Comparing Performance of Construction Projects Delivered through Different Delivery Methods

When new delivery methods are introduced in public procurement, it is customary to analyze and compare their performance against traditional methods. Many early studies compared performance of different project delivery systems, and often developed decision support tools to help owners follow a structured path in measuring performance and, consequently, choose the most appropriate project delivery method. However, the measurement process adopted by these studies was mostly specific to the dataset to be analyzed. Only rarely, it took into account differences deriving from varying project characteristics, and, therefore was not generalizable. Building upon these studies, this study proposes a general framework for comparing performance of projects delivered through different delivery methods. A discussion of how the framework could also be adapted to every industry sector is included. This work can help owners choose a set of metrics to evaluate and compare the performance of project portfolios delivered with more than one delivery method and different industry secto

A Qualitative Methodology for Studying Parent–Child Argumentation

This chapter provides a detailed exposé of the research methodology on which the investigation of parent–child argumentation during mealtime is based. In the first part, the conceptual tools adopted for the analysis of argumentative discussions between parents and children, i.e., the pragma-dialectical ideal model of a critical discussion and the Argumentum Model of Topics, are presented. Subsequently, the process of data gathering and the procedures for the transcription of oral data are discussed. Finally, in the last part of the chapter, ethical issues and practical problems in collecting parent–child mealtime conversations present throughout the study are considered

Institutional argumentation and conflict prevention: The case of the Swiss Federal Data Protection and Information Commissioner

By focusing on a case study of institutional argumentation in the sector of data protection and transparency, this paper offers a view on the role of institutional argumentative discourse aimed at conflict prevention in public organizations. In particular, the context we are analyzing is that of a Swiss institutional role named Federal Data Protection and Information Commissioner (FDPIC). Among other tasks, the person who serves as a FDPIC has the right to monitor data protection in the whole territory of the Swiss Confederation, with the possibility of issuing recommendations to subjects who are found in violation of the law on this matter. The FDPIC's role appears similar to that of ombudsmen; his or her recommendations are not binding for the parties, but they represent powerful argument-based warnings that serve the function of preventing escalation to a court proceeding. The specific nature of this type of recommendation is explored in this paper both at the level of a semantic–pragmatic analysis of the speech act “to recommend”, and at the level of argumentation. Integrating an argumentative level is necessary to fully explain the intended effect of this specific type of speech act of recommendation in this context. Argumentation is also advanced by the FDPIC to support his decision: by devising a comprehensive, convincing and well-structured argumentative discourse, the FDPIC pursues the ultimate pragmatic goal of preventing the emergence of conflicts between citizens and legal authorities

IRDR: causa-piloto ou causa-modelo?

O presente estudo tem como objetivo analisar as fontes internacionais que influenciaram o incidente de resolução de demandas repetitivas, principalmente a respeito da sua eficiência dentro do ordenamento jurídico brasileiro, buscando soluções alternativas para consolidar o instrumento no cotidiano do cidadão comum. Por meio da pesquisa dogmáticainstrumental, e da técnica bibliográfica, sistematizou-se a doutrina jurídica, a fim de investigar as consequências jurídicas geradas pela influência das fontes internacionais no procedimento de julgamento de massa. O estudo do processo civil nacional e sua estrutura pautada em dois instrumentos teóricos (causa-piloto e causa-modelo) possibilitou a comparação entre esses, demonstrando o modelo exclusivamente brasileiro/tupiniquim, como as suas peculiaridades. A crítica gira tem sua pertinência, na medida em que, o instrumento demonstra lacunas estruturais entre os institutos jurídicos do nosso ordenamento (civil law) e o common law. Por fim, o incidente de resolução de demandas de massa consolida-se de forma precoce no Código de Processo Civil de 2015, evidenciado por lacunas normativas, e panaceias jurídicas frutos dos modelos externos

Enhanced smoking cessation support for newly abstinent smokers discharged from hospital (The Hospital to Home trial): A randomised controlled trial

Background and aimsThe United Kingdom's National Institute for Health and Care Excellence guidance (NICE PH48) recommends that pharmacotherapy combined with behavioural support be provided for all smokers admitted to hospital; however, relapse to smoking after discharge remains common. This study aimed to assess the effect of adding home support for newly?abstinent smokers to conventional NICE?recommended support in smokers discharged from hospital.Designindividually?randomised parallel group trial.SettingOne UK acute hospital.Participants404 smokers aged >18 admitted to acute medical wards between June 2016 and July 2017 were randomised in equal numbers to each treatment group.Interventions and comparatorsThe intervention provided 12 weeks of at?home cessation support which included help in maintaining a smoke?free home, help in accessing and using medication, further behavioural support and personalised feedback on home air quality. The comparator was NICE PH48 care as usual.MeasuresThe primary outcome was self?reported continuous abstinence from smoking validated by an exhaled carbon monoxide level ?6ppm four?weeks after discharge from hospital.FindingsIn an intention?to?treat analysis at the four?week primary endpoint, 38 participants (18.8%) in the usual care group and 43 (21.3%) in the intervention group reported continuous abstinence from smoking (odds ratio 1.17, 95% confidence interval 0.72 to 1.90, Bayes factor 0.33). There were no significant differences in any secondary outcomes, including self?reported cessation at 3 months, having a smoke?free home, or number of cigarettes smoked per day in those who did not quit.ConclusionsProvision of a home visit and continued support to prevent relapse to smoking after hospital discharge did not appear to increase subsequent abstinence rate above usual care in accordance with UK guidance from the National Institute of Health and Care Excellence

Multisensory causal inference in the brain

At any given moment, our brain processes multiple inputs from its different sensory modalities (vision, hearing, touch, etc.). In deciphering this array of sensory information, the brain has to solve two problems: (1) which of the inputs originate from the same object and should be integrated and (2) for the sensations originating from the same object, how best to integrate them. Recent behavioural studies suggest that the human brain solves these problems using optimal probabilistic inference, known as Bayesian causal inference. However, how and where the underlying computations are carried out in the brain have remained unknown. By combining neuroimaging-based decoding techniques and computational modelling of behavioural data, a new study now sheds light on how multisensory causal inference maps onto specific brain areas. The results suggest that the complexity of neural computations increases along the visual hierarchy and link specific components of the causal inference process with specific visual and parietal regions

Antimicrobial Prophylaxis in Neonates and Children Undergoing Dental, Maxillo-Facial or Ear-Nose-Throat (ENT) Surgery: A RAND/UCLA Appropriateness Method Consensus Study

Surgical site infections (SSIs) represent a potential complication in surgical procedures, mainly because clean/contaminated surgery involves organs that are normally colonized by bacteria. Dental, maxillo-facial and ear-nose-throat (ENT) surgeries are among those that carry a risk of SSIs because the mouth and the first respiratory tracts are normally colonized by a bacterial flora. The aim of this consensus document was to provide clinicians with recommendations on surgical antimicrobial prophylaxis in neonates (<28 days of chronological age) and pediatric patients (within the age range of 29 days–18 years) undergoing dental, maxillo-facial or ENT surgical procedures. These included: (1) dental surgery; (2) maxilla-facial surgery following trauma with fracture; (3) temporo-mandibular surgery; (4) cleft palate and cleft lip repair; (5) ear surgery; (6) endoscopic paranasal cavity surgery and septoplasty; (7) clean head and neck surgery; (8) clean/contaminated head and neck surgery and (9) tonsillectomy and adenoidectomy. Due to the lack of pediatric data for the majority of dental, maxillo-facial and ENT surgeries and the fact that the recommendations for adults are currently used, there is a need for ad hoc studies to be rapidly planned for the most deficient areas. This seems even more urgent for interventions such as those involving the first airways since the different composition of the respiratory microbiota in children compared to adults implies the possibility that surgical antibiotic prophylaxis schemes that are ideal for adults may not be equally effective in children

Surgical Antimicrobial Prophylaxis in Abdominal Surgery for Neonates and Paediatrics: A RAND/UCLA Appropriateness Method Consensus Study

Surgical site infections (SSIs), i.e., surgery-related infections that occur within 30 days after surgery without an implant and within one year if an implant is placed, complicate surgical procedures in up to 10% of cases, but an underestimation of the data is possible since about 50% of SSIs occur after the hospital discharge. Gastrointestinal surgical procedures are among the surgical procedures with the highest risk of SSIs, especially when colon surgery is considered. Data that were collected from children seem to indicate that the risk of SSIs can be higher than in adults. This consensus document describes the use of preoperative antibiotic prophylaxis in neonates and children that are undergoing abdominal surgery and has the purpose of providing guidance to healthcare professionals who take care of children to avoid unnecessary and dangerous use of antibiotics in these patients. The following surgical procedures were analyzed: (1) gastrointestinal endoscopy; (2) abdominal surgery with a laparoscopic or laparotomy approach; (3) small bowel surgery; (4) appendectomy; (5) abdominal wall defect correction interventions; (6) ileo-colic perforation; (7) colorectal procedures; (8) biliary tract procedures; and (9) surgery on the liver or pancreas. Thanks to the multidisciplinary contribution of experts belonging to the most important Italian scientific societies that take care of neonates and children, this document presents an invaluable reference tool for perioperative antibiotic prophylaxis in the paediatric and neonatal populations

Persistence of antibody responses to the sars-cov-2 in dialysis patients and renal transplant recipients recovered from covid-19

Nephropathic subjects with impaired immune responses show dramatically high infection rates of coronavirus disease 2019 (COVID-19). This work evaluated the ability to acquire and maintain protective antibodies over time in 26 hemodialysis patients and 21 kidney transplant recipients. The subjects were followed-up through quantitative determination of circulating SARS-CoV-2 S1/S2 IgG and neutralizing antibodies in the 6-month period after clinical and laboratory recovery. A group of 143 healthcare workers with no underlying chronic pathologies or renal diseases recovered from COVID was also evaluated. In both dialysis and transplanted patients, antibody titers reached a zenith around the 3rd month, and then a decline occurred on average between the 270th and 300th day. Immunocompromised patients who lost antibodies around the 6th month were more common than non-renal subjects, although the difference was not significant (38.5% vs. 26.6%). Considering the decay of antibody levels below the positivity threshold (15 AU/mL) as “failure”, a progressive loss of immunisation was found in the overall population starting 6 months after recovery. A longer overall antibody persistence was observed in severe forms of COVID-19 (p = 0.0183), but within each group, given the small number of patients, the difference was not significant (dialysis: p = 0.0702; transplant: p = 0.1899). These data suggest that immunocompromised renal patients recovered from COVID-19 have weakened and heterogeneous humoral responses that tend to decay over time. Despite interindividual variability, an association emerged between antibody persistence and clinical severity, similar to the subjects with preserved immune function