Material Management in Confined Site Construction

The objective of this paper is to identify various managerial issues encountered and resulting strategies adopted, with regards management of materials on confined construction site. This is achieved through classifying the various managerial burdens encountered with the numerous strategies adopted, for the successful management of such confined environments within the realm of materials management.


Through conducting an extensive literature review and detailed interviews, a comprehensive insight into the materials management concerns within a confined construction site environment is envisaged and portrayed. The following are the leading issues highlighted; (1)Lack of adequate storage space, (2)Work place becoming over-crowded, (3)Lack of adequate room for the effective handling of materials and (4)Difficult to transport materials around site. The leading managerial strategies to the management of materials on confined construction sites may be listed in order of importance, as follows; (1)Pre-fabrication and pre-assembly, (2)Providing adequate storage, (3)Space scheduling, (4)Just-In-Time delivery techniques, and (5)Effective design site layout.

Based on the research conducted, it can be concluded, that through effective management of the issues identified along with implementing the various strategies highlighted; successful materials management within a confined construction site environment is attainable.


Innovative Aspect of Paper: An empirical study of three different construction sites in three different countries (Ireland, England and USA) investigating the managerial issues and strategies relating to implementation of materials management in confined construction sites.

The mediastinal staging accuracy of 18F-Fluorodeoxyglycose Positron Emission Tomography/Computed Tomography in non-small cell lung cancer with variable time intervals to surgery.

BACKGROUND: PET/CT scanning can determine suitability for curative therapy and inform decision making when considering radical therapy in patients with non-small cell lung cancer (NSCLC). Metastases to central mediastinal lymph nodes (N2) may alter such management decisions. We report a 2 year retrospective series assessing N2 lymph node staging accuracy with PET/CT compared to pathological analysis at surgery.

METHODS: Patients with NSCLC attending our centre (excluding those who had induction chemotherapy) who had staging PET/CT scans and pathological nodal sampling between June 2006 and June 2008 were analysed. For each lymph node assessed pathologically, the corresponding PET/CT status was determined. 64 patients with 200 N2 lymph nodes were analysed.

RESULTS: Sensitivity of PET/CT scans for indentifying involved N2 lymph nodes was
39%, specificity 96% and overall accuracy 90%. For individual lymph node analysis, logistic regression demonstrated a significant linear association between PET/CT sensitivity and time from scanning to surgery (p=0.031) but not for specificity and accuracy. Those scanned <9 weeks before pathological sampling were significantly more sensitive (64% >9 weeks, 0% ≥ 9 weeks, p=0.013) and more accurate (94% <9 weeks, 81% ≥ 9 weeks, p=0.007). Differences in specificity were not seen (97% <9 weeks, 91% ≥ 9 weeks, p=0.228). No significant difference in specificity was found at any time point.

CONCLUSIONS: We recommend that if a PET/CT scan is older than 9 weeks, and management would be altered by the presence of N2 nodes, re-staging of the
mediastinum should be undertaken.

Waste Management and Sustainability during the Design Phase of a Construction Project: A Qualitative Review

Waste management and sustainability are two core underlying philosophies that the construction sector must acknowledge and implement; however, this can prove difficult and time consuming. To this end, the aim of this paper is to examine waste management strategies and the possible benefits, advantages and disadvantages to their introduction and use, while also to examine any inter-relationship with sustainability, particularly at the design stage. The purpose of this paper is to gather, examine and review published works and investigate factors which influence economic decisions at the design phase of a construction project. In addressing this aim, a three tiered sequential research approach is adopted; in-depth literature review, interviews/focus groups and qualitative analysis. The resulting data is analyzed, discussed, with potential conclusions identified; paying particular attention to implications for practice within architectural firms. This research is of importance, particularly to the architectural sector, as it can add to the industry’s understanding of the design process, while also considering the application and integration of waste management into the design procedure. Results indicate that the researched topic had many advantages but also had inherent disadvantages. It was found that the potential advantages outweighed disadvantages, but uptake within industry was still slow and that better promotion and their benefits to; sustainability, the environment, society and the industry were required.

Perceptions of the Nurse Practitioner Role in Facilitating the Implementation of an Onsite Pain Management Team in Long Term Care

Background: One strategy to improve pain management in long term care (LTC) is to optimize the emerging role of the nurse practitioner (NP) in LTC. The purpose of this sub study was to learn about the NP role in implementing an onsite, interdisciplinary Pain Team in the LTC home setting.

Methods: We used a case study design that included two NPs who worked at separate LTC homes. Each of the NPs completed a weekly questionnaire of pain-related activities that they engaged in over a one-year implementation period; and a diary, using critical reflection, about their experiences and strategies used to implement the Pain Team. Descriptive statistics and thematic content analysis were used to analyze the case study data.

Findings: NPs tended to be most engaged in pain assessment and collaborated more with licensed nurses and personal support workers; less with pharmacists. NPs were more involved in organizational level activities, such as participating in committee work or assisting with the development of policies and procedures about pain. NPs created palliative care and pain service protocols; engaged in policy development, in-servicing, quality assurance and advocacy; and encouraged best practices. NPs were challenged with time constraints for pain management and balancing other role priorities and felt that increased scope of practice for them was needed.

Conclusions: The results of this study highlight how NPs implemented a Pain Team in LTC which may be helpful to others interested in implementing a similar strategy to reduce residents’ pain.

Lightweight Risk Management in Agile projects

Risk management in software engineering has become a recognized project management practice but it seems that not all companies are systematically applying it. At the same time, agile methods have become popular, partly because proponents claim that agile methods implicitly reduce risks due
to, for example, more frequent and earlier feedback, shorter periods of development time and easier prediction of cost. Therefore, there is a need to investigate how risk management can be usable in iterative and evolutionary software development processes. This paper investigates the gathering of empirical data on risk management from the project environment and presents
a novel approach to manage risk in agile projects. Our approach is based on a prototype tool, Agile Risk Tool (ART). This tool reduces human effort in risk management by using software agents to identify, assess and monitor risk, based on input and data collected from the project environment and by applying
some designated rules. As validation, groups of student project data were used to provide evidence of the efficacy of this approach. We demonstrate the approach and the feasibility of using a lightweight risk management tool to alert, assess and monitor risk with reduced human effort.

The Effectiveness of Weight Management Interventions in Breastfeeding Women—A Systematic Review and Critical Evaluation

Background: The postpartum period is a vulnerable time for excess weight retention, particularly for the increasing number of women who are overweight at the start of their pregnancy and subsequently find it difficult to lose additional weight gained during pregnancy. Although postpartum weight management interventions play an important role in breaking this potentially vicious cycle of weight gain, the effectiveness of such interventions in breastfeeding women remains unclear. Our aim was to systematically review the literature about the effectiveness of weight management interventions in breastfeeding women.

Methods: Seven electronic databases were searched for eligible papers. Intervention studies included were carried out exclusively in breastfeeding mothers, ≤2 years postpartum and with a body mass index greater than 18.5 kg/m2, with an outcome measure of change in weight and/or body composition.

Results: Six studies met the selection criteria, and were stratified according to the type of intervention and outcome measures. Despite considerable heterogeneity among studies, the dietary-based intervention studies appeared to be the most efficacious in promoting weight loss; however, few studies were tailored toward the needs of breastfeeding women.

Conclusions: Weight management interventions which include an energy-restricted diet may play a key role in successful postpartum weight loss for breastfeeding mothers.

Public management, Peace-building and Creating Change: Shifting the Lens of Analysis from the Macro to the Micro

Considerable time, research money and expertise has been spent exploring the complex reality of ethno nationalist conflict and the role that public management plays in supporting the transition from violent conflict to stability, order and prosperity (Esman 1999; Guelke and Milton-Edwards 2000; Brinkerhoff 2005; Brinkerhoff, Wetterberg et al. 2012; Rao 2014). However, there seems to be a gap in relation to the practical challenges of managing change within, through and beyond such conflict. This paper aims to begin the process of putting a framework around the real experience of public management in conflict and transition by shifting the lens of analysis from macros concerns about sequencing interventions (Rao 2014) and legitimate requirements of security, stability and service delivery (Brinkerhoff, Wetterberg et al. 2012) to a micro analysis of the attitudes, behaviours, challenges and compromises held and faced by those public servants on the front line of conflict management and conflict transformation processes. Using senior managers as the unit of analysis and Northern Ireland as an embryonic case study, this paper discusses the links between ethno nationalist societal conflict, public sector reform and manager behaviour. In doing so, it highlights some initial data from an early pilot study into the experiences of individuals in significant public service roles at various stages of the NI conflict / peace process and draws some tentative conclusions about the viability of a wider study.

Increase in the pharmacological management of Type 2 diabetes with pay-for-performance in primary care in the UK

Aims To determine whether the financial incentives for tight glycaemic control, introduced in the UK as part of a pay-for-performance scheme in 2004, increased the rate at which people with newly diagnosed Type 2 diabetes were started on anti-diabetic medication.

Methods A secondary analysis of data from the General Practice Research Database for the years 1999-2008 was performed using an interrupted time series analysis of the treatment patterns for people newly diagnosed with Type 2 diabetes (n=21 197).

Results Overall, the proportion of people with newly diagnosed diabetes managed without medication 12months after diagnosis was 47% and after 24months it was 40%. The annual rate of initiation of pharmacological treatment within 12months of diagnosis was decreasing before the introduction of the pay-for-performance scheme by 1.2% per year (95% CI -2.0, -0.5%) and increased after the introduction of the scheme by 1.9% per year (95% CI 1.1, 2.7%). The equivalent figures for treatment within 24months of diagnosis were -1.4% (95% CI -2.1, -0.8%) before the scheme was introduced and 1.6% (95% CI 0.8, 2.3%) after the scheme was introduced.

Conclusion The present study suggests that the introduction of financial incentives in 2004 has effected a change in the management of people newly diagnosed with diabetes. We conclude that a greater proportion of people with newly diagnosed diabetes are being initiated on medication within 1 and 2years of diagnosis as a result of the introduction of financial incentives for tight glycaemic control.

Real-time temperature estimation for power MOSFETs considering thermal aging effects

This paper presents a novel real-time power-device temperature estimation method that monitors the power MOSFET's junction temperature shift arising from thermal aging effects and incorporates the updated electrothermal models of power modules into digital controllers. Currently, the real-time estimator is emerging as an important tool for active control of device junction temperature as well as online health monitoring for power electronic systems, but its thermal model fails to address the device's ongoing degradation. Because of a mismatch of coefficients of thermal expansion between layers of power devices, repetitive thermal cycling will cause cracks, voids, and even delamination within the device components, particularly in the solder and thermal grease layers. Consequently, the thermal resistance of power devices will increase, making it possible to use thermal resistance (and junction temperature) as key indicators for condition monitoring and control purposes. In this paper, the predicted device temperature via threshold voltage measurements is compared with the real-time estimated ones, and the difference is attributed to the aging of the device. The thermal models in digital controllers are frequently updated to correct the shift caused by thermal aging effects. Experimental results on three power MOSFETs confirm that the proposed methodologies are effective to incorporate the thermal aging effects in the power-device temperature estimator with good accuracy. The developed adaptive technologies can be applied to other power devices such as IGBTs and SiC MOSFETs, and have significant economic implications. 

Methodologies for the Development of the Management of Cough: CHEST Guideline and Expert Panel Report

BACKGROUND: This series of guidance documents on cough, which will be published over time, is a hybrid of two processes: (1) evidence-based guidelines and (2) trustworthy consensus statements based on a robust and transparent process.

METHODS: The CHEST Guidelines Oversight Committee selected a nonconflicted Panel Chair and jointly assembled an international panel of experts in each clinical area with few, if any, conflicts of interest. PICO (population, intervention, comparator, outcome)-based key questions and parameters of eligibility were developed for each clinical topic to inform the comprehensive literature search. Existing guidelines, systematic reviews, and primary studies were assessed for relevance and quality. Data elements were extracted into evidence tables and synthesized to provide summary statistics. These, in turn, are presented to support the evidence-based graded recommendations. A highly structured consensus-based Delphi approach was used to provide expert advice on all guidance statements. Transparency of process was documented.

RESULTS: Evidence-based guideline recommendations and consensus-based suggestions were carefully crafted to provide direction to health-care providers and investigators who treat and/or study patients with cough. Manuscripts and tables summarize the evidence in each clinical area supporting the recommendations and suggestions.

CONCLUSIONS: The resulting guidance statements are based on a rigorous methodology and transparency of process. Unless otherwise stated, the recommendations and suggestions meet the guidelines for trustworthiness developed by the Institute of Medicine and can be applied with confidence by physicians, nurses, other health-care providers, investigators, and patients.

British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus

These guidelines provide a practical and evidence-based resource for the management of patients with Barrett's oesophagus and related early neoplasia. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was followed to provide a methodological strategy for the guideline development. A systematic review of the literature was performed for English language articles published up until December 2012 in order to address controversial issues in Barrett's oesophagus including definition, screening and diagnosis, surveillance, pathological grading for dysplasia, management of dysplasia, and early cancer including training requirements. The rigour and quality of the studies was evaluated using the SIGN checklist system. Recommendations on each topic were scored by each author using a five-tier system (A+, strong agreement, to D+, strongly disagree). Statements that failed to reach substantial agreement among authors, defined as >80% agreement (A or A+), were revisited and modified until substantial agreement (>80%) was reached. In formulating these guidelines, we took into consideration benefits and risks for the population and national health system, as well as patient perspectives. For the first time, we have suggested stratification of patients according to their estimated cancer risk based on clinical and histopathological criteria. In order to improve communication between clinicians, we recommend the use of minimum datasets for reporting endoscopic and pathological findings. We advocate endoscopic therapy for high-grade dysplasia and early cancer, which should be performed in high-volume centres. We hope that these guidelines will standardise and improve management for patients with Barrett's oesophagus and related neoplasia.

Blood eosinophils as a marker of likely corticosteroid response in children with preschool wheeze: time for an eosinophil guided clinical trial?

Childhood wheezing is common particularly in children under the age of six years and in this age-group is generally referred to as preschool wheezing. Particular diagnostic and treatment uncertainties exist in these young children due to the difficulty in obtaining objective evidence of reversible airways narrowing and inflammation. A diagnosis of asthma depends on the presence of relevant clinical signs and symptoms and the demonstration of reversible airways narrowing on lung function testing, which is difficult to perform in young children. Few treatments are available and inhaled corticosteroids are the recommended preventer treatment in most international asthma guidelines. There is however considerable controversy about its effectiveness in children with preschool wheeze and a corticosteroid responder phenotype has not been established. These diagnostic and treatment uncertainties in conjunction with the knowledge of corticosteroid side-effects, in particular the reduction of growth velocity, has resulted in a variable approach to inhaled corticosteroid prescribing by medical practitioners and a reluctance in carers to regularly administer the treatment. Identifying children who are likely responders to corticosteroid therapy would be a major benefit in the management of this condition. Eosinophils have emerged as a promising biomarker of corticosteroid responsive airways disease and evaluation of this biomarker in sputum has successfully been employed to direct management in adults with asthma. Obtaining sputum from young children is time-consuming and difficult and it is hard to justify more invasive procedures such as a bronchoscopy in young children routinely. Recently, in children, interest has shifted to assessing the value of less invasive biomarkers of likely corticosteroid response and the biomarker 'blood eosinophils' has emerged as an attractive candidate. The aim of this review is to summarise the evidence for blood eosinophils as a predictive biomarker for corticosteroid responsive disease with a particular focus on the difficult area of preschool wheeze. 

An integrated approach for real-time model-based state-of-charge estimation of lithium-ion batteries

Lithium-ion batteries have been widely adopted in electric vehicles (EVs), and accurate state of charge (SOC) estimation is of paramount importance for the EV battery management system. Though a number of methods have been proposed, the SOC estimation for Lithium-ion batteries, such as LiFePo4 battery, however, faces two key challenges: the flat open circuit voltage (OCV) vs SOC relationship for some SOC ranges and the hysteresis effect. To address these problems, an integrated approach for real-time model-based SOC estimation of Lithium-ion batteries is proposed in this paper. Firstly, an auto-regression model is adopted to reproduce the battery terminal behaviour, combined with a non-linear complementary model to capture the hysteresis effect. The model parameters, including linear parameters and non-linear parameters, are optimized off-line using a hybrid optimization method that combines a meta-heuristic method (i.e., the teaching learning based optimization method) and the least square method. Secondly, using the trained model, two real-time model-based SOC estimation methods are presented, one based on the real-time battery OCV regression model achieved through weighted recursive least square method, and the other based on the state estimation using the extended Kalman filter method (EKF). To tackle the problem caused by the flat OCV-vs-SOC segments when the OCV-based SOC estimation method is adopted, a method combining the coulombic counting and the OCV-based method is proposed. Finally, modelling results and SOC estimation results are presented and analysed using the data collected from LiFePo4 battery cell. The results confirmed the effectiveness of the proposed approach, in particular the joint-EKF method.