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Concrete shell structures offer a mechanically efficient solution as a building floor system to reduce the environmental impact of our buildings. Although the curved geometry of shells can be an obstacle to their fabrication and implementation, digital fabrication and affordable robotics provide a means for the automation of their construction in a sustainable manner at an industrial scale. The applicability of such structures is demonstrated in this paper with the realisation of a large-scale concrete shell floor system, completed by columns, tie rods, and a levelled floor. The shell was prefabricated off-site in segments that can be transported and assembled on-site, and which can be disassembled to enable a circular economy of construction. This paper presents the conceptual and structural design; the automation of fabrication, thanks to an actuated, reconfigurable, reusable mould and a robotic concrete spraying process; the strategy and sequence of assembly and disassembly on-site using standard scaffold elements; and the sustainability assessment using life-cycle analysis. This prototype offers a reduction of about 50% of cradle-to-gate embodied carbon benchmarked against regular flat slabs before further improvement and optimisation

PurposeUnderstanding the supply network of construction materials used to construct shelters in refugee camps, or during the reconstruction of communities, is important as it can reveal the intricate links between different stakeholders and the volumes and speeds of material flows to the end-user. Using social network analysis (SNA) enables another dimension to be analysed – the role of commonalities. This is likely to be particularly important when attempting to replace vernacular materials with higher-performing alternatives or when encouraging the use of non-vernacular methods. This paper aims to analyse the supply networks of four different disaster-relief situations.Design/methodology/approachData were collected from interviews with 272 displaced (or formally displaced) families in Afghanistan, Bangladesh, Nepal and Turkey, often in difficult conditions.FindingsThe results show that the form of the supply networks was highly influenced by the nature/cause of the initial displacement, the geographical location, the local availability of materials and the degree of support/advice given by aid agencies and or governments. In addition, it was found that SNA could be used to indicate which strategies might work in a particular context and which might not, thereby potentially speeding up the delivery of novel solutions.Research limitations/implicationsThis study represents the first attempt in theorising and empirically investigating supply networks using SNA in a post-disaster reconstruction context. It is suggested that future studies might map the up-stream supply chain to include manufacturers and higher-order, out of country, suppliers. This would provide a complete picture of the origins of all materials and components in the supply network.Originality/valueThis is original research, and it aims to produce new knowledge.

This paper provides a review of the capabilities of WAAM for manufacturing steel components for use in the construction industry, with a focus on the structural stability and design of WAAM builds. Manufacturing techniques that can be used for WAAM construction are first discussed. This is followed by a detailed review of the material and geometric properties, and the resulting structural stability performance of WAAM steel structures to date. To exploit the advantage of WAAM in building free-form shapes, structural optimisation techniques suitable for WAAM construction are discussed. Lastly, conclusions and future research directions are provided.

Thin, rectangular structural plates are used in a wide range of applications, including architectural sheet metal cladding, in which the magnitude of lateral deflection is much larger the material’s thickness. This study compares new experimental data with established algebraic models and assesses the influence of practicalities such as geometric tolerances and partial fixity of connections. Errors and anomalies are identified in existing analytical formulas. It is also shown that standardised test methods measure only part of an imperfectly-flat plate’s lateral movement, and that the actual displacement of plates in real structures can be several times greater than that inferred by a naive application of non-linear plate theory. Findings are presented as set of guidelines to help practising engineers create economical structures that will not deflect excessively when load is applied.

Aim:The aim of this paper is to investigate the effectiveness of physical exercise in managing fatigue during radiotherapy for prostate cancer patients. It explores the impact of various physical exercise regimes and their role in the prevention and management of fatigue to help inform best practice.Method:A literature search was conducted on OVID Medline database with a follow-up search on google scholar to include relevant references found during the initial search. Relevant systematic reviews and randomised controlled trials (RCTs) arising from this search were reviewed.Findings:There is evidence to support the notion that physical exercise in all its forms is an effective and safe intervention for fatigue management for prostate cancer patients undergoing radiotherapy. Although widely studied, there is limited evidence of fatigue management strategies being clearly implemented into current radiotherapy practice for patients with prostate cancer. This information is essential to enable therapeutic radiographers to educate prostate cancer patients regarding effective exercise strategies and ensure that fatigue is managed optimally.Conclusion:Further research is required into the optimum physical exercise prescription to reduce radiation-induced fatigue, and standardised best practice guidelines should be developed nationally. A future move toward patient education into physical exercise and wellbeing should be a central component of the therapeutic radiographer role with specialist advice offered by review radiographers, empowering patients to become more physically active during treatment. Therapeutic radiographers have a unique opportunity to educate and promote physical exercise through a holistic wellbeing approach that aims to mitigate fatigue and improve quality of life.

Purpose:To evaluate the information needs of radiotherapy patients and their families. To explore influential factors regarding information-seeking behaviours. To identify the preferred formats of information and the optimum time for radiotherapy patients to receive information. To assess the implications for clinical practice in satisfying patient information needs.Method:A Cumulative Index to Nursing and Allied Health Literature database search of literature was undertaken and publications screened for retrieval with 36 qualifying for inclusion in the evaluation.Results:There was inconclusive evidence exploring the impact that patient age, diagnosis, family background, and educational status had on the information-seeking behaviours and preferences of cancer patients. There is an agreement that there are positive and negative benefits of using different formats of information: verbal, written, virtual, and so on, and ultimately healthcare providers must utilise a combination of information formats to satisfy the information needs and preferences of individual patients. Inconsistent data were found on the optimum time to deliver cancer information to patients and professionals, and therapeutic radiographers should not assume that their information priorities are the same as those of their patients—every patient has unique and individually specific information needs.Conclusion:The information needs of patients and families are dependent on individual circumstances, and priorities have a tendency to change during the cancer management journey, presenting huge challenges for therapeutic radiographers who are required to regularly reassess and satisfy the varying needs and preferences. More research is needed within the area of information needs and preferences for cancer patients receiving radiotherapy.

Increasing evidence suggests that the COVID-19 pandemic has influenced the mental health of health professionals, including radiographers. Less is known about the effect of the pandemic on the mental health of radiography managers. Radiography managers have led their teams through the pandemic, making unpopular decisions to safeguard staff and patients. This study explores radiography managers' perceptions regarding the impact of the COVID-19 pandemic on the mental health of themselves and their staff.Ethical approval was obtained from the NHS Research Ethics Committee (ID 287032). Eleven interviews were conducted with therapeutic and diagnostic radiography managers between March-April 2021. Written information was also included from a paediatric diagnostic radiography manager. Data was analysed independently by 2 researchers using thematic analysis.Three central themes emerged: 1) Factors perceived to have negatively influenced mental health, which included changing PPE guidance, restructuring of work conditions, social isolation, challenges to patient care and lack of quality vacation leave. 2) Factors perceived to have positively influenced mental health, which included witnessing staff resilience and team camaraderie. 3) Support provided for mental health.Managers felt that they had implemented appropriate strategies to support their staff throughout the first year of the pandemic and expressed feeling responsible for the wellbeing of their staff. Strong empathy was evident towards staff and their experiences. Despite the availability of mental health support services, managers felt that resources were underutilised by radiography teams.Managers should be proactive in communicating their appreciation for their staff in an era where remote working can add to disconnect between staff and management. Mental health support services should be promoted and continually reviewed, to ensure that appropriate support services are maintained.

Structural optimization methods can be extremely powerful when used at the initial, conceptual, design stage of a building or bridge structure, potentially identifying materially efficient forms that are beyond the imagination of a human designer. This is particularly important at present, given the pressing need to reduce the carbon footprint associated with the built environment in the face of the current climate emergency. In this contribution, a computationally efficient global-local optimization framework is proposed, in which a linear programming-based truss layout optimization step is employed to generate initial (near-)optimal designs, with a non-linear optimization step then used to generate designs that take account of real-world complexity. To facilitate rapid exploration of design concepts, the proposed global-local optimization framework has been made available in the Peregrine plug-in for the popular Rhino-Grasshopper parametric modelling environment. The efficacy of the approach is demonstrated through its application to a range of case study problems.

UNSTRUCTURED Introduction The design of Personal Protective Equipment (PPE) may affect well-being and clinical work. PPE as an integrated item may improve usability and increase adherence by health workers (HW) and reduce occupational-acquired diseases. As integrated PPE, a lightweight battery-powered air-purifying respirator (L-PAPR) could be used during health procedures where HWs are exposed to airborne pathogens. The human factors affecting implementation of alternative PPE such as L-PAPR have not been thoroughly studied. Research Question Under which conditions and testing by human factors are NIOSH Standards compliant PAPRs and Light PAPRs superior to a NIOSH certified N95 Respirator and Face shield in clinical care. The population is healthcare professionals, the intervention is task type, the comparators are N95 and Face Shield, Traditional PAPR and Light PAPR. The outcomes are user-error, communications, safety and end-user preferences Type of study and main methods This is an interventional randomized crossover quality improvement feasibility study consisting of a 3 site simulation study (Phase 1; 10 participants each site) and 2 site field testing (Phase 2; 30 participants each site). The following aspects are evaluated comparing L-PAPR (integrated PPE), the traditional PAPR and N95 and Face shield: perceived workload, usability, usage errors, and heart rate. Interviews to identify barriers and enablers to implementation, and effective training will be conducted.

Over the last two decades, urban geometry has been shown to be a key determinant of the microclimatic conditions in urban areas. This study uses the Ladybug-tools, the plugins of Grasshopper3D to optimise building heights, street widths and orientation to maximise outdoor thermal comfort, represented by the diurnal average Universal Thermal Climate Index (UTCI). In the hot-arid climate of Cairo, Egypt, the optimised parameters of symmetrical and asymmetrical urban canyons are compared with the Egyptian Construction Act's design regulations. The results show a strong negative correlation between the height-to-width (H/W) ratios and the output UTCI, with R² = 0.71, and much stronger (R² = 0.91) if east-west orientations are excluded from the results, exceeding correlations previously reported for Cairo. Maximum UTCI reductions due to changing H/W and orientation approach ∼6°C. Considerable variation is shown in the strength of the correlation between UTCI and the asymmetrical H/W ratio of each flank, with R² = 0.81 for Southeast side compared to R² = 0.4 for Northwest side. Design recommendations are given urban planners based on using the optimised parameters that at least achieve a UTCI reduction benchmark that exceeds those resulting from using the regulations’ thresholds.

Background and purpose: The COVID-19 pandemic has led to the introduction of alternative on-treatment and post-treatment radiographer-led review clinics in an attempt to protect patients, staff and the public. Pre-COVID, patient reviews were routinely undertaken face-to-face, led by therapeutic review radiographers with advanced practice qualifications and skills in radiotherapy symptom management, triage, referral and support services. During the COVID-19 pandemic, an alternative option has been to follow-up in the form of telephone reviews to reduce face-to-face exposure whilst continuing to manage patient radiotherapy treatment-related toxicities. The aim of the narrative review is to explore the subject of telephone reviews and how therapeutic review radiographers might need to adapt communication skills so that they can continue to effectively assess and manage radiotherapy patient treatment reactions remotely. Method and discussion: A narrative review was conducted using the SCOPUS database and 28 publications were included from 2013 to 2021. The review highlights a paucity of literature exploring specific telephone training for radiographers and other allied healthcare professionals. Experiences within medical and nursing programmes demonstrate that development and integration of training in this area is critical in preparing for patient interaction via telephone. Conclusion and implications for practice: Multiple teaching modalities including simulation are ideal for teaching telephone-specific skills and content, demonstrating improvement in student knowledge, competence and confidence. Less is known regarding whether this knowledge translates to an improved patient experience. Enhancements in education and training, guided by the Health and Care Professions Council, may be warranted to ensure that patients continue to receive the optimal quality of care in a world where remote reviews are likely to become commonplace. Patient-reported outcome measures might be utilized for future training evaluations to ensure that effective patient care is being maintained.

Introduction:The management of breast cancer patients from diagnosis to treatment and beyond can be variable depending on factors including tumour extent and location, histology, genetics, health and wellbeing of the patient as well as personal patient preferences. The therapeutic radiographer’s role is not only vital to ensure safe and accurate radiotherapy delivery but also crucially, as the regular patient interface, they must be fully empowered to engage effectively with all aspects of the patient care pathway. They must be knowledgeable and up to date with evidence-based practices relating to the patient experience including surgery, chemotherapy, endocrine therapy and radiotherapy.Aim:The aim of this paper is to outline the breast cancer management pathway, highlighting the potential side effects that occur as a result of breast radiotherapy treatment and concomitant treatment in order to inform therapeutic radiographers and best practice.Discussion:The treatment pathway for breast cancer patients varies greatly depending on a wide range of factors and is very much individualised for each patient. Each treatment modality has its advantages and disadvantages, and all come with a number of side effects that can affect a patient’s daily living. Toxicities can arise during radiotherapy treatment or months after treatment, and education regarding the management of these is essential for effective patient care. Many technological advances in radiotherapy treatment techniques and regimes have the potential to decrease radiation-induced side effects. Despite attempts to standardise clinical guidelines on the use of topical agents and dressings, historical opinions and ideas are still evident in clinical practice. The use of grading systems in radiotherapy tends to only record patients’ physical symptoms and not their holistic wellbeing and emotional needs.Conclusion:Therapeutic radiographers must ensure that they remain equipped with the skills and knowledge to correctly manage and/or signpost services effectively. This overall outline of the management of patients with breast cancer is designed to help therapeutic radiographers reflect on the current practices and to inspire them, where evidence dictates, to seize opportunities, to explore improvement and to enhance best practice.

Introduction:Breast cancer patients referred for external beam radiotherapy and who have large and/or pendulous breasts can present positioning and immobilisation challenges. Deep infra-mammary and/or lateral wrap skin folds can occur that can lead to unwanted radiation-induced skin toxicity. The purpose of the study was to evaluate the immobilisation techniques adopted for this subgroup of patients in order to inform best practice.Method:A survey aimed to identify the current clinical practice in radiotherapy centres throughout the United Kingdom and Ireland was undertaken. The email survey was distributed with support of the Radiotherapy Services Managers group.Results:Twenty-six of the 74 radiotherapy centres responded to the survey. Responses demonstrated that supine positioning with or without additional immobilisation was preferable. Of the eight different immobilisation techniques identified, patients positioned supine on a breast board wearing a bra was the most common. Only two of the centres reported using a prone technique.Conclusions:Immobilisation and reproducibility are key for successful external beam radiotherapy particularly when advanced treatment techniques are being employed. No single technique gained widespread acceptance as the optimum for the effective immobilisation of patients with large and/or pendulous breasts. Further evaluative research in the form of a multi-centre trial is warranted in order to clearly establish the most effective immobilisation methods/devices for this ever expanding, subgroup of cancer patients.

Purpose Shell structures are highly efficient and are an elegant way of covering large uninterrupted spaces, but their complex geometry is notoriously difficult to model and analyse. This paper aims to describe a novel free-form shell modelling technique based on structural harmonics. Design/methodology/approach The method builds on work using weighted eigenmodes for three-dimensional mesh modelling in a computer graphics setting and extends it by specifically adapting the technique to an architectural design context. This not only enables the sculpting of free-form architectural surfaces using only a few control parameters but also takes advantage of the synergies between eigenmodes and structural buckling modes, to provide an efficient means of stiffening a shell against failure by buckling. Findings The result is a flexible free-form modelling tool that not only enables the creation of arbitrary doubly curved surfaces but also allows simultan. The tool helps to assist in the design of shells at the conceptual stage and encourages an interaction between the architect and engineer. A number of initiatives, including a single degree of freedom design, boundary constraints, visualisation aids and guidelines towards specific spatial configurations have been introduced to satisfactorily adapt the method to an architectural context. Originality/value The tool helps to assist in the design of shells at the conceptual stage and encourages an interaction between the architect and engineer. A number of initiatives, including a single degree of freedom design, boundary constraints, visualisation aids and guidelines towards specific spatial configurations have been introduced to satisfactorily adapt the method to an architectural context. This paper includes a full case study of the iconic British Museum Great Court Roof to demonstrate the applicability of the developed framework to real-world problems and the software developed to implement the method is available as an open-source download.

Aim:Breast cancer patients experience skin reactions during radiotherapy. Radiation-induced skin reactions can result in treatment delivery being interrupted. The aim of this paper is to evaluate the skincare management of patients receiving radiotherapy for breast cancer in order to inform best practice.Method:A literature search was undertaken using USearch and HONNI in support of the first-hand evidence gained from the supervised on-treatment review of patients receiving radiotherapy for breast cancer.Results:There is evidence to suggest that the skincare advice given to patients varies widely between departments in the UK with many not following nationally recommended guidelines. Studies demonstrate that there are ways to reduce skin reactions and that there are a range of effective management strategies being adopted. Prophylactic skincare has been explored to improve the resilience of the skin prior to commencing radiotherapy.Findings:Further investigation is required in order to clearly establish the optimum national skincare management for breast cancer patients. More studies are required to test the effectiveness and viability of prophylactic measures. Skincare guidance needs to be robustly developed and effectively promoted by therapeutic radiographers for radiotherapy patients to benefit from reduced, radiation-induced, skin reactions.

Modern architectural design has seen a shift towards iconic doubly-curved envelopes enclosing large column-free spaces. Gridshells have long been considered an efficient solution to such designs, but their actual use in practice has not spread worldwide. For elastic gridshells, their advantages in terms of substantial material savings can often be overshadowed by the significant challenges associated with their construction. Similarly, for rigid gridshells, the manufacture of a large number of different members and nodal connections is often a barrier to their implementation. This paper proposes an effective way of designing, fabricating and erecting gridshells. The "Patchwork Gridshell" consists of a number of efficient elastic gridshell patches assembled using rigid gridshell frames. It can easily generate a number of different configurations, use a wide range of materials, and allows more architectural expression of practical long-span forms. The benefits of combining the ingenuously simple efficiency of elastic lattices and the power of digital fabrication are demonstrated by digitally rebuilding four alternative configurations of the Japan Pavilion of the Hanover Expo 2000 as a case study. The result is a flexible digital workflow which creates large column-free spaces that are capable of being constructed efficiently by non- specialist contractors.

Truss layout optimization problems with global stability constraints are nonlinear and nonconvex and hence very challenging to solve, particularly when problems become large. In this paper, a relaxation of the nonlinear problem is modelled as a (linear) semidefinite programming problem for which we describe an efficient primal-dual interior point method capable of solving problems of a scale that would be prohibitively expensive to solve using standard methods. The proposed method exploits the sparse structure and low-rank property of the stiffness matrices involved, greatly reducing the computational effort required to process the associated linear systems. Moreover, an adaptive ‘member adding’ technique is employed which involves solving a sequence of much smaller problems, with the process ultimately converging on the solution for the original problem. Finally, a warm-start strategy is used when successive problems display sufficient similarity, leading to fewer interior point iterations being required. We perform several numerical experiments to show the efficiency of the method and discuss the status of the solutions obtained.

Background Coronavirus disease 2019 has impacted upon the role and safety of healthcare workers, with the potential to have a lasting effect on their wellbeing. Limited research has been conducted during previous pandemics exploring how student healthcare workers are impacted as they study and train for their professional careers. Objective The aim of the current study was to examine the specific impact of COVID-19 on the academic, clinical and personal experiences of healthcare students. Method Undergraduate students across three year groups within the School of Health Sciences at Ulster University completed online Qualtrics surveys at three timepoints during one academic year (2020/2021). Quantitative survey data was downloaded from Qualtrics into SPSS Version 25 for descriptive analysis of each cross-sectional sample. Qualitative survey data was downloaded into text format, which was thematically analysed using content analysis. Results 412 students completed the survey at Time 1 (October 2020), n = 309 at Time 2 (December 2020) and n = 259 at Time 3 (April 2021). Academically, the pandemic had mostly a negative impact on the learning environment, the development of practical skills, the assessment process and opportunities for peer learning and support. Students reported increased stress and challenges managing their workload and maintaining a sense of motivation and routine. Clinically, they felt unprepared by the university for placement where the pandemic had an increasingly negative impact over time on learning and skill development. In terms of personal experiences, despite the majority of students taking steps to keep physically and mentally well, negative impacts on friendships, mental wellbeing and concerns for family were reported. The pandemic had not impacted upon career choice for most students. Conclusion Consideration must be given to the development of practical skills so students feel prepared for their professional careers given the practical nature of their roles. Programme coordinators should adopt a holistic approach to student wellbeing.

In this paper, we introduce geometry optimization into an existing topology optimization workflow for truss structures with global stability constraints, assuming a linear buckling analysis. The design variables are the cross-sectional areas of the bars and the coordinates of the joints. This makes the optimization problem formulations highly nonlinear and yields nonconvex semidefinite programming problems, for which there are limited available numerical solvers compared with other classes of optimization problems. We present problem instances of truss geometry and topology optimization with global stability constraints solved using a standard primal-dual interior point implementation. During the solution process, both the cross-sectional areas of the bars and the coordinates of the joints are concurrently optimized. Additionally, we apply adaptive optimization techniques to allow the joints to navigate larger move limits and to improve the quality of the optimal designs.

Concrete is a major contributor to the environmental impact of the construction industry, due to its cement content but also its reinforcement. Reinforcement has a significant contribution because of construction rationalisation, resorting to regular mats or cages of steel bars, despite layoutoptimisation algorithms and additive-manufacturing technologies. This paper presents an automated framework, connecting design and fabrication requirements for the optimisation of spatial layouts as of reinforcement of concrete structures, by the means of robotic filament winding.