The critical success factors for stakeholder management in the restoration of built heritage assets in the UK

PurposeBuilt heritage or historic assets (BHAs) constructed in the pre-nineteenth century in the UK are perceived to have certain characteristics which instil cultural significance in them and have seen them become valuable to the economy of the country. The heritage sector makes significant contributions to the UK economy through provision of tourist attractive sites, construction and servicing of heritage assets, heritage conservation, research, and commercial activities carried out within and around heritage assets. These benefits have seen them draw considerable interests from diverse stakeholders within and outside the heritage sector. Hence, a lot of attention is drawn towards restoration of such assets, from stakeholders of different interests, ranging from advocacies for no alteration to complete alteration of the heritage assets. As with construction projects, conflict of interests amongst stakeholder affect the outcome of restoration projects and the purpose of this paper is to examine the critical success factors (CSFs) for managing the stakeholders to achieve the projects’ objectives. Design/methodology/approachThis paper examines the views and experiences of practitioners in the heritage sector who have been involved with BHA restoration projects. A total of 32 CSFs for stakeholder management, obtained through rigorous reviews of literature, were subjected to a severe scrutiny with eight restoration experts to determine the importance of the CSFs in restoration projects. The outcome of the exercise was a modified list of 20 CSFs which were further tested on 52 restoration practitioners in the United Kingdom (UK) using a structured questionnaire to determine the degree of importance of each of the CSFs in restoration projects and their relationships as perceived by the practitioners. FindingsThe results of the analyses performed on the data show that most of the CSFs were perceived by restoration practitioners as truly critical and vital for successful management of stakeholders in restoration of BHAs. The results also indicate that there is a strong consensus amongst a vast majority of practitioners on rankings of the CSFs. Practical implicationsThe identified CSFs could be used by the restoration practitioners as a “road map” for the development of appropriate solutions for successfully managing stakeholders associated with the promotion and BHAs restoration assets. Originality/valueAlthough CSFs for stakeholder management in construction have been studied by many scholars, no specific research could be identified prior to this study to have been done in defining the CSFs for stakeholder management in restoration projects. In this project, the authors have explored BHAs to identify and rank the CSFs for stakeholder management in restoration projects. Keywords: Built Heritage Assets, Stakeholder Management, Critical Success Factors, Restoration Projects, United Kingdom

BIM adoption within Australian small and medium-sized enterprises (SMEs) : an innovation diffusion model

Despite the envisaged benefits of BIM adoption for SMEs, BIM in SMEs has remained an underrepresented area within the available academic literature. This study proposes and draws upon a framework grounded on innovation diffusion theory (IDT) to provide an illuminating insight into the current state of BIM and the main barriers to BIM adoption within Australian SMEs. Based on analyses of 135 questionnaires completed by SMEs through partial least squares structural equation modelling (PLS-SEM) and grounded on the proposed framework, the current state of BIM adoption and barriers to BIM adoption for SMEs are discussed. The findings show that currently around 42% of Australian SMEs use BIM in Level 1 and Level 2 with only around 5% have tried Level 3. It comes to light that lack of knowledge within SMEs and across the construction supply chain is not a major barrier for Australian SMEs. In essence, the main barriers stem from the risks associated with an uncertain return on investment (ROI) for BIM as perceived by key players in SMEs. The findings also show the validity of the framework proposed for explaining BIM adoption in Australian SMEs

Exploring the linkages between project managers’ mindset behaviour and project leadership style in the Ghanaian construction industry

Purpose: Leadership encapsulates a process of influencing others to understand what needs to be done and how it can be done. The related area of mindset behaviour which moderates leadership styles adopted in various industries has hitherto received scant academic attention in a construction context. This paper thus explores the linkages between project manager’s mindset behaviour and project leadership style in the construction industry. Design/Methodology/Approach: Literature reviewed provides the basis for a questionnaire data collection instrument developed to gather primary data from construction professionals in the Ghanaian Construction Industry (GCI). A quantitative research strategy is then adopted using the Relative Importance Index (RII) to determine the level of significance of the leadership and mindset archetypes. A Pearson’s correlation test was run to ascertain whether the mindset behaviour of project managers has a significant impact upon the type of leadership style. Findings: The study’s results indicate that democratic, transformational and situational leadership styles were prevalent leadership styles in the GCI. The analysis also revealed that project managers favoured the ‘growth mindset’ and that furthermore, this style had a moderate positive relationship with democratic and transformational leadership styles. Conversely, a fixed mindset had a low positive relationship with autocratic and situational leadership styles but a low negative relationship with transformational leadership style. Practical and theoretical implications: This research provides sufficient data for project managers to identify the type of mindset to nurture (the growth mindset is recommended) and the effective leadership style to be employed. This study engenders wider discussion on mindset behaviour and project leadership style in developing countries. Moreover, the findings present policy makers and practitioners with the leadership styles to promote and develop (democratic, transformational and situational) and mindset behaviour (growth mindset) to ensure project success in Ghana and other developing countries. Originality/value: This research represents the first comprehensive study appraising the linkages between project manager’s mindset behaviour and project leadership style in the construction industry. Empirical data presented bridges the identified knowledge gap that exists on the lack of theoretical understanding of the influence that project managers’ mindset has on leadership styles in the GCI

The antecedents of construction project change: an analysis of design & build procurement application

Purpose: This research seeks to excoriate, define and delineate the main drivers of ‘change’ in commercial construction projects and generate guidelines on how to minimise exposure to the associated adverse effects upon project stakeholders. Methodology: The research adopts mixed doctrines through a combination of epistemological lenses, embracing two primary philosophical stances: (i) interpretivism, to identify the primary drivers of change based on a systematic literature review and (ii) a post-positivist, inductive approach to analyse the results of change within a Joint Contracts Tribunal (JCT) Design and Build (D&B) construction project case study. Findings: The causal nexus of change during the construction phase is assessed and delineated; the key affecting factors are thematically grouped under headings: extent and severity; time in relation to implementing; instigating party; individual(s) responsible for managing the change; reason for the change; available resource; recoverable or non-recoverable; contract / project type; type of client. Following this, the effects of change on key elements of the project are encapsulated and recommendations for adaptations which may provide improved experiences are offered. Originality: The study tackles the common issue of managing the deleterious effects of change on commercial construction projects, defining management techniques to minimise stakeholder tribulation

Immune response profiles of calves following vaccination with live BCG and inactivated Mycobacterium bovis vaccine candidates

<div><p>Conventional control and eradication strategies for bovine tuberculosis (BTB) face tremendous difficulties in developing countries; countries with wildlife reservoirs, a complex wildlife-livestock-human interface or a lack of veterinary and veterinary public health surveillance. Vaccination of cattle and other species might in some cases provide the only suitable control strategy for BTB, while in others it may supplement existing test-and-slaughter schemes. However, the use of live BCG has several limitations and the global rise of HIV/AIDS infections has furthermore warranted the exploration of inactivated vaccine preparations. The aim of this study was to compare the immune response profiles in response to parenteral vaccination with live BCG and two inactivated vaccine candidates in cattle.</p><p>Twenty-four mixed breed calves (<i>Bos taurus</i>) aged 4–6 months, were allocated to one of four groups and vaccinated sub-cutaneously with live <i>M</i>. <i>bovis</i> BCG (Danish 1331), formalin-inactivated <i>M</i>. <i>bovis</i> BCG, heat-killed <i>M</i>. <i>bovis</i> or PBS/Montanide™ (control). Interferon-γ responsiveness and antibody production were measured prior to vaccination and at weekly intervals thereafter for twelve weeks. At nine weeks post-priming, animals were skin tested using tuberculins and MTBC specific protein cocktails and subsequently challenged through intranodular injection of live <i>M</i>. <i>bovis</i> BCG.</p><p>The animals in the heat-killed <i>M</i>. <i>bovis</i> group demonstrated strong and sustained cell-mediated and humoral immune responses, significantly higher than the control group in response to vaccination, which may indicate a protective immune profile. Animals in this group showed reactivity to the skin test reagents, confirming good vaccine take. Lastly, although not statistically significant, recovery of BCG after challenge was lowest in the heat-killed <i>M</i>. <i>bovis</i> group.</p><p>In conclusion, the parenteral heat-killed <i>M</i>. <i>bovis</i> vaccine proved to be clearly immunogenic in cattle in the present study, urging further evaluation of the vaccine in challenge studies using virulent <i>M</i>. <i>bovis</i> and assessment of vaccine efficacy in field conditions.</p></div

Risk Factors for Mortality in Children Hospitalized With Severe Malaria in Northern Zambia: A Retrospective Case-Control Study

Malaria remains a public health crisis in areas where it has resisted control efforts. In Nchelenge District, a high-transmission area in northern Zambia, malaria accounts for more than one-third of pediatric hospitalizations and nearly one-half of hospital deaths in children. To identify risk factors for death due to malaria, we conducted a retrospective, time-matched case-control study of 126 children hospitalized with malaria who died (cases) and 126 children who survived (controls). There were no differences in age, gender, hemoglobin concentration, or prevalence of severe anemia between cases and controls. Children who died were more likely to come from villages located at greater distances from the hospital than children who survived (median 13.5 versus 3.2 km). Each additional kilometer of distance from the hospital increased the odds of death by 4% (odds ratio 1.04, 95% confidence interval 1.01–1.07, P \u3c 0.01). Extent of anemia and admission during periods when blood was unavailable for transfusion were associated with early death (P £ 0.03). Delays in initiation of treatment of severe malaria contribute to the increased odds of death in children referred from more distant health centers, and might be mitigated by transportation improvements, capacity at rural health posts to administer treatment before transfer, hospital triage systems that minimize time to treatment, and reliable blood product stores at referral hospitals

Community-facility linkage models and maternal and infant health outcomes in Malawi’s PMTCT/ART program: a cohort study

Background: In sub-Saharan Africa, 3 community-facility linkage (CFL) models—Expert Clients, Community Health Workers (CHWs), and Mentor Mothers—have been widely implemented to support pregnant and breastfeeding women (PBFW) living with HIV and their infants to access and sustain care for prevention of mother-to-child transmission of HIV (PMTCT), yet their comparative impact under real-world conditions is poorly understood. Methods and findings: We sought to estimate the effects of CFL models on a primary outcome of maternal loss to follow-up (LTFU), and secondary outcomes of maternal longitudinal viral suppression and infant “poor outcome” (encompassing documented HIV-positive test result, LTFU, or death), in Malawi’s PMTCT/ART program. We sampled 30 of 42 high-volume health facilities (“sites”) in 5 Malawi districts for study inclusion. At each site, we reviewed medical records for all newly HIV-diagnosed PBFW entering the PMTCT program between July 1, 2016 and June 30, 2017, and, for pregnancies resulting in live births, their HIV-exposed infants, yielding 2,589 potentially eligible mother–infant pairs. Of these, 2,049 (79.1%) had an available HIV treatment record and formed the study cohort. A randomly selected subset of 817 (40.0%) cohort members underwent a field survey, consisting of a questionnaire and HIV biomarker assessment. Survey responses and biomarker results were used to impute CFL model exposure, maternal viral load, and early infant diagnosis (EID) outcomes for those missing these measures to enrich data in the larger cohort. We applied sampling weights in all statistical analyses to account for the differing proportions of facilities sampled by district. Of the 2,049 mother–infant pairs analyzed, 62.2% enrolled in PMTCT at a primary health center, at which time 43.7% of PBFW were ≤24 years old, and 778 (38.0%) received the Expert Client model, 640 (31.2%) the CHW model, 345 (16.8%) the Mentor Mother model, 192 (9.4%) ≥2 models, and 94 (4.6%) no model. Maternal LTFU varied by model, with LTFU being more likely among Mentor Mother model recipients (adjusted hazard ratio [aHR]: 1.45; 95% confidence interval [CI]: 1.14, 1.84; p = 0.003) than Expert Client recipients. Over 2 years from HIV diagnosis, PBFW supported by CHWs spent 14.3% (95% CI: 2.6%, 26.1%; p = 0.02) more days in an optimal state of antiretroviral therapy (ART) retention with viral suppression than women supported by Expert Clients. Infants receiving the Mentor Mother model (aHR: 1.24, 95% CI: 1.01, 1.52; p = 0.04) and ≥2 models (aHR: 1.44, 95% CI: 1.20, 1.74; p < 0.001) were more likely to undergo EID testing by age 6 months than infants supported by Expert Clients. Infants receiving the CHW and Mentor Mother models were 1.15 (95% CI: 0.80, 1.67; p = 0.44) and 0.84 (95% CI: 0.50, 1.42; p = 0.51) times as likely, respectively, to experience a poor outcome by 1 year than those supported by Expert Clients, but not significantly so. Study limitations include possible residual confounding, which may lead to inaccurate conclusions about the impacts of CFL models, uncertain generalizability of findings to other settings, and missing infant medical record data that limited the precision of infant outcome measurement. Conclusions: In this descriptive study, we observed widespread reach of CFL models in Malawi, with favorable maternal outcomes in the CHW model and greater infant EID testing uptake in the Mentor Mother model. Our findings point to important differences in maternal and infant HIV outcomes by CFL model along the PMTCT continuum and suggest future opportunities to identify key features of CFL models driving these outcome differences

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.814.4 million) incident T2D cases, representing 70.3% (68.871.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.027.1%)), excess refined rice and wheat intake (24.6% (22.327.2%)) and excess processed meat intake (20.3% (18.323.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.487.7%)) and Latin America and the Caribbean (81.8% (80.183.4%)); and lowest proportional burdens were in South Asia (55.4% (52.160.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally. (c) 2023, The Author(s)