Integrated delivery of quality, safety and environment through road sector procurement: The case of public sector agencies in Ghana

Poor quality, safety and environmental (QSE) performance within Ghana's road sector has been cited as a major challenge in the procurement of infrastructure. This study evaluates the applicability and level of integrated consideration of QSE in the delivery of roads through procurement by public sector agencies in Ghana. Integrated delivery is explored on the basis of theoretical and empirical evidence of an existing synergistic relationship among QSE in the management and delivery of projects. A mixed methodological design was adopted to investigate two public road agencies through a questionnaire survey and interviews of technical staff with procurement responsibilities. This was done concurrently with soliciting professional perspectives on the subject. Procurement is widely regarded as paramount to the delivery of better QSE in the Ghana road sector. However, the level of synergistic consideration is low, which is attributable to an over-reliance on traditional procurement arrangements as a result of non-supportive local procurement regulatory frameworks. It is further established that a general lack of know-how and experience in the use of modern and integrated procurement arrangements prevent effective management and realisation of QSE beyond the current focus on time and cost through procurement processes within public road sector agencies

Observations and a model of undertow over the inner continental shelf

Author Posting. © American Meteorological Society, 2008. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Physical Oceanography 38 (2008): 2341-2357, doi:10.1175/2008JPO3986.1.Onshore volume transport (Stokes drift) due to surface gravity waves propagating toward the beach can result in a compensating Eulerian offshore flow in the surf zone referred to as undertow. Observed offshore flows indicate that wave-driven undertow extends well offshore of the surf zone, over the inner shelves of Martha’s Vineyard, Massachusetts, and North Carolina. Theoretical estimates of the wave-driven offshore transport from linear wave theory and observed wave characteristics account for 50% or more of the observed offshore transport variance in water depths between 5 and 12 m, and reproduce the observed dependence on wave height and water depth. During weak winds, wave-driven cross-shelf velocity profiles over the inner shelf have maximum offshore flow (1–6 cm s−1) and vertical shear near the surface and weak flow and shear in the lower half of the water column. The observed offshore flow profiles do not resemble the parabolic profiles with maximum flow at middepth observed within the surf zone. Instead, the vertical structure is similar to the Stokes drift velocity profile but with the opposite direction. This vertical structure is consistent with a dynamical balance between the Coriolis force associated with the offshore flow and an along-shelf “Hasselmann wave stress” due to the influence of the earth’s rotation on surface gravity waves. The close agreement between the observed and modeled profiles provides compelling evidence for the importance of the Hasselmann wave stress in forcing oceanic flows. Summer profiles are more vertically sheared than either winter profiles or model profiles, for reasons that remain unclear.This research was funded by the Ocean Sciences Division of the National Science Foundation under Grants OCE-0241292 and OCE-0548961

Germline pathogenic variants in PALB2 and other cancer-predisposing genes in families with hereditary diffuse gastric cancer without CDH1 mutation: a whole-exome sequencing study.

BACKGROUND: Germline pathogenic variants in the E-cadherin gene (CDH1) are strongly associated with the development of hereditary diffuse gastric cancer. There is a paucity of data to guide risk assessment and management of families with hereditary diffuse gastric cancer that do not carry a CDH1 pathogenic variant, making it difficult to make informed decisions about surveillance and risk-reducing surgery. We aimed to identify new candidate genes associated with predisposition to hereditary diffuse gastric cancer in affected families without pathogenic CDH1 variants. METHODS: We did whole-exome sequencing on DNA extracted from the blood of 39 individuals (28 individuals diagnosed with hereditary diffuse gastric cancer and 11 unaffected first-degree relatives) in 22 families without pathogenic CDH1 variants. Genes with loss-of-function variants were prioritised using gene-interaction analysis to identify clusters of genes that could be involved in predisposition to hereditary diffuse gastric cancer. FINDINGS: Protein-affecting germline variants were identified in probands from six families with hereditary diffuse gastric cancer; variants were found in genes known to predispose to cancer and in lesser-studied DNA repair genes. A frameshift deletion in PALB2 was found in one member of a family with a history of gastric and breast cancer. Two different MSH2 variants were identified in two unrelated affected individuals, including one frameshift insertion and one previously described start-codon loss. One family had a unique combination of variants in the DNA repair genes ATR and NBN. Two variants in the DNA repair gene RECQL5 were identified in two unrelated families: one missense variant and a splice-acceptor variant. INTERPRETATION: The results of this study suggest a role for the known cancer predisposition gene PALB2 in families with hereditary diffuse gastric cancer and no detected pathogenic CDH1 variants. We also identified new candidate genes associated with disease risk in these families. FUNDING: UK Medical Research Council (Sackler programme), European Research Council under the European Union's Seventh Framework Programme (2007-13), National Institute for Health Research Cambridge Biomedical Research Centre, Experimental Cancer Medicine Centres, and Cancer Research UK

Genome-wide Association Study of Response to Methotrexate in Early Rheumatoid Arthritis Patients

Methotrexate (MTX) monotherapy is a common first treatment for rheumatoid arthritis (RA), but many patients do not respond adequately. In order to identify genetic predictors of response, we have combined data from two consortia to carry out a genome-wide study of response to MTX in 1424 early RA patients of European ancestry. Clinical endpoints were change from baseline to 6 months after starting treatment in swollen 28-joint count, tender 28-joint count, C-reactive protein and the overall 3-component disease activity score (DAS28). No single nucleotide polymorphism (SNP) reached genome-wide statistical significance for any outcome measure. The strongest evidence for association was with rs168201 in NRG3 (p = 10‾⁷ for change in DAS28). Some support was also seen for association with ZMIZ1, previously highlighted in a study of response to MTX in juvenile idiopathic arthritis. Follow-up in two smaller cohorts of 429 and 177 RA patients did not support these findings, although these cohorts were more heterogeneous

Ethics for the built environment

xix,377hlm.;bib.;indek

Comparing value for money in healthcare and transport PFI projects

New research identifies and compares the main factors that complicate PFI projects in the UK healthcare and transport sectors. The findings cast light on the fundamentals of the public-private procurement dynamic just as PFI comes under review in the UK