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There is emerging evidence of the detrimental impact of the pandemic and associated restrictions on young people’s mental health in the UK but to date, these data have been largely quantitative. The aim of the current study was to gain a deeper understanding of young people’s experiences in relation to their mental health and wellbeing during the pandemic. Seventeen young people, aged 11 to 16 years, sampled for diverse characteristics, and living in the UK, were interviewed virtually between December 2020 and February 2021. Reflexive thematic analysis was carried out by the research team, which included two young people, and five themes were developed: (1) positives; (2) worries and anxiety; (3) sadness and anger about losses; (4) mental exhaustion; and (5) support from others. Aspects of young people’s individual circumstances (e.g., pre-existing mental health difficulties; special educational needs and neurodevelopmental disorders) appeared to play a role in their experiences. Continued measurement of young people’s mental health, initiatives to identify young people who have been struggling and the provision of support (including evidence-based and accessible interventions) will be important for protecting young people from future adversities as we emerge from the pandemic.

The ability to communicate is integral to all human relationships. Previous research has specifically highlighted communication in families as both a risk and protective factor for anxiety disorders and/or depression. Yet, there is limited understanding about whether communication is amenable to intervention in the context of adolescent psychopathology and whether doing so improves outcomes. The aim of this systematic review was to determine in which contexts and for whom does addressing communication in families appear to work, not work, and why? From a total of 2418 papers that were screened, eight randomised controlled trials were identified from a systematic search of the literature. There was significant heterogeneity in the features of communication that were measured across these studies. There were mixed findings regarding whether family-focussed interventions led to improvements in communication. While there was limited evidence that family-focussed interventions led to improvements in communication relative to interventions without a family-focussed component, we discuss these findings in the context of the significant limitations in the studies reviewed. We conclude that further research is required to assess the efficacy of family focused interventions for improving communication in the context of anxiety and depression in those aged 14-24 years.

There is emerging evidence of the detrimental impact of the pandemic and associated restrictions on young people’s mental health in the UK but to date, this data has been largely quantitative. The aim of the current study was to gain a deeper understanding of young people’s experiences in relation to their mental health and wellbeing during the pandemic. Seventeen young people, aged 11-16 years, sampled for diverse characteristics, and living in the UK, were interviewed virtually between December 2020 and February 2021. Eighteen parents/carers and 10 professionals working with children and families and were also interviewed to gain a more comprehensive perspective of young people’s experiences. Reflexive thematic analysis was carried out by the research team, which included individuals with lived experience, and revealed five overarching themes: (1) positives; (2) worries and anxiety; (3) sadness and anger about losses; (4) mental exhaustion; and (5) support from others. Young people’s experiences appeared to vary according to key background characteristics. Continued measurement of young people’s mental health, initiatives to identify young people who have been struggling and the provision of support (including evidence-based and accessible interventions) will be important for protecting young people from future adversities as we emerge from the pandemic.

This qualitative study examined parents’ experiences of supporting their children during the COVID-19 pandemic. Seventeen parents of children aged 2-16 years from diverse backgrounds, living in the UK, were interviewed one-to-one about their experiences. Ten professionals working with children and families were also interviewed to gain a broader perspective of parents’ experiences. Using Reflexive Thematic Analysis, we identified four central themes: a) worries and uncertainties; b) mental exhaustion; c) resources available to cope with the challenges; and d) finding the positives. Findings revealed the worries and uncertainties that parents faced regarding how best to support their child and the long-term consequences of the pandemic, as well as feelings of mental exhaustion from juggling multiple responsibilities. The impact of Covid-19 on parents’ wellbeing was varied and parents identified several factors that determined their ability to support their children, such as space in the home environment, support networks and their personal mental health. Despite the challenges, some parents reported positive experiences, such as strengthened family bonds during the pandemic. Our study emphasizes the importance of flexible work arrangements and family-friendly employment policies, as well as support for parents to enable them to support their children and look after their own wellbeing.

A new software tool, called HEPTAD (Hospital Evacuation Planning Tool for Assistance Devices), designed to aid evacuation planning in hospitals is described and demonstrated in this paper. The software can identify regions within a hospital geometry that are inappropriate for patients who require the use of specific movement assistance devices in the event of an emergency evacuation. Using the software, Hospital Emergency Coordinators can reduce the risk of allocating a bed to a patient from which they cannot be evacuated within a safe time. In addition, HEPTAD is designed to be a proof of concept for algorithms that will later be incorporated within the EXODUS egress model. HEPTAD utilises several techniques from autonomous robotics to generate the fastest viable egress route for movement assistance devices from every location in the geometry while considering device spatial constraints (size and shape) and kinematic constraints (maximum speeds, turning radius and holonomicity). It then uses the egress time of this route along with factors from space syntax (isovist and spaciousness) to analyse the emergency vulnerability of every location within the geometry.

Mental health disorders in children and adolescents are highly prevalent yet undertreated. A detailed understanding of the reasons for not seeking or accessing help as perceived by young people is crucial to address this gap. We conducted a systematic review (PROSPERO 42018088591) of quantitative and qualitative studies reporting barriers and facilitators to children and adolescents seeking and accessing professional help for mental health problems. We identified 53 eligible studies; 22 provided quantitative data, 30 provided qualitative data, and one provided both. Four main barrier/facilitator themes were identified. Almost all studies (96%) reported barriers related to young people’s individual factors, such as limited mental health knowledge and broader perceptions of help-seeking. The second most commonly (92%) reported theme related to social factors, for example, perceived social stigma and embarrassment. The third theme captured young people’s perceptions of the therapeutic relationship with professionals (68%) including perceived confidentiality and the ability to trust an unknown person. The fourth theme related to systemic and structural barriers and facilitators (58%), such as financial costs associated with mental health services, logistical barriers, and the availability of professional help. The findings highlight the complex array of internal and external factors that determine whether young people seek and access help for mental health difficulties. In addition to making effective support more available, targeted evidence-based interventions are required to reduce perceived public stigma and improve young people’s knowledge of mental health problems and available support, including what to expect from professionals and services. Electronic supplementary material The online version of this article (10.1007/s00787-019-01469-4) contains supplementary material, which is available to authorized users.

Anxiety disorders are common in adolescence but outcomes for adolescents are unclear and we do not know what factors moderate treatment outcome for this age group. We conducted meta-analyses to establish the effectiveness of psychological therapies for adolescent anxiety disorders in (i) reducing anxiety disorder symptoms, and (ii) remission from the primary anxiety disorder, compared with controls, and examine potential moderators of treatment effects. The protocol was registered with PROSPERO (CRD42018091744). Electronic databases (Web of Science, MEDLINE, Psycinfo, EMBASE) were searched from January 1990 to December 2019. 2511 articles were reviewed, those meeting strict criteria were included. Random effects meta-analyses were conducted. Analyses of symptom severity outcomes comprised sixteen studies (CBT k = 15, non-CBT k = 1; n = 766 adolescents), and analyses of diagnostic remission outcomes comprised nine (CBT k = 9; n = 563 adolescents). Post-treatment, those receiving treatment were significantly more likely to experience reduced symptom severity (SMD = 0.454, 95% CI 0.22–0.69) and remission from the primary anxiety disorder than controls (RR = 7.94, 95% CI 3.19–12.7) (36% treatment vs. 9% controls in remission). None of the moderators analysed were statistically significant. Psychological therapies targeting anxiety disorders in adolescents are more effective than controls. However, with only just over a third in remission post-treatment, there is a clear need to develop more effective treatments for adolescents, evaluated through high-quality randomised controlled trials incorporating active controls and follow-up data.

Guidance is scarce on whether and how to involve parents in treatment for anxiety and depressive disorders in children and young people. We did a scoping review of randomised controlled trials of psychological interventions for anxiety and depressive disorders in children and young people, in which parents were involved in treatment, to identify how parents and carers have been involved in such treatments, how this relates to both child and broader outcomes, and where research should focus. We identified 73 trials: 62 focused on anxiety and 11 on depressive disorders. How parents were involved in treatments varied greatly, with at least 13 different combinations of ways of involving parents in the anxiety trials and seven different combinations in the depression trials. Including parents in treatment did not impair children's and young people's outcomes, but the wide variability in how they were involved prevents clarity about why some trials favoured parent involvement and others did not. Studies must consider the long-term and wider benefits beyond children's and young people's mental health, such as enhanced engagement, family wellbeing, and economic gains.

Increasing attention is being paid to the carbon sequestration and storage services provided by coastal blue carbon ecosystems such as saltmarshes. Sites restored by managed realignment, where existing sea walls are breached to reinstate tidal inundation to the land behind, have considerable potential to accumulate carbon through deposition of sediment brought in by the tide and burial of vegetation in the site. While this potential has been recognised, it is not yet a common motivating factor for saltmarsh restoration, partly due to uncertainties about the rate of carbon accumulation and how this balances against the greenhouse gases emitted during site construction. We use a combination of field measurements over four years and remote sensing to quantify carbon accumulation at a large managed realignment site, Steart Marshes, UK. Sediment accumulated rapidly at Steart Marshes (mean of 75 mm yr-1) and had a high carbon content (4.4% total carbon, 2.2% total organic carbon), resulting in carbon accumulation of 36.6 t ha-1yr-1total carbon (19.4 t ha- 1yr-1total organic carbon). This rate of carbon accumulation is an order of magnitude higher than reported in many other restored saltmarshes, and is higher although more similar to values previously reported from another hypertidal system (Bay of Fundy, Canada). The estimated carbon emissions associated with the construction of the site were ∼2-4% of the observed carbon accumulation during the study period, supporting the view that managed realignment projects in such settings are likely to have significant carbon accumulation benefits. We outline further considerations that are needed to move towards a full carbon budget for saltmarsh restoration.

Increasing attention is being paid to the carbon sequestration and storage services provided by coastal blue carbon ecosystems such as saltmarshes. Sites restored by managed realignment, where existing sea walls are breached to reinstate tidal inundation to the land behind, have considerable potential to accumulate carbon through deposition of sediment brought in by the tide and burial of vegetation in the site. While this potential has been recognised, it is not yet a common motivating factor for saltmarsh restoration, partly due to uncertainties about the rate of carbon accumulation and how this balances against the greenhouse gases emitted during site construction. We use a combination of field measurements over four years and remote sensing to quantify carbon accumulation at a large managed realignment site, Steart Marshes, UK. Sediment accumulated rapidly at Steart Marshes (mean of 75 mm yr-1) and had a high carbon content (4.4% total carbon, 2.2% total organic carbon), resulting in carbon accumulation of 36.6 t ha-1 yr-1 total carbon (19.4 t ha-1 yr-1 total organic carbon). This rate of carbon accumulation is an order of magnitude higher than reported in many other restored saltmarshes, and is somewhat higher than values previously reported from another hypertidal system (Bay of Fundy, Canada). The estimated carbon emissions associated with the construction of the site were ~2–4% of the observed carbon accumulation during the study period, supporting the view that managed realignment projects in such settings may have significant carbon accumulation benefits. However, uncertainties such as the origin of carbon (allochthonous or autochthonous) and changes in gas fluxes need to be resolved to move towards a full carbon budget for saltmarsh restoration.

Emergency exit signs used in buildings aid occupant wayfinding during an emergency. However, research suggests that conventional signs lack the ability to attract people's attention in an emergency. This can result in the underuse of emergency exits and the overuse of main entrances with potentially fatal consequences. The effectiveness of signage depends on their ability to draw occupants' attention. A novel dynamic signage design, Active Dynamic Signage System (ADSS), was proposed to address this issue through incorporating flashing green LEDs into the arrow of conventional exit signs. Its effectiveness was tested in a series of experiments achieving a detection rate of up to 77% as opposed to 38% for conventional exit signs. In this paper, the signage model within the buildingEXODUS software was adapted to represent the ADSS and a series of simulations were run to investigate the potential effectiveness of the ADSS compared to conventional signs. The scenarios examined involved a supermarket geometry, 900 agents and three levels of signage configuration. The modelling results suggest that the ADSS can reduce total egress times for this structure by 18%, congestion by 36%, travel distances by 12%, resulting in a more efficient evacuation compared with that produced by conventional signage.

Anxiety disorders are the most common psychiatric disorders among children and young people, affecting an estimated 6.5% of children and young people worldwide. Childhood anxiety disorders often persist into adulthood if left untreated and are associated with a significant emotional and financial cost to individuals, their families, and wider society. Models of the development and maintenance of childhood anxiety disorders have underpinned prevention and treatment approaches, and cognitive behavioral treatments have good evidence for their efficacy. Ongoing challenges for the field include the need to improve outcomes for those that do not benefit from current prevention and treatment, and to increase access to those who could benefit.

Anxiety aggregates in families. The key putative environmental mediators of risk transmission from parents to children include parental psychological control and behavioral control, which are important features of parenting in Chinese culture. It is unclear, however, whether Chinese parents’ own anxiety is associated with their partners’ controlling behaviors and whether control mediates the transmission of anxiety. This study aimed to examine whether and how anxiety is transmitted from parents to children with a mediation model incorporating an actor–partner interdependent model. We conducted a prospective longitudinal study with parents of Chinese children aged 7–12 years old (N = 651). Our results found the intergenerational transmission of anxiety from parents to children and maternal transmission of anxiety was mediated by maternal psychological control. Parental anxiety was positively associated with parents’ own psychological, but not behavioral, control. The data showed no association between parents’ own anxiety and their partners’ psychological or behavioral control. These findings support parental anxiety and maternal psychological control as critical risk factors in children’s development of anxiety in Chinese families.

List of key featuresBulbous nasal tipFull cheeks and lipsSlightly everted lower lipComplex focal seizuresDevelopmental delayStereotypic movementsIntroductionThe CASPR2 deficiency syndrome (MIM #610042) is an ultra-rare autosomal recessive condition characterized by moderate-to-severe intellectual di

Objective We conducted meta-analyses to assess risk for anxiety disorders among offspring of parents with anxiety disorders, and to establish whether there is evidence of specificity of risk for anxiety disorders as opposed to depression in offspring, and whether particular parent anxiety disorders confer risks for particular child anxiety disorders. We also examined whether risk was moderated by offspring age, gender, temperament, and the presence of depressive disorders in parents. Method We searched PsycINFO, PubMed, and Web of Science in June, 2016, and July, 2017 (PROSPERO CRD42016048814). Study inclusion criteria were as follows: published in peer-reviewed journals; contained at least one group of parents with anxiety disorders and at least one comparison group of parents who did not have anxiety disorders; reported rates of anxiety disorders in offspring; and used validated diagnostic tools to ascertain diagnoses. We used random and mixed-effects models and evaluated study quality. Results We included 25 studies (7,285 offspring). Where parents had an anxiety disorder, offspring were significantly more likely to have anxiety (risk ratio [RR] = 1.76, 95% CI = 1.58−1.96) and depressive disorders (RR = 1.31, 95% CI = 1.13−1.52) than offspring of parents without anxiety disorders. Parent panic disorder and generalized anxiety disorder appeared to confer particular risk. Risk was greater for offspring anxiety than for depressive disorders (RR = 2.50, 95% CI = 1.50−4.16), and specifically for offspring generalized anxiety disorder, separation anxiety disorder and specific phobia, but there was no evidence that children of parents with particular anxiety disorders were at increased risk for the same particular anxiety disorders. Moderation analyses were possible only for offspring age, sex, and parental depressive disorder; none were significant. Conclusion Parent anxiety disorders pose specific risks of anxiety disorders to offspring. However, there is limited support for transmission of the same particular anxiety disorder. These results support the potential for targeted prevention of anxiety disorders.

Background Coral reefs are rapidly changing in response to local and global stressors. Research to better understand and inform the management of these stressors is burgeoning. However, in situ studies of coral reef ecology are constrained by complex logistics and limited resources. Many reef studies are also hampered by the scale-dependent nature of ecological patterns, and inferences made on causal relationships within coral reef systems are limited by the scales of observation. This is because most socio-ecological studies are conducted at scales relevant to the phenomenon of interest. However, management often occurs across a significantly broader, often geopolitical, range of scales. While there is a critical need for incisive coral reef management actions at relevant spatial and temporal scales, it remains unclear to what extent the scales of empirical study overlap with the scales at which management inferences and recommendations are made. This systematic map protocol will evaluate this potential scale mismatch with the goal of raising awareness about the significance of effectively addressing and reporting the scales at which researchers collect data and make assumptions. Methods We will use the Collaboration for Environmental Evidence (CEE) systematic mapping guidelines to identify relevant studies using a framework-based synthesis to summarise the spatial and temporal scales of coral reef fish ecology research and the scales at which management inferences or recommendations are made. Using tested predefined terms, we will search for relevant published academic and grey literature, including bibliographic databases, web-based search engines, and organisational websites. Inclusion criteria for the evidence map are empirical studies that focus on coral reef fish ecological organisation and processes, those informing management interventions and policy decisions, and management documents that cite coral reef research for management decision-making. Study results will be displayed graphically using data matrices and heat maps. This is the first attempt to systematically assess and compare the scales of socio-ecological research conducted on coral reef systems with their management.

Background:Mental imagery plays an important role in models of anxiety disorders in adults. This understanding rests on qualitative and quantitative studies. Qualitative studies of imagery in anxious adolescents have not been reported in the literature.Aims:To address this gap, we aimed to explore adolescents’ experiences of spontaneous imagery in the context of anxiety disorders.Method:We conducted one-to-one semi-structured interviews, with 13 adolescents aged 13–17 years with a DSM-5 anxiety disorder, regarding their experiences of spontaneous imagery. We analysed participants’ responses using thematic analysis.Results:We identified five superordinate themes relating to adolescents’ influences on images, distractions from images, controllability of images, emotional responses to imagery and contextual influences on imagery.Conclusions:Our findings suggest that spontaneous images are an important phenomenon in anxiety disorders in adolescents, associated with negative emotions during and after their occurrence. Contextual factors and adolescents’ own cognitive styles appear to influence adolescents’ experiences of images in anxiety disorders.

This review represents a comprehensive analysis on pollutants in elasmobranchs including meta-analysis on the most studied pollutants: mercury, cadmium, PCBs and DDTs, in muscle and liver tissue. Elasmobranchs are particularly vulnerable to pollutant exposure which may pose a risk to the organism as well as humans that consume elasmobranch products. The highest concentrations of pollutants were found in sharks occupying top trophic levels (Carcharhiniformes and Lamniformes). A human health risk assessment identified that children and adults consuming shark once a week are exposed to over three times more mercury than is recommended by the US EPA. This poses a risk to local fishing communities and international consumers of shark-based products, as well as those subject to the widespread mislabelling of elasmobranch products. Wider screening studies are recommended to determine the risk to elasmobranchs from emerging pollutants and more robust studies are recommended to assess the risks to human health.

In hospitals, the evacuation of those with severe movement impairments can be highly problematic for the patients, for the staff and for other evacuees. It is critical to understand the performance of horizontal and vertical evacuation procedures, including the means by which people with reduced mobility can be assisted during stair descent. Microsimulation modelling provides a useful tool to assess evacuation strategies, given the challenges of preparing and transporting patients in need of on-going care and the unfeasibility of real evacuation drills. However, current simulation models typically focus on the movement of individual agents, not the staff-patient interactions and sizable equipment required to carry out assisted evacuation. To address this, the buildingEXODUS evacuation model has been enhanced to represent moving objects in addition to moving individual agents. This paper describes the modelling theory behind this development, where dedicated data has been applied to enable the explicit specification of evacuation devices, operated by agents (for instance, representing the vertical travel speeds achieved—with averages ranging between 0.6 m/s and 0.84 m/s—when employing different movement devices). Algorithms are presented that calculate the movement of devices along corridors, through doorways and in stairway descent, including a method of geometric decomposition of the available hospital evacuation routes. This new functionality addresses the key evacuation components of repeated patient collection and has numerous applications, both in simulating hospital evacuation and in representing evacuation of other premises that include people with reduced mobility. Examination of the performance of this functionality found it predicated performance within 6% of expectation. Once further testing is completed, the resultant tool can be used to significantly enhance planning and diagnostic capabilities related to the evacuation of hospital and other healthcare facilities.

Coastal ecosystems are threatened by habitat loss and anthropogenic “smoothing” as hard engineering approaches to sea defence, such as sea-walls, rock armouring, and offshore reefs, become common place. These artificial structures use homogenous materials (e.g. concrete or quarried rock) and as a result, lack the surface heterogeneity of natural rocky shoreline known to play a key role in niche creation and higher species diversity. Despite significant investment and research into soft engineering and ecologically sensitive approaches to coastal development, there are still knowledge gaps, particularly in relation to how patterns that are observed in nature can be utilised to improve artificial shores.Given the technical improvements and significant reductions in cost within the portable remote sensing field (structure from motion and laser scanning), we are now able to plug gaps in our understanding of how habitat heterogeneity can influence overall site diversity. These improvements represent an excellent opportunity to improve our understanding of the spatial scales and complexity of habitats that species occur within and ultimately improve the ecological design of engineered structures in areas experiencing “smoothing” and habitat loss.In this talk, I will highlight how advances in remote sensing techniques can be applied to context-specific ecological problems, such as low diversity and loss of rare species within marine infrastructure. I will describe our approach to combining large-scale ecological, 3D geophysical and engineering research to design statistically-derived ecologically-inspired solutions to smooth artificial surfaces. We created experimental concrete enhancement units and deployed them at a number of coastal locations. I will present preliminary ecological results, provide a workflow of unit development and statistical approaches, and finally discuss how these advances may improve future ecological intervention and design options.

During a major evacuation of high capacity buildings, such as a tower block or transportation hub, the emergency services will need to consider the safety of the people within the vicinity of the emergency. However, in general, when assessing the safety of a building for evacuation only the behaviour within the building is considered. One method of assessing this is to utilise a computer based simulation tool. This research outlines a number of developments required to simulate the impact of traffic on the evacuation process in an urban environment in relation to post-exiting behaviour. It uses a unique data set and model capabilities for representing pedestrian-vehicle interaction post-evacuation, which also considers the impact of time pressures on decision making. In addition, a number of software developments and pedestrian behaviours are identified for bridging the behavioural gaps when interfacing an emergency pedestrian model with a traffic simulation.

The devastating effects of wildfires cannot be overlooked; these include massive resettlement of people, destruction of property and loss of lives. The considerable distances over which wild fires spread and the rates at which these fires can spread is a major concern as this places considerable challenges on the evacuation mechanisms that need to be put in place. It is therefore crucial for personnel, involved in evacuation planning, to obtain reliable estimates of evacuation times faster than real time, to assist their decision making in response to actual unfolding of events. In this work, we present a hybrid approach, which we refer to as the Hybrid Spatial Discretisation (HSD) for large scale evacuation simulation. The HSD integrates the three spatial representation techniques typically used for representing space usage in evacuation models; namely Coarse regions, Fine nodes and Continuous regions. In this work, we describe the core models constituting the HSD coupled with the approaches used for representing the transition of agents across the different spatial types. Using a large scale case, we demonstrate how the HSD can be used to obtain higher resolution of results where it is most required while optimising the use of available computational resources for the overall simulation. The HSD is seen to provide improvements in run times of more than 40% when compared to modelling the whole area using just the Fine node method.

Saltmarshes can be created to compensate for lost habitat by a process known as managed realignment (MR), where sea defences are deliberately breached to flood low-lying agricultural land. However, the vegetation that develops on MR sites is not equivalent to natural habitat. In natural sites, surface topography and creek networks are drivers of vegetation diversity, but their development on restored sites has not been well studied. We investigate the topographic characteristics of 19 MR areas, and compare these to nearby natural saltmarshes (representing desired conditions) and to coastal agricultural landscapes (representing conditions prior to MR). From high-resolution LiDAR data, we extracted values of elevation, six measures of surface topography (although two were later excluded due to colliniarity), and three measures of creek density. MR and natural marshes differed significantly in all surface topographic indices, with MR sites having lower rugosity and more concave features, with greater potential for water accumulation. MR sites also had significantly lower creek density. MRs and coastal agricultural landscapes were more similar, differing in only one topographic measure. Importantly, there was no relationship between age since restoration and any of the topographic variables, indicating that restored sites are not on a trajectory to become topographically similar to natural marshes. MR schemes need to consider actively constructing topographic heterogeneity; better mirroring natural sites in this way is likely to benefit the development of saltmarsh vegetation, and will also have implications for a range of ecosystem functions.

The Hackitt Report into the tragic loss of 72 lives in the Grenfell Tower fire, identified failures and poor practices associated with the UK construction industry. To address these failures the report makes several recommendations, including the development of a “golden thread of information” to be embedded throughout the entire building lifecycle enabling the recording and preservation of information. This is to be achieved through Building Information Modelling (BIM). However, to create a “golden thread of information” in BIM from the Fire Safety Engineering (FSE) perspective particularly for the performance-based approach, many significant challenges and limitations must be resolved. These challenges include the fact that no FSE specific information exchange is available in BIM and that the results produced by fire and evacuation modelling tools are not explicitly captured in the BIM Industry Foundation Classes (IFC) Model. Of the FSE tools that support BIM, this is mainly limited to geometry extraction from an IFC file. In this paper, a practical conceptual strategy to pave the way to resolve these problems is proposed. A number of developments by the authors are discussed, forming part of an international collaboration project proposal administered by buildingSMART to enhance the IFC Model from the FSE perspective. Additionally, to evaluate and demonstrate the benefits of two-way data flow between BIM and FSE tools, a prototype system together with a preliminary FSE based analysis database have been developed. The work presented in this paper, provides a practical road map for creating a ‘golden thread of information’ in BIM for performance-based FSE analysis.

Evacuation simulation has the potential to be used as part of a decision support system during large-scale incidents to provide advice to incident commanders. To be viable in these applications, it is essential that the simulation can run many times faster than real time. Parallel processing is a method of reducing run times for very large computational simulations by distributing the workload amongst a number of processors. This paper presents the development of a parallel version of the rule based evacuation simulation software buildingEXODUS using domain decomposition. Four Case Studies (CS) were tested using a cluster, consisting of 10 Intel Core 2 Duo (dual core) 3.16 GHz CPUs. CS-1 involved an idealised large geometry, with 20 exits, intended to illustrate the peak computational speed up performance of the parallel implementation, the population consisted of 100,000 agents; the peak computational speedup (PCS) was 14.6 and the peak real-time speedup (PRTS) was 4.0. CS-2 was a long area with a single exit area with a population of 100,000 agents; the PCS was 13.2 and the PRTS was 17.2. CS-3 was a 50 storey high rise building with a population of 8000/16,000 agents; the PCS was 2.48/4.49 and the PRTS was 17.9/12.9. CS-4 is a large realistic urban area with 60,000/120,000 agents; the PCS was 5.3/6.89 and the PRTS was 5.31/3.0. This type of computational performance opens evacuation simulation to a range of new innovative application areas such as real-time incident support, dynamic signage in smart buildings and virtual training environments.

A new type of train configuration, known as Open Wide Gangway (OWG) is becoming popular, particularly in underground environments. Previous fire modelling analysis demonstrated that the OWG configuration was considered safe as or safer than conventional configurations as it reduced the likelihood of flashover. However, these studies have ignored the impact on evacuation of the spread of fire effluent to non-fire cars. Here we explore the fire safety offered by conventional and OWG configurations using coupled fire and evacuation modelling techniques. Two tunnel train situations are considered; one in which the car side doors are available for evacuation (train in a wide tunnel) and the other in which only the end cab doors are available (train in a narrow tunnel). Two population configurations are considered, fully and half loaded. Two ignition sources are also considered, one representing an accidental fire and the other an arson fire. The analysis demonstrates that while the OWG configuration may produce improved fire performance in the car of fire origin compared to the conventional configuration, if the interaction of the fire effluent with the evacuating passengers is considered, the OWG configuration results in a significantly greater number of casualties in virtually all the scenarios considered.

Background: Social anxiety disorder (SAD) aggregates in families. To elucidate intergenerational transmission of risk, we examined whether childhood SAD and symptoms of anxiety were prospectively predicted by stable infant temperamental inhibition, maternal SAD, maternal generalized anxiety disorder (GAD) and maternal parenting behaviours. Methods: We conducted a longitudinal study beginning prenatally with follow‐up at 4, 10, 14 and 58 months postnatally. Mothers were assessed for anxiety disorders prenatally and assigned to one of three groups: SAD (n = 67), GAD (n = 56) and nonanxious controls (n = 94). We assessed infant temperamental inhibition at 4 and 14 months, maternal parenting behaviours at 10 and 58 months, and child anxiety disorders and symptoms at 58 months. Results: Child SAD at 58 months was predicted by prenatal maternal SAD (OR = 23.76, 95% CI = 1.15–60.37), but not by prenatal maternal GAD (OR = 7.44, 95% CI = 0.32–124.49), stable temperamental inhibition or maternal behaviours. Child anxiety symptoms at 58 months were predicted specifically by maternal SAD (but not GAD), and also by concurrent maternal intrusiveness. Stable temperamental inhibition moderated the association between 10‐month maternal encouragement and 58‐month child anxiety symptoms. Conclusions: We found evidence for specificity of risk for child SAD and anxiety symptoms from maternal SAD compared to maternal GAD. Childhood anxiety symptoms were also predicted by an interaction between a lack of maternal encouragement in infancy and stable temperamental inhibition, as well as concurrent maternal intrusiveness. The findings have clinical implications for targeted prevention of child anxiety.

Behavioral genetic studies have indicated a substantial environmental contribution to the development and maintenance of anxiety disorders. Research that has aimed to elucidate the key environmental influences has predominantly focused on parenting-related factors; however, there has also been some consideration of broader factors including life events, peer relationships, siblings, and the school environment. We conclude that there is evidence that particular parenting practices are implicated in the development and maintenance of anxiety disorders in children; however, these are likely to vary in their effects in different contexts influenced by, for example, child temperament and developmental stage. Future studies need to examine how different factors interact and may potentially compound risks, in order to improve our understanding and enable further developments of clinical prevention and intervention for child anxiety disorders.

Ocean sprawl is a growing threat to marine and coastal ecosystems globally, with wide-ranging consequences for natural habitats and species. Artificial structures built in the marine environment often support less diverse communities than natural rocky marine habitats because of low topographic complexity. Some structures can be eco-engineered to increase their complexity and promote biodiversity. Tried-and-tested eco-engineering approaches include building-in habitat designs to mimic features of natural reef topography that are important for biodiversity. Most designs mimic discrete microhabitat features like crevices or holes and are geometrically-simplified. Here we propose that directly replicating the full fingerprint of natural reef topography in habitat designs makes a novel addition to the growing toolkit of eco-engineering options. We developed a five-step process for designing natural topography-based eco-engineering interventions for marine artificial structures. Given that topography is highly spatially variable in rocky reef habitats, our targeted approach seeks to identify and replicate the ‘best’ types of reef topography to satisfy specific eco-engineering objectives. We demonstrate and evaluate the process by designing three natural topography-based habitat units for intertidal structures, each targeting one of three hypothetical eco-engineering objectives. The process described can be adapted and applied according to user-specific priorities. Expanding the toolkit for eco-engineering marine structures is crucial to enable ecologically-informed designs that maximise biodiversity benefits from burgeoning ocean sprawl.

Naval platform survivability is a key enabler to ensure maritime warfighting capability. Therefore, assessment of naval platform recoverability, after a damage event, is critical to assure platform survivability in a warfighting environment. To support such an assessment, an innovative modelling and simulation capability, known as the Naval Damage Incident Recoverability Toolset (NavDIRecT) is being developed. NavDIRecT is being designed as a component-based, open architecture providing the necessary framework to allow analysts to integrate domain models of their choosing. NavDIRecT will facilitate analysis of warfighting and peacetime damage events using a variety of mathematical models, thereby avoiding the limitations of other survivability assessment techniques. Development of NavDIRecT is exemplified by integrating the human movement simulator, maritimeEXODUS, the fire simulation environment, SMARTFIRE, and a three-dimensional naval platform model. NavDIRecT will enable analysis of crew interaction with damage events, thereby allowing acquisition programs and mission planners to examine platform survivability with respect to mission capability requirements. The impetus for NavDIRecT development is for assessment of naval platform survivability and mission success; however, the tools and techniques are equally suitable for use in incident management, training, and analysis of merchant and commercial shipping in accordance with the Safety of Life at Sea (SOLAS).

Forest fires are an annual occurrence in many parts of the world forcing large-scale evacuation. The frequent and growing occurrence of these events makes it necessary to develop appropriate evacuation plans for areas that are susceptible to forest fires. The buildingEXODUS evacuation model has been extended to model large-scale urban evacuations by including the road network and open spaces (e.g. parks, green spaces and town squares) along with buildings. The evacuation simulation results have been coupled with the results of a forest fire spread model and applied to the Swinley forest fire which occurred in Berkshire, UK in May 2011. Four evacuation procedures differing in the routes taken by the pedestrians were evaluated providing key evacuation statistics such as time to reach the assembly location, the distance travelled, congestion experienced by the agents and the safety margins associated with using each evacuation route. A key finding of this work is the importance of formulating evacuation procedures that identifies the threatened population, provides timely evacuation notice, identifies appropriate routes that maintains a safe distance from the hazard front thereby maximising safety margins even at the cost of taking longer evacuation routes. Evacuation simulation offers a means of achieving these goals.

BackgroundMaternal postnatal depression occurs following 10–15% of births and is associated with a range of negative child outcomes. Risks to children are particularly increased when postnatal depression is persistent. We aimed to examine whether a parenting video-feedback therapy (VFT) intervention versus a control treatment of progressive muscle relaxation (PMR), both added to cognitive behavioural therapy (CBT) for persistent postnatal depression, would lead to improved child outcomes at age 2 years.MethodsIn this two-arm, parallel-design, individually randomised controlled trial, we recruited a community sample of women aged 18 years or older living within 50 miles of Oxford, UK, between 4·5 and 9·0 months post partum. All participants met diagnostic criteria for current major depressive disorder that had persisted for at least 3 months and had infants at 35 or more weeks of gestation, with a birthweight of 2000 g or greater, and without serious neonatal complications. Through a centralised service, women were randomly assigned by use of a minimisation algorithm, to receive either VFT or PMR, balanced for child sex, temperament, age, socioeconomic status, and severity of depression. Both groups also received CBT for depression. Primary outcomes were child cognitive development, language development, behaviour problems, and attachment security at age 2 years. There were 11 home-based treatment sessions before child age 1 year, followed by two booster sessions in the second year. Assessors were masked to treatment group allocation. All analyses were done according to the intention-to-treat principle. This trial is registered with the ISRCTN registry, number ISRCTN07336477.FindingsBetween March 18, 2011, and Dec 9, 2013, we randomly assigned 144 women, 72 to each group. Primary outcome data were available for 62–64 (86–89%) VFT and 67–68 (93–94%) PMR participants. There were no group differences in child outcome (cognitive development, adjusted difference −1·01 [95% CI −5·11 to 3·09], p=0·63; language development, 1·33 [–4·16 to 6·82], p=0·63; behaviour problems, −1·77 [–4·39 to 0·85], p=0·19; attachment security, 0·02 [–0·06 to 0·10], p=0·58), with both groups achieving scores similar to non-clinical norms on all outcomes. There were six serious adverse events: five in the VFT group (in two participants) and one in the PMR group. None was treatment-related.InterpretationThe effect of persistent postnatal depression on children is a major public health issue. For both treatment groups there was sustained remission from depression, and child development outcomes were in the normal range. The precise mechanisms accounting for the observed positive child outcomes cannot be ascertained from this study.

Background: anxiety disorders are common, often start in childhood and run a chronic course. As such there is a need for effective prevention.Methods: we conducted a systematic review and meta‐analyses of randomized, controlled trials to prevent the onset of anxiety disorders in ‘at risk’ young people. Diagnostic and symptom outcomes were examined. Putative moderators were tested as was publication bias.Results: we included 16 trials (2545 young people). Two trials reported diagnostic outcomes, and significant effects were found for these at end‐of‐programme (RR = .09, 95%CI = .02 to .16), 6‐ (RR = .17, 95%CI = .06 to .27) and 12‐month (RR = .31, 95%CI .17 to .45) follow‐ups. Based on 16 trials, improved anxiety symptoms were significant compared to nonattention controls only, with small effect sizes reported by young people at the end‐of‐programmes, 6‐ and 12‐month follow‐ups; and by parents at the end of the programmes and 12‐, but not 6‐, month follow‐ups. There was no evidence of significant moderation or publication bias.Conclusions: fourteen studies included children and young people who presented with elevated anxiety symptoms, but anxiety disorder was not ruled out in the participants in these studies. Hence, these studies might be reporting results of mixed prevention/early intervention programmes. Prevention programmes that target developmental risk factors, not only disorder maintaining factors, appear most promising. The clinically meaningful impact of anxiety disorder prevention programmes remains unknown.

This paper describes work undertaken to quantify the performance of trained hospital staff in evacuating people with reduced mobility. Data were collected from 32 trials in which a test subject was evacuated through 11 floors of Ghent University Hospital using four commonly used movement assistance devices: stretcher, carry chair, evacuation chair and rescue sheet. Presented in the paper are performance results for both male and female assist teams, including device preparation time, horizontal speeds, vertical speeds and overtaking potential in stairwells. These data form the basis of the device performance evaluation presented in this paper. A comparative methodology is derived to assess the efficiency of the devices and enable performance differences to be established. Finally, the data collected are used in a numerical simulation of the evacuation of a ward, located on the 11th floor of a hospital, containing 28 non-ambulant patients. The scenarios investigate the time required to evacuate the ward using each of the four assist devices, assuming only the day or night shift staff are available. Furthermore, the scenarios consider the performance of all-male and all-female handlers and also take into consideration the impact of fatigue on the handlers

Egress models typically use one of three methods to represent the physical space in which the agents move: coarse network, fine network or continuous. In this work, we present a novel approach to represent space, which we call the 'Hybrid Spatial Discretisation' (HSD), in which all three spatial representations can be utilised to represent the physical space of the geometry within a single integrated software tool. The aim of the HSD approach is to encompass the benefits of the three spatial representation methods and maximise computational efficiency while providing an optimal environment to represent the movement and interaction of agents.

Intrusive thoughts are key features of depression, anxiety, and obsessive-compulsive disorder (OCD).1 Such thoughts are also common in the general population, where their content is the same as found in those with a psychiatric disorder. Intrusive thoughts comprise unwanted negative thoughts and images that frequently intrude, are difficult to dismiss, and, when dismissed, recur. Furthermore, they lead to a narrowed focus of attention that, in turn, can impair a person’s ability to respond to the external world. They can play an important role in maintaining the disorders in which they occur.2 One form of intrusive thoughts that is particularly distressing in the postnatal period is of intentionally harming one’s infant (Box 1). Such thoughts and images have been reported to occur in very nearly half of parents of infants in the general population.3 Although such intrusions are not in themselves indicative of risk, they are likely to be of particular significance when they occur as part of depression, anxiety disorders, or OCD, where they are often associated with great distress and shame. Although much of the research in this area has been with mothers, these intrusive thoughts also frequently occur in fathers.4 Box 1. ### Specific content of intrusive thoughts of intentionally harming one’s infant

Signage systems play an important role in aiding occupants during both circulation and evacuation. Despite the fact that signage systems are an important component in building wayfinding systems, there is a lack of relevant data regarding how occupants perceive, interpret and use the information conveyed by emergency signage. The effectiveness of signage systems is therefore difficult to assess. In this paper, we address this issue through experimentation. The experiment involved measuring the impact of a signage system on a population of 68 test subjects who were instructed to individually vacate a building as quickly as possible via any means they thought appropriate. The evacuation path involved a number of decision points at which emergency signage was available to identify the appropriate path. Through analysis of video footage and data derived from questionnaires, the number of people who saw and utilised the signage information to assist their egress is determined. The experimental results are used to enhance the existing signage model within the buildingEXODUS software. In particular, the signage detection and acceptance probabilities are assigned values based on the experimental data rather than the ideal values previously used in the model. The impact that the enhanced signage model has on evacuation analysis is demonstrated in a hypothetical evacuation scenario. The enhanced signage model is shown to produce a more conservative lower estimate of expected egress times.

This paper presents a detailed description of an agent-based lift (elevator) model developed within building EXODUS software intended to represent evacuation scenarios. The main components of the lift model are described including the lift: kinematics, attributes and dispatch control. The agent–lift interaction model is also described, including the lift bank selection, the lift waiting area behaviour (wait location selection and wait duration) and the lift car selection and entry. The lift model is used to investigate a series of full building evacuation scenarios based on a hypothetical 50 floor building with four staircases and a population of 7840 agents. The analysis explores the relative merits of using up to 32 lifts (arranged in four banks) and various egress lift dispatch strategies to evacuate the entire building population. Findings from the investigation suggest that the most efficient evacuation strategy utilizes a combination of lifts and stairs to empty the building and clear the upper half of the building in minimum time. Combined stair lift evacuation times have been shown to be as much as 50% faster than stair only evacuation times. The introduction of the agent milling behaviour resulted in reductions in evacuation times compared with the same scenarios without milling behaviour.