Understanding stakeholder requirements on an NHS hospital project: application of semiotics-rooted theories.

Hospitals represent complex and difficult contexts for AEC (architecture, engineering and construction) professionals to engage with due to their functional complexity and diversity of stakeholder interests (i.e. patient, visitor, medical specialist). Hospital designers need to take note of changing NHS policy contexts (e.g. the possible empowerment of general practitioners to shape services), technological advances in medical equipment design and the potential health needs of future generations. It is imperative for hospital designers and architects to align their processes and methodologies (e.g. briefing and requirements capture) to the needs and desires of their clients so that a medical facility design is produced which is truly aligned to the requirements of the hospital stakeholders. Semiotics, the “study” or “discipline” of signs aims to investigate the nature of signs (their inception, representation and meaning), whilst semiotics-rooted theories are concerned with investigating how meaning and understanding is mobilized between persons and between organisations. This paper details a semiotics-rooted research approach for investigating the interactions between hospital designers and stakeholders on a forthcoming NHS hospital project in the UK. A semiotics grounded study will potentially provide a deeper understanding of how meaning and understanding is established between hospital project stakeholders and construction professionals.

Implications of climate change for expanding cities worldwide

This paper analyses the trends of the changing environmental effects within growing megacities as their diameters exceed 50–100 km and their populations rise beyond 30 million people. The authors consider how these effects are influenced by climate change, to which urban areas themselves contribute, caused by their increasing greenhouse gas emissions associated with rapidly expanding energy use. Other environmental and social factors are assessed, quantitatively and qualitatively, using detailed modelling of urban mesoscale meteorology, which shows how these factors can lead to large conurbations becoming more vulnerable to climatic and environmental hazards. The paper discusses the likely changes in meteorological and hydrological hazards in urban areas, both as the climate changes and the sizes of urban areas grow. Examples are given of how these risks are being reduced through innovations in warning and response systems, planning and infrastructure design, which should include refuges against extreme natural disasters. Policies are shown to be more effective when they are integrated and based on substantial community involvement. Some conclusions are drawn regarding how policies for the natural and artificial environment and for reducing many kinds of climate and hazard risk are related to future designs and planning of infrastructure and open spaces.

Developing construction professional services in the international market: SWOT analysis of China

Construction professional services (CPSs), such as architecture, engineering, and consultancy, are not only high value-added profit centers in their own right but also have a knock-on effect on other businesses, such as construction and the export of materials and machinery. Arguably, competition in the international construction market has shifted to these knowledge-intensive CPS areas. Yet CPSs represent a research frontier that has received scant attention. This research aims to enrich the body of knowledge on CPSs by examining strengths, weaknesses, opportunities, and threats (SWOT) of Chinese CPSs (CCPSs) in the international context. It does so by triangulating theories with quantitative and qualitative data gleaned from yearbooks, annual reports, interviews, seminars, and interactions with managers in major CCPS companies. It is found that CCPSs present both strengths and weaknesses in talents, administration systems, and development strategies in dealing with the external opportunities and threats brought about by globalization and market evolution. Low price, which has helped the Chinese construction business to succeed in the international market, is also a major CCPS strength. An opportunity for CCPSs is the relatively strong delivery capability possessed by Chinese contractors; by partnering with them CCPSs can better establish themselves in the international arena. This is probably the first ever comprehensive study on the performance of CCPSs in the international marketplace. The research is conducted at an opportune time, particularly when the world is witnessing the burgeoning force of Chinese businesses in many areas including manufacturing, construction, and, potentially, professional services. It adds new insights to the knowledge body of CPSs and provides valuable references to other countries faced with the challenge of developing CPS business efficiently in the international market.

Developing construction professional services in the international market: a SWOT analysis of China

In contrast to their bustling construction counterparts, Chinese construction professional services (CPS) such as architecture, engineering, and consultancy, seem still to be stagnant in the international market. CPS are not only high value-added profit centers in their own right, but also have a knock-on effect on subsequent businesses such as construction, and the export of materials and machinery. Arguably, competition in the international construction market has shifted to knowledge-intensive CPS. Yet,CPS represent a research area that has been paid scant attention. This research aims to add to the body of knowledge of CPS by examining strengths, weaknesses, opportunities, and threats (SWOT) of Chinese CPS (CCPS) in the international context. It does so by triangulating theories with quantitative and qualitative data gleaned from yearbooks, annual reports, interviews, seminars, and interactions with managers in major CCPS companies. It is found that CCPS present both strengths and weaknesses in talents, administration systems, and development strategies in dealing with the external opportunities and threats brought about by globalization and market evolvement. Low price, which has helped the Chinese construction business to succeed in the international market, is also a CCPS major strength. An opportunity for CCPS is the relatively strong delivery capability possessed by Chinese contractors. By partnering with them CCPS can better edge into the international arena. This is probably the first ever comprehensive study in investigating the performance of CCPS in the international market. The research is also timely, particularly when the world is witnessing the burgeoning force of Chinese businesses in many areas including manufacturing, construction, and potentially, professional services.

Educational simulation in construction: the virtual construction simulator

Students in the architecture, engineering, and construction disciplines are often challenged with visualizing and understanding the complex spatial and temporal relationships involved in designing and constructing three-dimensional (3D) structures. An evolving body of research traces the use of educational computer simulations to enhance student learning experiences through testing real-world scenarios and the development of student decision-making skills. Ongoing research at Pennsylvania State University aims to improve engineering education in construction through interactive construction project learning applications in an immersive virtual reality environment. This paper describes the first- and second-generation development of the Virtual Construction Simulator (VCS), a tool that enables students to simultaneously create and review construction schedules through 3D model interaction. The educational value and utility of VCS was assessed through surveys, focus group interviews, and a student exercise conducted in a construction management class. Results revealed VCS is a valuable and effective four-dimensional (4D) model creation and schedule review application that fosters collaborative work and greater student task focus. This paper concludes with a discussion of the findings and the future development steps of the VCS educational simulation

Barabas's Fall

Early modern play-texts present numerous puzzles for scholars interested in ascertaining how plays were (or may have been) staged. the principal evidence of course for a notional "reconstruction" of practices is the apparatus of stage directions, augmented by indications in the dialogue. in conjunction a joining-of-the-dots is often possible, at least in broad-brush terms. But as is well known, the problem is that stage directions tend to be incomplete, imprecise, inaccurate ­ or missing altogether; more significantly, even when present they offer only slight and indirect evidence of actual stagecraft. Some stage directions are rather more "literary" than "theatrical" in provenance, and in any case to the extent that they do serve the reader (early modern or modern) they cannot be regarded as providing a record of stage practice. After all, words can be no more than imperfect substitutes for (and of another order from) the things they represent. For the most part directions serve as a guide that provides the basis for reasonable interpretation informed by our knowledge of theatre architecture, technology, and comparable play-situations, rather than concrete evidence of actual practice. Quite how some stage business was carried out remains uncertain, leaving the scholar little option but to hypothesize solutions. One such conundrum arises in christopher Marlowe's The Jew of Malta. the scenario in question is hardly an obscure one, but it has not been examined in detail, even by modern editors. the purpose of this essay is to explore what sense might be made of the surviving textual evidence, in combination with our knowledge of theatre architecture and playmaking culture in the late sixteenth century.

A multicentre randomized controlled trial of an empowerment-inspired intervention for adolescents starting continuous subcutaneous insulin infusion : a study protocol

Background. Continuous subcutaneous insulin infusion (CSII) treatment among children with type 1 diabetes is increasing in Sweden. However, studies evaluating glycaemic control in children using CSII show inconsistent results. Omitting bolus insulin doses using CSII may cause reduced glycaemic control among adolescents. The distribution of responsibility for diabetes self-management between children and parents is often unclear and needs clarification. There is much published support for continued parental involvement and shared diabetes management during adolescence. Guided Self-Determination (GSD) is an empowerment-based, person-centred, reflection and problem solving method intended to guide the patient to become self-sufficient and develop life skills for managing difficulties in diabetes self-management. This method has been adapted for adolescents and parents as Guided Self-Determination-Young (GSD-Y). This study aims to evaluate the effect of an intervention with GSD-Y in groups of adolescents starting on insulin pumps and their parents on diabetes-related family conflicts, perceived health and quality of life (QoL), and metabolic control. Here, we describe the protocol and plans for study enrolment. Methods. This study is designed as a randomized, controlled, prospective, multicentre study. Eighty patients between 12-18 years of age who are planning to start CSII will be included. All adolescents and their parents will receive standard insulin pump training. The education intervention will be conducted when CSII is to be started and at four appointments in the first 4 months after starting CSII. The primary outcome is haemoglobin A1c levels. Secondary outcomes are perceived health and QoL, frequency of blood glucose self-monitoring and bolus doses, and usage of carbohydrate counting. The following instruments will be used to evaluate perceived health and QoL: Disabkids, 'Check your health', the Diabetes Family Conflict Scale and the Swedish Diabetes Empowerment Scale. Outcomes will be evaluated within and between groups by comparing data at baseline, and at 6 and 12 months after starting treatment. Results and discussion. In this study, we will assess the effect of starting an insulin pump together with the model of Guided Self-Determination to determine whether this approach leads to retention of improved glycaemic control, QoL, responsibility distribution and reduced diabetes-related conflicts in the family. Trial registration: Current controlled trials: ISRCTN22444034