Background: Cognitive Muscular TherapyTM (CMT) is an integrated behavioural intervention developed for knee osteoarthritis. CMT teaches patients to reconceptualise the condition, integrates muscle biofeedback and aims to reduce muscle overactivity, both in response to pain and during daily activities. This nested qualitative study explored patient and physiotherapist perspectives and experiences of CMT.Methods: Five physiotherapists were trained to follow a well-defined protocol and then delivered CMT to at least two patients with knee osteoarthritis. Each patient received seven individual clinical sessions and was provided with access to online learning materials incorporating animated videos. Semi-structured interviews took place after delivery/completion of the intervention and data were analysed at the patient and physiotherapist level.Results: Five physiotherapists and five patients were interviewed. All described a process of changing beliefs throughout their engagement with CMT. A framework with three phases was developed to organise the data according to how osteoarthritis was conceptualised and how this changed throughout their interactions with CMT. Firstly, was an identification of pain beliefs to be challenged and recognition of how current beliefs can misalign with daily experiences. Secondly was a process of challenging and changing beliefs, validated through new experiences. Finally, there was an embedding of changed beliefs into self-management to continue with activities. Conclusion:This study identified a range of psychological changes which occur during exposure to CMT. These changes enabled patients to reconceptualise their condition, develop a new understanding of their body, understand psychological processes, and make sense of their knee pain.

Buildings are one of the biggest assets of Lisbon's central downtown accumulated over a period of several centuries. The effi cient use and optimization of the value of these assets are a challenge for both the owners of individual buildings and for society as a whole. Recently, a new regeneration initiative was announced for old urban Lisbon's downtown, covering three fi elds of intervention: the economic, social and physical fi elds. This paper presents a case study of the regeneration program for the Lisbon's old downtown including an analysis of the framework used to assess the costs and benefi ts.

Purpose -Agile methods have proven successful in increasing customer satisfaction and decreasing time and cost to market under uncertain conditions. Key characteristics of agile methods are lean, flexibility and highly iterative development with a strong emphasis on stakeholder involvement. Today construction firms in general and small to medium-sized enterprises (SMEs) in particular are surviving in a drastic competitive environment in which they are facing more and more challenges. Additional innovation is needed in the construction sector, with increased participation from more competitive SMEs. The main purpose of this paper is to present a model to prioritize available management systems to help SMEs address the challenge of today's market competition more effectively. Design/methodology/approach -The research methodology used is that of interpretative case study and grounded theory based on a strong empirical foundation, on which new theoretical insight into knowledge management as an autonomous action is developed. The paper looks at ways by which SMEs are managed, based on the empirical data collected from 12 case studies. It presents the empirical findings drawn from the case studies. Finally, the adoption of agile methods is subjectively assessed as to its potential contribution for improving the business processes of small and medium construction firms. Findings -It is assessed that agile methods offers considerable potential for application in construction SMEs and that there are significant hurdles to its adoption in the actual phase. Should these be overcome, agile methods offers benefits well beyond any individual company. Practical implications -Construction firms need to be aware of the advantages of new management paradigms and practices. The analysis shows that SMEs in the construction sector have to internalize agile values into their business processes to reap the benefits of agile methods. It also reveals that existing practices show some kind of agile flavours. Originality/value -Agile principles and methods are explored, including: philosophy, values, practices and benefits. The management approaches used by construction SMEs are analyzed and discussed. The paper presents recommendations and insights for enhancing the performance and efficiency of SMEs by adopting agile values in their business processes.

Purpose -Construction is an information and knowledge driven industry. Construction firms all over the world are increasingly being challenged by high-cost pressure, shortened project cycles and increasing competition. Within a business environment, where fast and reliable access to knowledge is a key success factor, the efficient handling of organisational knowledge is crucial. The purpose of this paper is to look at ways knowledge and expertise are managed in project-based firms, based on three case studies. The knowledge management (KM) effort established in these cases studies is analysed. Finally, the findings from the case studies from the perspective of the construction firm are presented. Design/methodology/approach -The research methodology of the study is that of interpretative case study and grounded theory based on a strong empirical foundation, on which new theoretical insight into KM as an autonomous action is developed. Case study research is one of the most widely-used research designs in qualitative research. The grounded theory method develops theory from data collected through direct contact with research situations. The methodology looks at large, successful companies already using KM, which not typical companies, but which provide useful insights for others. Findings -This paper analyses KM effort, based on three case studies and offers recommendations and insights for enhancing KM in construction firms. Research limitations/implications -Construction firms need to be aware of the advantages of KM initiatives and practices. KM requires an environment that allows workers to create, capture, share, and leverage knowledge to improve performance. Firms are increasingly utilizing interdisciplinary organisational structures in which employees share knowledge and expertise within and between groups in order to cope with complex tasks. Originality/value -This paper presents the findings from case studies of three large, high-performing project-based firms, involving exploratory, open-ended interviews with managers at various levels, and identifies key KM implementation issues in construction firms; it also provides valuable insights and recommendations for enhancing the capture, sharing and use of corporate knowledge assets.

Delivering a building project on time and under budget is still an increasingly complex and risky business. A host of new project delivery methods and management techniques have been promoted to help achieve this. Developing a project delivery strategy and contractual relationships is a particularly complex and large problem domain that requires diverse, highly sophisticated skills, expertise and knowledge. Expert knowledge and lessons learned in the construction phase of a building project hold a wealth of knowledge and expertise that can be often taken for granted. However, this body of knowledge is not systematically incorporated into the procurement phase of subsequent projects. Case‐based reasoning is a technology for problem solving based on recall and reuse of specific experiences; it offers techniques for acquiring, representing and managing the knowledge gained from previous experiences and augmenting a set of specific experiences with generalised knowledge. Outlines how current case‐based reasoning techniques support project delivery method decisions. Presents a case‐based framework for project delivery method selection. Finally, reports the findings of the first phase of the system development cycle.