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.

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.

Purpose -The study was designed to assess the knowledge, adoption and perceived effectiveness of sustainable retrofit technologies within the UK social housing sector. Design/methodology/approach -The study was undertaken using a structured questionnaire that was completed by 130 providers of social housing. Findings -The study showed that social housing providers were evenly split in their reliance on internal or external information for sustainable retrofit knowledge. In terms of adoption identified that this was strongly driven by government-funded programmes, leading to widespread adoption of low technology solutions. The respondents identified that many leading edge technologies were perceived to be less effective.Research limitations/implications -The study represents a snap-shot of adoption and effectiveness issues, therefore does not show the trajectory of adoption which should be addressed in a follow-up study. Practical implications -The social housing sector has been viewed as a market maker for some of the newer technologies. It indicates that some of the newer technologies, such as heat pumps are viewed as less effective than more established technologies. Social implications -The study has implications for the adoption of technology to address fuel poverty and climate change, as well as informing future policy such as Green Deal. Originality/value -The study includes 130 responses from the social housing stock and gives a perspective of current views on adoption and effectiveness of retrofit technologies within the social housing sector. This is useful for both other social housing providers and policy makers.

The construction industry is no longer focused on providing a single product ‐ i.e. a building or a physical infrastructure, but a variety of services and improvement to the human environment. Major trends such as Performance‐based Building as well as Sustainable Built Environment are calling for major changes. These changes mean additional roles for the industry as well as the need for new indicators to measure its performance and its economic impact. This paper proposes a new approach based on the development of a framework for the analysis of the entire construction and property sector ‐ the “built environment cluster”. It extends the analysis of an international study based on nine countries ‐Australia, Canada, Denmark, France, Germany, Lithuania, Portugal, Sweden, and the United Kingdom. The need for improving statistical data is stressed particularly in the context of enlarging the scope of the industry. This new approach provides an excellent starting point for developing new performance indicators that will take into account the changing nature of the industry, for an integrative perspective providing a basis for strategic management, for studying sustainable development in construction and for understanding innovation processes and changes. A comprehensive perspective of the industry performance is crucial for policy initiatives as well as for strategic analysis of firms.

In the context of a truly global market for construction, an international strategy is required to ensure that national and international statistical systems are able to provide accurate and valid information. In many parts of the world the collection of reliable national information on construction activity is not an easy task, and the measurement of comparable, cross-national data can be problematic. This paper considers possible strategies for the improvement of data collection systems in the context of user needs.Construction Activity, International Comparability, Statistical Systems,