Factors Affecting the Competencies and Project Delivery of Small-Sized Indigenous Construction Firms in Lagos State

Every industry is prone to problems Performance is a general challenge affecting construction and most especially small-sized indigenous construction companies. The study focused on determining the likely factors affecting the competencies and project delivery of small-sized construction firms in Lagos. 60 questionnaires were designed and administered to professionals (15-Architects, 15-Builders, 15-Engineers, and 15-Quantity Surveyors) working in the construction companies in Lagos State and 48 questionnaires were retrieved. These questionnaires were analysed with SPSS and several findings were derived from this analysis. The various factors affecting the performance and project delivery at varying degrees are: high cost of plants, equipment, materials and labour, lack of skilled craftsmen, unavailability of funds, poor managerial skills, lack of government patronage, and poor communication among stakeholders. The study found out that the most prominent factors are poor managerial skills, lack of project planning and unavailability of funds. The main factors affecting the performance of small sized indigenous construction firms are based on three key elements namely time, quality and cost. These three elements when properly harnessed will increase the performance of small sized indigenous firms. The study recommended that the use of ICT would help improve performance by making work flow more easily. Access to bank loans and more machinery on site and sufficient government patronage would improve performance. It concluded that better management and project planning would go a long way in improving competencies and project delivery of small sized construction firms

INVESTIGATING FOR POZZOLANIC ACTIVITY IN THE BLEND OF GROUND GLASS WASTE WITH CEMENT FOR SUSTAINABLE CONCRETE

This research work investigates the tensile and flexural strengths of concrete containing ground glass as a partial replacement for cement. Sustainability is to be attained by the reduced volume and cost of disposing the glass wastes that would have been meant for landfills, reduce the cost of glass-cements blend because the glass are unwanted wastes that needs lesser heat to process as a pozzolan for use in concrete, and reduce greenhouse gas emissions due to the reduced use of cement needed per unit concrete due to the replacement. The ground glass was obtained from waste louver blades, pulverized and sieved with a 100μm sieve size. The physical properties such as moisture content, bulk density and specific gravity of the ground glass (GG) were determined. Sixty (60) cylinders of 150mm diameter and 300mm high were cast, three (3) samples for each of the percentage replacement groups of 0%, 10%, 20%, 30% and 40% corresponding to the curing ages of 3, 7, 28 and 56 days for each test. Thirty-six (36) beams of 100x100x500mm were also cast for flexural strength test, three (3) samples for each of the percentage replacement groups of 0%, 20% and 40% corresponding to the curing ages of 3, 7, 28 and 56 days. The specific gravity of the GG was found to be 3.67 and the bulk density was 1275kg/m3. The results of the findings show that as the partial replacement of cement with ground glass increases from 10% to 40%, the tensile strength of specimens for all curing periods of 3 to 56 days decreases. The flexural strength tests show a similar pattern of reducing flexural strength for all the curing ages as percentage replacement increases. However, it was observed that concrete with 10% replacement of cement with ground glass at 100μm fineness level had slight improved tensile strength of the concrete than the control (0% replacement with the GG) for the later curing period indicating the pozzolanic activity of ground glass

A Clinicopathological Review of Colonic Polyps in a Tertiary Hospital in North Central Nigeria

Background: Colorectal polyps, especially adenomas, are known as precursors of colorectal carcinomas. This study was aimed at determining the prevalence and histopathologic characteristics of colonic polyps among Nigerians that underwent colonoscopy at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. The authors also determined the polyp detection rate and adenoma detection rate. Materials and Methods: This was a hospital-based cross-sectional study of all colonoscopy examinations performed at the University of Ilorin Teaching Hospital, Ilorin from March 2013 to September 2017. The endoscopy register was reviewed, and patients’ biodata, indications for colonoscopy and colonoscopic findings were recorded on a proforma. The histopathologic reports of the polyps were also retrieved and their diagnosis confirmed. Results: A total of 289 patients had colonoscopy carried out on them. The age of the patients ranged from 14 to 90 years with a mean ±SD of 57.0 ± 15.3 years and a median age of 58 years. There were 178 (61.6%) males and 111 (38.4%) females giving a M:F ratio of 1.6:1. The indications for colonoscopy were rectalbleeding 124 (42.9%); suspected colorectal cancer 67 (23.2%); abdominal pain 22 (7.6%); chronic diarrhea 18 (6.2%); surveillance colonoscopy 12 (4.2%); constipation 11 (3.8%); change in bowel habit 9 (3.1%); occult bleeding 6 (2.1%); others 20 (6.9%). Endoscopic findings were normal findings 89 (30.8%); hemorrhoids 88 (30.4%); colonic polyps 50 (17.3%); diverticulosis 34 (11.8%); rectal cancer 29 (10.0%); colon cancer 24 (8.3%); colitis 19 (6.6%); others 13 (4.5%). The findings were not mutually exclusive. The diagnostic yield was 69.2%. The overall polyp detection rate was 17.3%. Of the 50 patients with polyps, 33 (66.0%) were males (p = 0.481). Theadenoma detection rate was 4.8%. Conclusion: The authors conclude that their observed polyp detection rate is consistent with the estimated rates for Africa. Rectal bleeding and adenomatous polyps were the commonest presentation and histopathologic finding, respectively

Breast Cancer Phenotypes in Africa: A Scoping Review and Meta-Analysis

PURPOSE Africans have been associated with more aggressive forms of breast cancer (BC).However, there is a lack of data regarding the incidence and distribution of different subtypes on the basis of phenotypic classification. This scoping review and meta-analysis was undertaken to determine the distribution pattern of BC phenotypes (luminal, human epidermal growth factor receptor 2 [HER2]1, and triple-negative breast cancer [TNBC]) across the African region. METHODS Four online databases (PubMed, Scopus, ProQuest, and EBSCOhost) were accessed to identify studies published between 2000 and 2022 reporting the representation of receptor status (estrogen receptor, progesterone receptor, and HER2) in African patients with BC. Furthermore, the meta-analysis was carried out using a random-effects model and pooled using the inverse variance method and logit transformation. 95% CI and I2 statistics were calculated using the Clopper-Pearson method to estimate between-study heterogeneity. RESULTS A total of 2,734 records were retrieved, of which 2,133 were retained for further screening. After the screening, 63 studies were finally selected for the scoping review and meta-analysis. The pooled frequency of luminal, HER2-positive (HER21), and TNBC was estimated at 56.30%, 12.61%, and 28.10%, respectively.Northern Africa had the highest frequency of the luminal subtype, while West Africa showed higher frequencies of HER21 and TNBC subtypes. The review also had a representation of only 24 countries in Africa. CONCLUSION Our results highlight the disparity in the representation of molecular subtypes among the people in different regions of Africa. There is a need to incorporate routine molecular subtyping into the management of African patients with BC

Influence of well-being and quality of work-life on quality of care among healthcare professionals in southwest, Nigeria

The Nigerian healthcare industry is bedevilled with infrastructural dilapidations and a dysfunctional healthcare system. This study investigated the influence of healthcare professionals' well-being and quality of work-life (QoWL) on the quality of care (QoC) of patients in Nigeria. A multicentre cross-sectional study was conducted at four tertiary healthcare institutions in southwest, Nigeria. Participants' demographic information, well-being, quality of life (QoL), QoWL, and QoC were obtained using four standardised questionnaires. Data were summarised using descriptive statistics. Inferential statistics included Chi-square, Pearson's correlation, independent samples t-test, confirmatory factor analyses and structural equation model. Medical practitioners (n = 609) and nurses (n = 570) constituted 74.6% of all the healthcare professionals with physiotherapists, pharmacists, and medical laboratory scientists constituting 25.4%. The mean (SD) participants' well-being = 71.65% (14.65), QoL = 61.8% (21.31), QoWL = 65.73% (10.52) and QoC = 70.14% (12.77). Participants' QoL had a significant negative correlation with QoC while well-being and quality of work-life had a significant positive correlation with QoC. We concluded that healthcare professionals' well-being and QoWL are important factors that influence the QoC rendered to patients. Healthcare policymakers in Nigeria should ensure improved work-related factors and the well-being of healthcare professionals to ensure good QoC for patients

Physician Attitudes towards Pharmacological Cognitive Enhancement: Safety Concerns Are Paramount

The ethical dimensions of pharmacological cognitive enhancement have been widely discussed in academic circles and the popular media, but missing from the conversation have been the perspectives of physicians - key decision makers in the adoption of new technologies into medical practice. We queried primary care physicians in major urban centers in Canada and the United States with the aim of understanding their attitudes towards cognitive enhancement. Our primary hypothesis was that physicians would be more comfortable prescribing cognitive enhancers to older patients than to young adults. Physicians were presented with a hypothetical pharmaceutical cognitive enhancer that had been approved by the regulatory authorities for use in healthy adults, and was characterized as being safe, effective, and without significant adverse side effects. Respondents overwhelmingly reported increasing comfort with prescribing cognitive enhancers as the patient age increased from 25 to 65. When asked about their comfort with prescribing extant drugs that might be considered enhancements (sildenafil, modafinil, and methylphenidate) or our hypothetical cognitive enhancer to a normal, healthy 40 year old, physicians were more comfortable prescribing sildenafil than any of the other three agents. When queried as to the reasons they answered as they did, the most prominent concerns physicians expressed were issues of safety that were not offset by the benefit afforded the individual, even in the face of explicit safety claims. Moreover, many physicians indicated that they viewed safety claims with considerable skepticism. It has become routine for safety to be raised and summarily dismissed as an issue in the debate over pharmacological cognitive enhancement; the observation that physicians were so skeptical in the face of explicit safety claims suggests that such a conclusion may be premature. Thus, physician attitudes suggest that greater weight be placed upon the balance between safety and benefit in consideration of pharmacological cognitive enhancement

Track E Implementation Science, Health Systems and Economics

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138412/1/jia218443.pd

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A Clinicopathological Review of Colonic Polyps in A Tertiary Hospital in North Central Nigeria

Background: Colorectal polyps, especially adenomas, are known as precursors of colorectal carcinomas. This study was aimed at determining the prevalence and histopathologic characteristics of colonic polyps among Nigerians that underwent colonoscopy at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. The authors also determined the polyp detection rate and adenoma detection rate. Materials and Methods: This was a hospital-based cross-sectional study of all colonoscopy examinations performed at the University of Ilorin Teaching Hospital, Ilorin from March 2013 to September 2017. The endoscopy register was reviewed, and patients' biodata, indications for colonoscopy and colonoscopic findings were recorded on a proforma. The histopathologic reports of the polyps were also retrieved and their diagnosis confirmed. Results: A total of 289 patients had colonoscopy carried out on them. The age of the patients ranged from 14 to 90 years with a mean ±SD of 57.0 ± 15.3 years and a median age of 58 years. There were 178 (61.6%) males and 111 (38.4%) females giving a M:F ratio of 1.6:1. The indications for colonoscopy were rectalbleeding 124 (42.9%); suspected colorectal cancer 67 (23.2%); abdominal pain 22 (7.6%); chronic diarrhea 18 (6.2%); surveillance colonoscopy 12 (4.2%); constipation 11 (3.8%); change in bowel habit 9 (3.1%); occult bleeding 6 (2.1%); others 20 (6.9%). Endoscopic findings were normal findings 89 (30.8%); hemorrhoids 88 (30.4%); colonic polyps 50 (17.3%); diverticulosis 34 (11.8%); rectal cancer 29 (10.0%); colon cancer 24 (8.3%); colitis 19 (6.6%); others 13 (4.5%). The findings were not mutually exclusive. The diagnostic yield was 69.2%. The overall polyp detection rate was 17.3%. Of the 50 patients with polyps, 33 (66.0%) were males (p = 0.481). Theadenoma detection rate was 4.8%. Conclusion: The authors conclude that their observed polyp detection rate is consistent with the estimated rates for Africa. Rectal bleeding and adenomatous polyps were the commonest presentation and histopathologic finding, respectively