Human Factors Influencing Contractors' Risk Attitudes: A Case Study of the Malaysian Construction Industry

Malaysia is one of the most rapidly developing countries among developing nations. The construction industry has played a major role in Malaysia’s rapid economic growth. Among the major sectors in Malaysia, the importance of the construction industry is unique regardless of the level of the country’s development. However, the attitude of the construction industry in Malaysia towards managing contractors’ risk attitudes is very weak. The introduction of the Occupational Safety and Health Act in 1994 by the Malaysian government made all industries in Malaysia to identify risks, conduct risk assessment and control risk. In addition, the Malaysian construction industry simultaneously implemented an integrated system to ensure consistency and better performance of projects. To identify the factors influencing contractors' risk attitudes, relevant literature was reviewed, and a questionnaire survey was conducted. This study focused on the G7 contractors operating in the Malaysian construction industry. One hundred and nineteen copies of a structured questionnaire were analysed with a response rate of 85%. Structural equation modelling was utilized to test the hypotheses developed for the study. Results showed that government policies played a moderating role in enhancing the relationship between human-related factors affecting contractors’ risk attitudes in the construction industry

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran