Addressing effective construction logistics through the lens of vehicle movements

Purpose – Construction logistics is an essential part of construction supply chain management (CSCM). However, limited attention has been paid to this issue in the New Zealand construction industry. The purpose of this paper is to contribute to the knowledge about what hampers efficiency in transporting construction materials and plants to a construction site. The intention is to gain detailed understanding of the practice and obstacles in efficient construction logistics and thus identify interventions to improve logistics efficiency, especially using the numbers of vehicle movements to the construction site as an indicator. Design/methodology/approach – A case study approach was adopted with on-site observations and interviews. Observations were performed during constructions on-site from the start of construction to “hand-over” to the building owner. A selection of construction suppliers and subcontractors involved in the studied project were interviewed. Findings – Data analysis suggested that cost-related factors affecting the construction logistics, both monetary and non-monetary factors were not measured and largely ignored, especially the possible environmental and/or social impact occurred by the truck movement. Factors in the service-related sector were insufficiently managed in the observed site. The main contribution to inefficient construction logistics are related to understanding and implementing CSCM. It is noticed that there is inadequate awareness of CSCM and logistics efficiency largely due to lack of commitment from the management level and skills at the operational level. Originality/value – Significant intrinsic and extrinsic interventions necessary to enhance construction logistics were acknowledged from the data analysis. These include both qualitative and quantitative data. These intrinsic and extrinsic interventions, such as implementing appropriate logistics tools that suits individual site and introducing traffic management costs, offer plausible explanations regarding how to improve the efficiency in construction logistics through optimising transportation movements to the construction site

Evaluating defect reporting in new residential buildings in New Zealand

The need for defect reporting is becoming increasingly difficult to ignore at handover of new residential buildings. A general review in defect studies has consistently shown that newly built properties can be found to have a significant number of defects. Very often the responsibility for rectifying these common defects is borne by the new homeowner even though house developers are liable. In the current study, survey data is obtained from 216 recent home purchasers/owners across New Zealand urban cities. The intent of the investigation is to show that opportunities exist for defect reporting that will act as a mechanism to measure performance and thus improve the quality of finished construction products in New Zealand. The study found that a significant number (81%) of the participants were involved in the construction of their homes and could influence quality performance if they were proactive enough. The results show that (64.7%) did not engage the service of independent building inspectors for defect reporting on their new homes. Seventy-four percent now agree that independent building inspection was important in hindsight. The study findings are in line with literature on defects and the poor use of defect reporting in new residential buildings. The current challenge for defect rectification by house developers after handover is real and this could increase the confidence that new home owners can have in their developers. Defect reporting could confer benefits to new residential building quality in New Zealand and should be embraced as part of a wider best practice

Supply chain collaboration in New Zealand house construction

Concurrent with the development of interest in supply chain management (SCM) in the broad manufacturing sector, there has been increasing interest and research in SCM in relation to construction. The construction supply chain comprises a network of project parties connected upstream and downstream to produce what the end consumer wants – much like in any production process. However in construction there is little by way of aggregation or integration in the supply chain. Indeed historically disintegration has been the default state in the construction supply chain. The key to achieving project success within a defined timeframe is based on collaborative interactions within the supply chain. Collaboration is the key to solving issues in on-going construction. The study collects the views of construction materials manufacturers, suppliers, architects, and homeowners on the significance of collaboration in the New Zealand residential construction sector. The study collated data from 30 ssemi- structured interviews. Thematic analysis of the responses identified the significance of collaborative materials supply chain practices in the residential building construction sector. The study found that collaboration is appreciated by all the parties in the construction supply chain in order to find appropriate building materials for use on projects. Further, good communication across the supply chain was identified as a key driving factor to strengthening existing collaborative efforts

Specific support needs and experiences of carers of people with frontotemporal dementia: A systematic review

INTRODUCTION: Frontotemporal dementia (FTD) is one of the most common types of dementia in persons younger than 65 years of age. Diagnosis is often delayed due to slow, gradual decline and misinterpretation of 'non-typical' dementia symptoms. Informal carers of people with FTD experience greater levels of overall burden than carers of people with other forms of dementia. The aim of this systematic review was to describe the subjective experience of being an informal carer of a person with FTD and to identify the specific needs, coping strategies and helpful support resources of this carer population. METHODS: Four electronic databases were used to search for published literature presenting experiences of carers of people with FTD between January 2003 and July 2019. Search strategy followed PRISMA guidelines. Findings were analysed using framework analysis, employing five stages of analysis to develop a coding index and thematic framework that included key aspects of the carer experience, which were grouped into themes and presented in a narrative format. RESULTS: 1213 articles were identified in total. Twelve studies were included in the final synthesis of the review. Six themes were identified: 'Challenging road to and receipt of diagnosis', 'relationship change and loss', 'challenging experiences in caring', 'positive experiences and resilience', 'coping' and 'support needs'. DISCUSSION: Findings highlight an increased need for carers of people with FTD to receive support during the pre-diagnostic stage, including support to manage symptoms. Further research should explore relationship changes and loss amongst carers to inform approaches for carer support. In conclusion, the lack of knowledge and unique needs of carers highlight the importance of public awareness campaigns and healthcare professional education to support carers with FTD symptom impact

Maternal and foetal outcomes among 4118 women with HIV infection treated with lopinavir/ritonavir during pregnancy: analysis of population-based surveillance data from the national study of HIV in pregnancy and childhood in the United Kingdom and Ireland

BACKGROUND: The National Study of HIV in Pregnancy and Childhood (NSHPC) conducts comprehensive population-based surveillance of pregnancies in women with HIV infection in the United Kingdom/Ireland. Use of antepartum antiretroviral therapy (ART) for prevention of mother-to-child transmission (MTCT) and to treat maternal infection, if required, is standard practise in this population; lopinavir/ritonavir (LPV/r) is commonly used. The study objective was to examine the use of LPV/r among pregnant women with HIV infection to describe maternal and foetal outcomes. METHODS: The NSHPC study collected maternal, perinatal and paediatric data through confidential and voluntary obstetric and paediatric reporting schemes. Pregnancies reported to the NSHPC by June 2013, due to deliver 2003-2012 and with LPV/r exposure were included in this analysis, using pregnancy as the unit of observation. RESULTS: Four thousand eight hundred sixty-four LPV/r-exposed pregnancies resulting in 4702 deliveries in 4118 women were identified. Maternal region of birth was primarily sub-Saharan Africa (77 %) or United Kingdom/Ireland (14 %). Median maternal age at conception was 30 years. LPV/r was initiated preconception in 980 (20 %) and postconception in 3884 (80 %) pregnancies; median duration of antepartum LPV/r exposure was 270 and 107 days, respectively. Viral load close to delivery was <50 copies/mL in 73 % and <1000 copies/mL in 94 % of women. 63 % of deliveries were by caesarean section (elective, 62 %; emergency, 38 %). Among singleton live births, 13 % were <37 weeks of gestation (2.5 % <32 weeks) and 15 % had birth weight <2500 g (2.3 % <1500 g). MTCT rates were 1.1 (2003-2007) and 0.5 % (2008-2012). 134 live born children (2.9 %) had ≥1 congenital abnormality. CONCLUSIONS: The results of this analysis using real-world data from a large number of pregnant women with HIV infection in the United Kingdom and Ireland who received LPV/r-containing ART regimens demonstrate that these regimens have a good safety profile and are effective for viral suppression during pregnancy, with associated low rates of MTCT

Sustaining construction organisations in NZ: A linear regression model approach to analysing determinants of their performance

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"It pains me because as a woman you have to breastfeed your baby": decision-making about infant feeding among African women living with HIV in the UK

OBJECTIVES: UK guidance advises HIV-positive women to abstain from breast feeding. Although this eliminates the risk of postnatal vertical transmission of HIV, the impact of replacement feeding on mothers is often overlooked. This qualitative study examines, for the first time in the UK, decision-making about infant feeding among African women living with HIV. METHODS: Between 2010 and 2011, we conducted semistructured interviews with 23 HIV-positive African women who were pregnant or had recently given birth. We recruited participants from three HIV antenatal clinics in London. RESULTS: Women highlighted the cultural importance of breast feeding in African communities and the social pressure to breast feed, also describing fears that replacement feeding would signify their HIV status. Participants had significant concerns about physical and psychological effects of replacement feeding on their child and felt their identity as good mothers was compromised by not breast feeding. However, almost all chose to refrain from breast feeding, driven by the desire to minimise vertical transmission risk. Participants' resilience was strengthened by financial assistance with replacement feeding, examples of healthy formula-fed children and support from partners, family, peers and professionals. CONCLUSIONS: The decision to avoid breast feeding came at considerable emotional cost to participants. Professionals should be aware of the difficulties encountered by HIV-positive women in refraining from breast feeding, especially those from migrant African communities where breast feeding is culturally normative. Appropriate financial and emotional support increases women's capacity to adhere to their infant-feeding decisions and may reduce the emotional impact

Loss to Follow-Up After Pregnancy Among Sub-Saharan Africa-Born Women Living With Human Immunodeficiency Virus in England, Wales and Northern Ireland: Results From a Large National Cohort.

BACKGROUND: Little is known about retention in human immunodeficiency virus (HIV) care in HIV-positive women after pregnancy in the United Kingdom. We explored the association between loss to follow-up (LTFU) in the year after pregnancy, maternal place of birth and duration of UK residence, in HIV-positive women in England, Wales, and Northern Ireland. METHODS: We analyzed combined data from 2 national data sets: the National Study of HIV in Pregnancy and Childhood; and the Survey of Prevalent HIV Infections Diagnosed, including pregnancies in 2000 to 2009 in women with diagnosed HIV. Logistic regression models were fitted with robust standard errors to estimate adjusted odds ratios (AOR). RESULTS: Overall, 902 of 7211 (12.5%) women did not access HIV care in the year after pregnancy. Factors associated with LTFU included younger age, last CD4 in pregnancy of 350 cells/μL or greater and detectable HIV viral load at the end of pregnancy (all P < 0.001). On multivariable analysis, LTFU was more likely in sub-Saharan Africa-born (SSA-born) women than white UK-born women (AOR, 2.17; 95% confidence interval, 1.50-3.14; P < 0.001). The SSA-born women who had migrated to the UK during pregnancy were 3 times more likely than white UK-born women to be lost to follow-up (AOR, 3.19; 95% confidence interval, 1.94-3.23; P < 0.001). CONCLUSIONS: One in 8 HIV-positive women in England, Wales, and Northern Ireland did not return for HIV care in the year after pregnancy, with SSA-born women, especially those who migrated to the United Kingdom during pregnancy, at increased risk. Although emigration is a possible explanatory factor, disengagement from care may also play a role

Pregnancy is associated with elevation of liver enzymes in HIV-positive women on antiretroviral therapy.

The objective of this study is to assess whether pregnancy is associated with an increased risk of liver enzyme elevation (LEE) and severe LEE in HIV-positive women on antiretroviral therapy (ART)

The impact of African ethnicity and migration on pregnancy in women living with HIV in the UK: design and methods

Background The number of reported pregnancies in women with diagnosed HIV in the UK increased from 80 in 1990 to over 1400 in 2010; the majority were among women born in sub-Saharan Africa. There is a paucity of research on how social adversity impacts upon pregnancy in HIV positive women in the UK; furthermore, little is known about important outcomes such as treatment uptake and return for follow-up after pregnancy. The aim of this study was to examine pregnancy in African women living with HIV in the UK. Methods and design This was a two phase mixed methods study. The first phase involved analysis of data on approximately 12,000 pregnancies occurring between 2000 and 2010 reported to the UK’s National Study of HIV in Pregnancy and Childhood (NSHPC). The second phase was based in London and comprised: (i) semi-structured interviews with 23 pregnant African women living with HIV, 4 health care professionals and 2 voluntary sector workers; (ii) approximately 90 hours of ethnographic fieldwork in an HIV charity; and (iii) approximately 40 hours of ethnographic fieldwork in a Pentecostal church. Discussion We have developed an innovative methodology utilising epidemiological and anthropological methods to explore pregnancy in African women living with HIV in the UK. The data collected in this mixed methods study are currently being analysed and will facilitate the development of appropriate services for this group