston, Simon Browne, Søren Pold, Sunni Liao, Winnie Soon
Ionic Liquid Processing of Residual Wood Powder into Additive-Free Wood Composites
Get PDFThis work presents a novel process for production of additive-free wood composites by ionic liquid treatment of wood powder involving extraction of lignin followed by precipitation onto particle surfaces, and hot pressing to form a cellulose-reinforced lignin biocomposite. Physicochemical properties of lignin-coated wood powders, as well as their degree of fusion upon hot pressing, were evaluated with the aim of optimising ionic liquid treatment and hot-pressing conditions. Optimal conditions to achieve complete fusion while minimising process energy demand were determined using response surface methodology, and mechanisms of process parameter effects investigated using gas pycnometry, electron microscopy, image analysis, thermogravimetry, and calorimetry. These novel materials, derived solely from waste with only reusable reagents, represent a sustainable alternative to existing engineered wood products, which rely on petrochemical additives that release toxic volatile compounds, offering a means to reduce environmental and health hazards associated with production and use of composites from wood waste
Interventions for Quitting Vaping
Get PDFThis is a protocol for a Cochrane Review (intervention). The objectives are as follows:
To conduct a living systematic review to assess the benefits and harms of interventions to help people quit vaping compared to each other and to placebo or no intervention.
We will also assess how these interventions affect the use of combustible tobacco and whether effects vary based on participant characteristics
Everyday Welfare in Modern British History: Introduction
No full textEveryday Welfare in Modern British History: experience, expertise and activism addresses forms of action and activism used by individuals and groups who undertake the work of experiential expertise in relation to welfare cultures. We conceive of “experiential experts” as individuals whose action and activism has been catalysed by their personal experiences and knowledge. These individuals have asserted an expert witness status in welfare practice and sought out new forums to expand the scope, inclusivity, and applicability of welfare services.
Our book takes Robert Pinker’s idea of “a state of welfare” as the springboard to re-conceptualise the history of everyday welfare in twentieth century Britain. Shifting attention from the welfare state to “a state of welfare” has important impact, allowing us to de-centre the privileging in histories of welfare of the welfare state, and instead to focus on the subjective and experiential dimensions of welfare. In doing so, we also engage anew with what Pinker argued was the need to consider welfare through the lens of people “faring well”. The chapters in the book offer routes into examining varied ways people identified with how to live a life where they “far[ed] well”, contested models of “faring well” that were applied to them through formal welfare provision, and protested perceived injustices around what it meant to “fare well”. Everyday Welfare offers a new framing for histories of welfare. It opens a more inclusive, diverse, and representative account of what the experience of welfare meant to people, how they felt about it and what they did with it, reconceptualising the centrality of welfare in daily life, and the embeddedness of activism within welfare cultures
Integrating three pillars of sustainability for evaluating the modular construction building
Get PDFPurpose – The purpose of this study is to evaluate the sustainability performance of modular construction from a life cycle perspective. So far, the sustainability performance of modular buildings has been explored from a life cycle viewpoint. There is no comprehensive study showing which material is the best choice for modular construction considering all three sustainable pillars. Therefore, a life cycle sustainability performance framework, including the three-pillar evaluation framework, was developed for different modular buildings. The materials are concrete, steel and timber constructed as a modular construction method.
Design/methodology/approach – Transitioning the built environment to a circular economy is vital to achieving sustainability goals. Modular construction is perceived as the future of the construction industry, and in combination with objective sustainability, it is still in the evaluation phase. A life cycle sustainability assessment, which includes life cycle assessment, life cycle cost and social life cycle assessment, has been selected to evaluate alternative materials for constructing a case study building using modular strategies. Subsequently, the multi-criteria decision-making (MCDM) method was used to compute the outranking scores for each modular component.
Findings – The calculated embodied impacts and global warming potential (GWP) showed that material production is the most critical phase (65%–88% of embodied energy and 64%–86% of GWP). The result of embodied energy and GWP shows timber as an ideal choice. Timber modular has a 21% and 11% lower GWP than concrete and steel, respectively. The timber structure also has 19%and 13% lower embodied energy than concrete and steel. However, the result of the economic analysis revealed that concrete is the most economical choice. The cost calculations indicate that concrete exhibits a lower total cost by 4% compared to timber and 11% higher than steel structures. However, the social assessment suggests that steel emerges as the optimal material when contrasted with timber and concrete. Consequently, determining the best single material for constructing modular buildings becomes challenging. To address this, the MCDM technique is used to identify the optimal choice. Through MCDM analysis, steel demonstrates the best overall performance.
Originality/value – This research is valuable for construction professionals as it gives a deliberate framework for modular buildings’ life cycle sustainability performance and assists with sustainable construction materials
Face the Music: A 20 year plan
No full textThere has been ten years of progress since the 40th anniversary of the Institute of Acoustics Tyndall Medal presentation, 2014. Presented is an update on the on-going 20 year project to improve the working environment for musicians through the application of acoustics. The paper will cover advances in the awareness of the risks of hearing damage; developments in the assessment of hearing health through regular surveillance; and potential and implemented solutions. This research represents a collaboration with the Royal Academy of Music, the Royal Opera House, Henry Wood Hall and St Paul’s Cathedral