The megaproject sponsor as leader

CITATION: Louw, W., et al. 2018. The megaproject sponsor as leader. South African Journal of Industrial Engineering, 29(3):173-187, doi:10.7166/29-3-2058.The original publication is available at http://sajie.journals.ac.zaENGLISH ABSTRACT: The importance of the sponsor role, including its contribution to the success or failure of a project, is widely recognised in the project management literature. References to the sponsor’s leadership, and the substantial component it represents in the profile of the sponsor, are equally prevalent in the literature reviewed. A megaproject is a large-scale, complex venture that typically costs US$1 billion or more, takes many years to develop and build, involves multiple public and private stakeholders, is transformational, and influences millions of people. Executive sponsors are primarily allocated to projects of strategic importance that are complex, carry a considerable degree of risk, and are very visible. A megaproject is thus entitled to a sponsor from the executive (most senior) ranks within an organisation. Rather than joining the debates on complexity and leadership in the project management literature, this paper explains how leadership theories are used to identify instruments that can assist in the assessment of the leadership style and traits/attributes of a sponsor. A framework is then proposed to identify assessment instruments to evaluate the leadership style and leader traits/attributes of a project sponsor.AFRIKAANSE OPSOMMING: Die belangrikheid van die rol van die bestuursborg, insluitend die bydrae wat hy/sy maak tot die sukses of faling van ’n projek word wyd erken in die projekbestuur literatuur. Verwysings na die leierskapsrol van die bestuursborg asook die wesenlike komponent wat dit uitmaak van die profiel van die bestuursborg word bykans net soveel aangetref in die literatuur. ’n Megaprojek word gedefinieer as ’n grootskaalse, komplekse onderneming wat tipies 1 miljard Amerikaanse dollar of meer kos, etlike jare neem om te ontwikkel en te bou, veelvuldige publieke en privaat belanghebbendes betrek, transformasioneel van aard is, en miljoene mense beïnvloed. Uitvoerende bestuursborge word hoofsaaklik aangewys vir projekte van strategiese aard wat kompleks is, ’n beduidende hoeveelheid risiko dra, en uitsonderlik sigbaar is. Dit is dus duidelik dat ’n megaprojek geregtig is op ’n bestuursborg vanuit die uitvoerende en mees senior bestuursvlakke van ’n organisasie. Eerder as om aan te sluit by die debatte oor kompleksiteit en leierskap in die projekbestuur literatuur, dui hierdie artikel aan tot welke mate leierskapsteorieë benut kan word om instrumente te identifiseer wat kan meehelp in die evaluering van leierskapstyle asook die leierskap eienskappe/ attribute van ’n bestuursborg. Ter afsluiting word ’n raamwerk voorgestel om assesseringsinstrumente te identifiseer vir die evaluering van leierskapstyle en leier eienskappe/ attribute.http://sajie.journals.ac.za/pub/article/view/2058Publisher's versio

Effect of low energy diet for eight weeks to adults with overweight or obesity on folate, retinol, vitamin B₁₂, D and e status and the degree of inflammation: a post hoc analysis of a randomized intervention trial

Abstract Background Obesity is associated with vitamin insufficiency and low grade inflammation. The purpose of this study was to investigate the effect of weight loss on folate, retinol, vitamin B12, D and E status and the degree of inflammation. Methods Out of 110, 85 individuals (75% women) aged 39 ± 11 years with a mean ± SD BMI of 33 ± 4 kg/m2, completed an eight-week low energy diet (LED). Serum concentration of folate, retinol, B12, D and E and C-reactive protein and homocysteine (Hcy) were measured at baseline and at end of the LED. Results At baseline, 8% of the participants were deficient in folate, 13% in vitamin B12, 2% in retinol, 28% in vitamin D (72% were insufficient in vitamin D), and none were deficient in vitamin E. At baseline, BMI was inversely associated with retinol (P < 0.05) as was total and abdominal fat percentage with folate (P < 0.05); further BMI and measures of adiposity were positively associated with CRP (P < 0.01) and Hcy (P < 0.05). Homocysteine was inversely associated with all vitamins but retinol (P < 0.001). After the LED, the participants lost a mean [95% confidence intervals] of 12.3 [− 13.1,-11.6] kg. The serum concentration of folate, vitamin B12 and D were increased (P < 0.001) after the LED whereas the concentration of retinol and vitamin E were reduced (P < 0.001). Conclusion Eight-weeks LED resulted in 13% weight loss and an increase in the serum concentrations of folate, vitamin B12 and D. Baseline adiposity was inversely associated with folate and retinol, and positively associated with markers of inflammation. Trial registration Ethical Committee of Copenhagen as no. H-4-2013-135, NCT01561131

The production of nominal and verbal inflection in an agglutinative language: evidence from Hungarian

The contrast between regular and irregular inflectional morphology has been useful in investigating the functional and neural architecture of language. However, most studies have examined the regular/irregular distinction in non-agglutinative Indo-European languages (primarily English) with relatively simple morphology. Additionally, the majority of research has focused on verbal rather than nominal inflectional morphology. The present study attempts to address these gaps by introducing both plural and past tense production tasks in Hungarian, an agglutinative non-Indo-European language with complex morphology. Here we report results on these tasks from healthy Hungarian native-speaking adults, in whom we examine regular and irregular nominal and verbal inflection in a within-subjects design. Regular and irregular nouns and verbs were stem on frequency, word length and phonological structure, and both accuracy and response times were acquired. The results revealed that the regular/irregular contrast yields similar patterns in Hungarian, for both nominal and verbal inflection, as in previous studies of non-agglutinative Indo-European languages: the production of irregular inflected forms was both less accurate and slower than of regular forms, both for plural and past-tense inflection. The results replicate and extend previous findings to an agglutinative language with complex morphology. Together with previous studies, the evidence suggests that the regular/irregular distinction yields a basic behavioral pattern that holds across language families and linguistic typologies. Finally, the study sets the stage for further research examining the neurocognitive substrates of regular and irregular morphology in an agglutinative non-Indo-European language

Efficacy and safety of oral semaglutide with flexible dose adjustment versus sitagliptin in type 2 diabetes (PIONEER 7): a multicentre, open-label, randomised, phase 3a trial

Background: Oral semaglutide is the first oral formulation of a glucagon-like peptide-1 (GLP-1) receptor agonist developed for the treatment of type 2 diabetes. We aimed to compare the efficacy and safety of flexible dose adjustments of oral semaglutide with sitagliptin 100 mg. Methods: In this 52-week, multicentre, randomised, open-label, phase 3a trial, we recruited patients with type 2 diabetes from 81 sites in ten countries. Patients were eligible if they were aged 18 years or older (19 years or older in South Korea), had type 2 diabetes (diagnosed ≥90 days before screening), HbA1c of 7·5–9·5% (58–80 mmol/mol), and were inadequately controlled on stable daily doses of one or two oral glucose-lowering drugs (for 90 days or more before screening). Participants were randomly assigned (1:1) by use of an interactive web-response system, stratified by background glucose-lowering medication at screening, to oral semaglutide with flexible dose adjustments to 3, 7, or 14 mg once daily or sitagliptin 100 mg once daily. To approximate treatment individualisation in clinical practice, oral semaglutide dose could be adjusted on the basis of prespecified HbA1c and tolerability criteria. Two efficacy-related estimands were prespecified: treatment policy (regardless of treatment discontinuation or use of rescue medication) and trial product (on treatment and without use of rescue medication) for participants randomly assigned to treatment. The primary endpoint was achievement of HbA1c of less than 7% (53 mmol/mol) at week 52 and the confirmatory secondary efficacy endpoint was change in bodyweight from baseline to week 52. Safety was assessed in all participants who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov, number NCT02849080, and European Clinical Trials Database, EudraCT number 2015-005593-38, and an open-label extension is ongoing. Findings: Between Sept 20, 2016, and Feb 7, 2017, of 804 patients assessed for eligibility, 504 were eligible and randomly assigned to oral semaglutide (n=253) or sitagliptin (n=251). Most participants were male (285 [57%] of 504) with a mean age of 57·4 years (SD 9·9). All participants were given at least one dose of their allocated study drug except for one participant in the sitagliptin group. From a mean baseline HbA1c of 8·3% (SD 0·6%; 67 mmol/mol [SD 6·4]), a greater proportion of participants achieved an HbA1c of less than 7% with oral semaglutide than did with sitagliptin (treatment policy estimand: 58% [134 of 230] vs 25% [60 of 238]; and trial product estimand: 63% [123 of 196] vs 28% [52 of 184]). The odds of achieving an HbA1c of less than 7% was significantly better with oral semaglutide than sitagliptin (treatment policy estimand: odds ratio [OR] 4·40, 95% CI 2·89–6·70, p&lt;0·0001; and trial product estimand: 5·54, 3·54–8·68, p&lt;0·0001). The odds of decreasing mean bodyweight from baseline to week 52 were higher with oral semaglutide than with sitagliptin (estimated mean change in bodyweight, treatment policy estimand: −2·6 kg [SE 0·3] vs −0·7 kg [SE 0·2], estimated treatment difference [ETD] −1·9 kg, 95% CI −2·6 to −1·2; p&lt;0·0001; and trial product estimand: −2·9 kg [SE 0·3] vs −0·8 kg [SE 0·3], ETD −2·2 kg, −2·9 to −1·5; p&lt;0·0001). Adverse events occurred in 197 (78%) of 253 participants in the oral semaglutide group versus 172 (69%) of 250 in the sitagliptin group, and nausea was the most common adverse event with oral semaglutide (53 [21%]). Two deaths occurred in the sitagliptin group during the trial. Interpretation: Oral semaglutide, with flexible dose adjustment, based on efficacy and tolerability, provided superior glycaemic control and weight loss compared with sitagliptin, and with a safety profile consistent with subcutaneous GLP-1 receptor agonists. Funding: Novo Nordisk A/S