A review of IBS implementation in Malaysia and Singapore

This paper is a review of IBS implementation in Malaysia and Singapore. It investigates the limitations and opportunities in implementation of IBS in Malaysia and Singapore. In Malaysia, Construction Industry Development Board (CIDB) defines Industrialised Building System (IBS) as a construction technique in which components are manufactured in a controlled environment (either onsite or offsite), then transported, positioned and installed into a structure with less additional onsite works. Content analysis is the method adopted in this study. Data is collected from books, journal articles, annual reports and newspaper articles. Studies show that IBS contributes many benefits including labour reduction, cleaner and neater sites, easy installation, fast completion, enhancement of quality finished products and flexibility. Construction industries in countries like Singapore and Malaysia have shifted the construction methods from conventional to prefabrication. In Malaysia, Construction Industry Development Board (CIDB) is still promoting IBS in the private sector, whereas, government sector has successfully adopted IBS. However, in Singapore, Housing and Development Board (HDB) has implemented prefabrication in its construction industry. IBS has many benefits but with these benefits there are some limitations and hindrances as IBS is not widely adopted. This study highlights the benefits and challenges to overcome for the improvement in the implementation of IBS

Assessing Water Consumption of Major Crops in the Command Area of Malwah Distributary, Shaheed Benazirabad, Sindh.

Soil and water are vital natural resources on which agriculture sector growth and village livelihood depend and having the proper knowledge of the Soil, Plant, and water relationship are extremely important to achieve sustainable agricultural productivity. Pakistan has entered the 21st century with the rising challenge to meet food and fiber requirements for its population for domestic consumption and export. Without having appropriate knowledge about the intense water need of plants, most of the agricultural land in Pakistan is still being irrigated by conventional methods, which in turn produces so many problems and reduces the agricultural productivity putting extra stress on the country’s economy, so to avoid these issues, it is extremely necessary to provide the required quantity of water to plant, which will only be possible by consideration and accurate estimation of Evapotranspiration of plant so to enhance awareness and practice of water-saving agriculture in Pakistan to increase the agricultural commodities. In this study, estimation of Actual Evapotranspiration ( ETa ) of Malwah Distributary located in Shaheed Benazirbad, Sindh was selected from Command area of Rohri Canal, ET of four different crops; Cotton, Fallow, Rice and Sugarcane for the period of Rabi 2019-2020 and Kharif 2020 was estimated by using satellite-based evapotranspiration mapping tool namely METRIC REFLUX. The actual ET for each season was obtained using the Reference ET fraction (ETrf) of satellite data and reference ET(ETr) obtained from the literature. The classified crop mask was obtained using maximum likelihood classification on bands 8,4, and 3 of sentinel-2 images of the year 2020. The overall accuracy obtained is 93% with a kappa coefficient 0.921841. The average Actual Evapotranspiration of different crops namely, banana, cotton, rice, and sugarcane were found to be 1527.2 mm, 536.6 mm, 386.80 mm, and 814.02 m

Land Covers Change Assessment After Small Dam’s Construction Based on the Satellite Data

The small dams were constructed in the study area for storing the rainwater. The present study was conducted to assess the impact of small dams on the LCC (Land Cover Change) in Nangarparkar, Pakistan based on the satellite data. The ENVI (Environment for Visualizing Images) software was used for classification of the four year’s images and three classes viz. water, vegetation, and soil were taken for detection of LCC. The MLH (Maximum Likelihood) supervised method was used to classify the multispectral satellite images. The classified results of the classes were found different each year before and after dam construction. Average results of the two years before dam’s construction revealed that water availability, vegetation cover and soil cover was 3.02%, 18.52%, and 32.30% respectively. However, after the dam construction, the water availability, vegetation cover and soil cover was 8.49%, 34.33%, and 17.15% respectively. Overall results revealed that water availability and vegetation cover were increased by 5.47 % and 15.18% respectively while soil cover decreased 15.15% after the construction of dams. Hence, based on the results, it is confirmed that the constructions of small dams have a direct and indirect positive impact on the land cover changes and it can play an important role in the resettlement of the communities of the arid areas

Socio-Economic Impact Assessment of Small Dams Based on T-Paired Sample Test Using SPSS Software

A dam is a barrier/structure that impounds water and retains it for later use. Thus, it plays an important role and offers a reserve stock of water for rural communities in remote areas. The present study was conducted to assess the socio-economic impact of small dams on local communities. The impact was analyzed based on descriptive statistics and t- paired sample tests using SPSS software to study and analyze the Nagarparkar area, Sindh, Pakistan. Primary and secondary data were used for collecting the data. The data was collected randomly from 250 people through interviews and group discussions Also, 104 sets of data were obtained through a questionnaire survey. The overall results summary of the parameters revealed that a significantly positive variation occurred in the study area after construction of the dam. The number of the packa houses and water depth were increased. The distance to collect water and water-fetching time were decreased 6% and 5.61 % respectively. The overall average area cultivated with crops was increased by 26.55%. The average yield of almost every crop in both Rabi and Kharif seasons were increased by 55% in the areas surrounding the dams. The overall number of livestock was increased by 18.08%, while the number of horses decreased by 1.5% after construction of the dam. The income, expenditure, and savings have increased significantly to 36.16%, 17.68%, and 32.15%, respectively, while the migration rate has decreased19.09% since construction of the dam. The choice of crops has also changed from inferior crops to superior and market-oriented crops. The water table and quality have improved, and wells have been recharged

Higher Education Capacity Building in Water Resources Engineering and Management to Support Achieving the Sustainable Development Goal for Water in Pakistan

Achieving the Sustainable Development Goals requires a multi‐pronged approach, with a key element being the development of a trained Community of Practice to sustain the advances in the relevant sectors. The engagement of higher education as a catalyst in the development and capacity building of the next generation of professionals and citizens comprising the Community of Practice is essential to meet the challenges of poverty, climate change, and clean water and to sustain those advances past 2030. This paper describes a capacity building program funded by the United States Agency for International Development to partner the University of Utah, in the United States, with Mehran University of Engineering and Technology, in Pakistan, to create the U.S.‐Pakistan Center for Advanced Studies in Water (USPCASW). The USPCASW program includes six core components of Curriculum Reform, Applied Research, Exchanges and Training, Governance, Gender Equity, and Sustainability. This paper describes the project, the activities for each component, and the multi‐level assessment of the program, activities, and impact. The paper also highlights the overarching impact of the program and its alignment with achieving the Sustainable Development Goal for Water. Following the description of the program components and assessment, the paper concludes with a discussion of challenges and lessons learned

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

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

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

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

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone