Constructability Research Trends: A Review and Future Directions

Implementing constructability concepts in a project can bring many benefits such as reduced project cost & duration, enhanced project quality, and improved site management. There were numerous research on constructability concepts since its introduction in late 1970. However, there are limited contemporary literature to review the research on constructability in a structured way. Therefore, this paper aims to review the literature with respective to the constructability concepts. The trend of constructability development, limitations of current research, research gaps and future direction will be briefly presented. Constructability development internationally will be discussed first before the limitation of the constructability research conducted in Malaysia are presented. The literature review reveals that the constructability research in Malaysia are still limited. Apart from building projects, there is a need for more constructability studies with respect to infrastructure projects. The trend of constructability development had moved towards the use of quantitative models. For future direction, quantitative models related to infrastructure projects in Malaysia can be developed. There is a potential of the quantitative models to be embedded with Building Information Modelling (BIM) so that automated assessment is made possible

Critical Constructability Principles for Girder Bridge Construction in Malaysia

Implementing constructability concepts in a project can bring many benefits such as reduced project cost & duration, enhanced project quality, and improved site management. There were numerous research on the constructability concept since its introduction in late 1970. However, there are limited studies that identified the critical constructability principles for infrastructure projects. This study identified the critical design stage constructability principles for girder type river bridge construction in Malaysia. Based on extensive literature review and unstructured interviews with the experts in bridge construction, 54 constructability principles were identified. Questionnaires were distributed to professional engineers and G6 & G7 contractors in Malaysia to rate the 54 constructability principles in term of their importance or impact in enhancing the constructability of bridge construction based on 5-point Likert scale. The received 143 responses were analysed using factor analysis which is a data reduction tool of SPSS. Varimax method of orthogonal approach was adopted for factor rotation. Factor analysis had helped to generate 11 principal components or critical constructability principles. Cronbach’s Alpha reliability test also indicated good reliability of the questionnaire scale. The identified critical constructability principles can provide guidelines to the construction practitioners at the design stage to enhance the performance of bridge construction

Building Information Modelling application: focus-group discussion

Iako znanstvena zajednica u osnovnim crtama prihvaća mogući doprinos Building Information Modelinga (BIM) radi postizanja održivog razvoja, stupanj provedbe još uvijek je vrlo mali. Većina istraživanja danas se usredotočuje na analizu prepreka i strategija za primjenu BIM-a i pritom se koristi kvantitativni pristup. U ovom radu određuju se ključne prepreke i odgovarajuće strategije za primjenu BIM-a, ali se pritom koristi kvalitativni pristup na osnovi ispitivanja interesnih skupina. Rezultati pokazuju da troškovi provedbe nisu ključna prepreka, te da su u tom smislu značajnije prepreke nedostatak znanja, osposobljenosti i svijesti o potrebi uvođenja BIM-a.Although the potential of building information modelling to achieve sustainability has been widely acknowledged by the scientific community, the level of implementation is nevertheless quite low. Most of the existing research focuses on the study of the barriers and strategies of BIM application through a quantitative approach. This study ascertains critical barriers and appropriate strategies for the application of BIM through qualitative approach via focus group discussions. The findings reveal that the cost of implementation is not indicated as a critical barrier, and that the lack of expertise, training, and awareness, is more critical in that respect

A Proposed Model for Assessing Organisational Culture Towards Achieving Business Objectives

Most of the traditional business performances measures are based on productivity and process criteria, which mainly focus on method of investment appraisal such as payback method, return on investment (ROI), cost-benefits analysis (CBA), net present value (NPV), internal rate of return (IRR). However, the measurement scales of business performance are not limited to those measures. One element that has strong correlation to the business performances is ‘organisational culture’. Many studies proved that one of the significant criteria for achieving desired business objectives is the right organisational culture within workplace. Basically, the measurement of organisational culture is reflecting on two distinct elements: organisational culture and business objectives. In broader perspective, an organisation is considered effective if it meets its business objectives. This paper aims to present and discuss the preliminary culture model to indicate the culture performance within organisational. The model has been developed through literature review, expert opinion and experience which is anticipated of being able to potentially measure the culture capability of organisations across industries to “successfully achieve business objectives”. The model is composed of six progressive stages of maturity that an organisation can achieve its culture performance. For each maturity stage, the model describes a set of characteristics that must be in place for the company to achieve each stage. The validity of the proposed model will be tested by a few case studies. The idea is to provide managers with a qualitative measurement tools to enable them to identify where culture improvements are required within their organisations and to indicate their readiness for achieving business objectives

Enablers for malaysian contractors to internationalise construction services

Construction industry is a complex environment, unpredictable and full of uncertainties. The economic woes that take place in the late nineties have indeed dampened Malaysian construction industry. Projects are scarce and in order to survive, many construction companies seek for other alternative in order to remain in this industry. Thus, many took a brave step and venture upon overseas market. Due to this, research is carried out in order to identify problems that triggered Malaysian contractors to move into overseas market. Apart from that problems encountered in the foreign countries in which the construction companies are operating too are identified. With these objectives in mind, case studies are conducted in India and the Middle East to better understand the situation. Two notable Malaysian contractors companies point of view are taken into account regarding the case studies in which these companies are operating their projects there respectively. The findings from these interviews reveal the success factors of overseas ventures basically lies in the strategic marketing done by each construction companies. This is vital as it determines the company’s long term objectives

Project meeting and guidelines: the impact on time performance of construction projects in Malaysia

A project meeting is an event in which stakeholders communicate amongst themselves to meet expectations in the projects by follow up, update, and get feedback. It is a platform for the team to communicate in any projects to serve the purpose of the meeting. As there is a limited study from the literature on the time performance of the project meeting, it is important to determine whether the impact of the project meeting contributes significantly to project time performance or leads to time waste and affects the project time performance. This qualitative study investigates the most significant factors that impact the project meeting to project time performance. Data analysis was obtained from interviews with twenty-seven project managers in the construction industry among local property developers based in Klang Valley, West Malaysia. The study using nvivo technique of analysis revealed most of the project managers agreed scheduling project meetings will improve time performance. The study also proposed guidelines for project meetings incorporating insightful general elements of meetings and time monitoring by incorporating project time spend and analysis of time spent that will assist the project manager to manage meetings efficiently. The findings revealed most of the project managers agreed that the presence of guidelines for meetings helps to guide meetings efficiently and enhance time project performance

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially