Review of critical success factors for the implementation of total quality management in the construction industry

Abstract: Total Quality Management (TQM) is a philosophy that involves every organization in the industry in the effort to improve performance. The concept is an integrative management principle for continuously improving the quality of products and processes to achieve customer satisfaction. To achieve this concept required a clear establishment of Critical Success Factors (CSFs). However, lack of clear establishment of CSFs for the implementation of TQM in the construction industry has led to failure of the system. In the pursuit of performance excellence in the construction industry and with an increasing awareness of construction quality, construction firms have no option than to implement TQM with clear CSFs

Manure characteristics of small ruminants fed agro by-products in the guinea savannah agro-ecological zone of Ghana

A 90 day study on evaluating quantity and quality of manure from small ruminants in the Guinea Savannah agro-ecological zone of Ghana was conducted. 36 goats and 36 sheep were random­ly allotted to three dietary treatments - Basal diets of maize stover, cassava and yam peels as Treatment one (T1), T1 supplemented with cowpea residues as Treatment two (T2) and T1 supplemented with groundnut residues as Treatment three (T3) in a randomized complete block design. Feed composition and intake and manure characteristics were assessed and data ana­lyzed statistically using Generalized Linear Model procedures of SAS at 5% significance level. The Chemical composition of feed resources ranged from 3.2-17.3% crude protein, 82-97.2% organic matter and 2.8-18% ash. Total feed intake ranged from 519.55-659.72 g/day and 331.84-420.17 g/day for sheep and goats respectively. Sheep manure weighed 319.17-423.33 g/day and contained 20.74-29.01% carbon, 1.87-2.32% nitrogen, 0.77-3.00 potassium, 9.52-26.50% ash, 0.44-0.77 pH and C:N ratio of 10.98-15.53. Goat manure weighed 178.67-216.17 g/day with 19.58-30.61%, 1.56-2.21% nitrogen, 0.82-2.33% potassium, 10.75-19.80% ash, 0.37-1.47 pH and C:N ratio of 9.49-19.92. Results indicated that manure from small ruminants could serve as alternative source of fertilizer in Ghana since its characteristics compare well with chemical fertilizers. Keywords: sheep; goats; feed resources; manure; fertilizer

Roasting effects on phenolic content and free-radical scavenging activities of pulp preconditioned and fermented cocoa (Theobroma cacao) beans

Polyphenols are phytochemicals responsible for the astringency, bitterness, green flavours and antioxidant activities in Theobroma cacao beans. Polyphenols degradation in cocoa beans during roasting is crucial to the flavour outcome and it is influenced by factors such as temperature, time and pod storage. Antioxidants are compounds that help to inhibit oxidation reactions caused by free radicals such as singlet oxygen, superoxide, peroxyl radicals, hydroxyl radicals and peroxynitrite thereby preventing damage to the cells and tissues. Their mechanisms of action include scavenging reactive oxygen and decreasing localised oxygen concentration thereby reducing molecular oxygen’s oxidation potential, metabolising lipid peroxides to non-radical products and chelating metal ions to prevent generation of free radicals in humans. The study aimed at investigating changes in total polyphenols, anthocyanins, o-diphenols and antioxidant activity (free-radical scavenging activities) after roasting of pulp preconditioned and fermented cocoa beans using standard analytical methods. A 4×4 full factorial design with the principal experimental factors as pod storage time (0, 3, 7 and 10 days) and roasting duration (0, 15, 30 and 45 minutes) at 120oC were used to study the changes in the total polyphenols, anthocyanins, o-diphenols and % free-radical scavenging activities of the cocoa beans. Variable decrease in total polyphenols, odiphenols and anthocyanins were observed with increase in pre-conditioning (pod storage time) and roasting duration. However, variable trends were observed for the % free-radical scavenging activities. The total polyphenols, anthocyanins and o-diphenols in the cocoa beans after 45 minutes roasting decreased in the range 132.24 to 57.17 mg/g, 6.71 to 1.07 mg/kg and 15.94 to 8.25 mg/g respectively at all pod storage treatments. The total polyphenols of the fermented, dried and unstored (freshly harvested) cocoa beans was 132.25 mg/g which reduced to 122.14 mg/g (7.6% degradation), 116.721 mg/g (11.7% degradation) and 92.22 mg/g (30.3% degradation) after storage for 3, 7 and 10 days, respectively. The optimum decrease in the % freeradical scavenging activity was 7 days and above of pods storage. Increasing roasting time caused a continuous decrease in the % free-radical scavenging activity from 89.10% to 74.31% after 45 minutes for beans from the unstored (freshly harvested) pods. However, pod storage caused an increase in the % free radical scavenging activities during roasting. Pulp pre-conditioning (pod storage) and roasting duration could be used to reduce the astringency and bitterness caused by polyphenols, o-diphenols and anthocyanins in cocoa beans as well as increase the antioxidant activity imparted by cocoa.Key words: Cocoa, pod storage, roasting, polyphenols

Primary beam effects of radio astronomy antennas -- II. Modelling the MeerKAT L-band beam

After a decade of design and construction, South Africa's SKA-MID precursor MeerKAT has begun its science operations. To make full use of the widefield capability of the array, it is imperative that we have an accurate model of the primary beam of its antennas. We have taken available L-band full-polarization 'astro-holographic' observations of three antennas and a generic electromagnetic simulation and created sparse representations of the beams using principal components and Zernike polynomials. The spectral behaviour of the spatial coefficients has been modelled using discrete cosine transform. We have provided the Zernike-based model over a diameter of 10 deg averaged over the beams of three antennas in an associated software tool (EIDOS) that can be useful in direction-dependent calibration and imaging. The model is more accurate for the diagonal elements of the beam Jones matrix and at lower frequencies. As we get more accurate beam measurements and simulations in the future, especially for the cross-polarization patterns, our pipeline can be used to create more accurate sparse representations of MeerKAT beams.Comment: 16 pages, 18 figures. This is a pre-copyedited, author-produced PDF of an article accepted for publication in MNRAS following peer review. The version of record [K. M. B. Asad et al., 2021] is available online at: https://doi.org/10.1093/mnras/stab10

Profile and outcomes of hospitalized patients with COVID-19 at a tertiary institution hospital in Ghana

Background: In high-income countries, mortality related to hospitalized patients with the Coronavirus disease 2019 (COVID-19) is approximately 4-5%. However, data on COVID-19 admissions from sub-Saharan Africa are scanty.Objective: To describe the clinical profile and determinants of outcomes of patients with confirmed COVID-19 admitted at a hospital in Ghana.Methods: A prospective study involving 25 patients with real time polymerase chain reaction confirmed COVID-19 admitted to the treatment centre of the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana from 1st June to 27th July, 2020. They were managed and followed up for outcomes. Data were analysed descriptively, and predictors of mortality assessed using a multivariate logistic regression modelling.Results: The mean age of the patients was 59.3 ± 20.6 years, and 14 (56%) were males. The main symptoms at presentation were breathlessness (68%) followed by fever (56%). The cases were categorized as mild (6), moderate (6), severe (10) and critical (3). Hypertension was the commonest comorbidity present in 72% of patients. Medications used in patient management included dexamethasone (68%), azithromycin (96%), and hydroxychloroquine (4%). Five of 25 cases died (Case fatality ratio 20%). Increasing age and high systolic blood pressure were associated with mortality.Conclusion: Case fatality in this sample of hospitalized COVID-19 patients was high. Thorough clinical assessment, severity stratification, aggressive management of underlying co-morbidities and standardized protocols incountry might improve outcomes

"Even if the test result is negative, they should be able to tell us what is wrong with us": a qualitative study of patient expectations of rapid diagnostic tests for malaria.

BACKGROUND: The debate on rapid diagnostic tests (RDTs) for malaria has begun to shift from whether RDTs should be used, to how and under what circumstances their use can be optimized. This has increased the need for a better understanding of the complexities surrounding the role of RDTs in appropriate treatment of fever. Studies have focused on clinician practices, but few have sought to understand patient perspectives, beyond notions of acceptability. METHODS: This qualitative study aimed to explore patient and caregiver perceptions and experiences of RDTs following a trial to assess the introduction of the tests into routine clinical care at four health facilities in one district in Ghana. Six focus group discussions and one in-depth interview were carried out with those who had received an RDT with a negative test result. RESULTS: Patients had high expectations of RDTs. They welcomed the tests as aiding clinical diagnoses and as tools that could communicate their problem better than they could, verbally. However, respondents also believed the tests could identify any cause of illness, beyond malaria. Experiences of patients suggested that RDTs were adopted into an existing system where patients are both physically and intellectually removed from diagnostic processes and where clinicians retain authority that supersedes tests and their results. In this situation, patients did not feel able to articulate a demand for test-driven diagnosis. CONCLUSIONS: Improvements in communication between the health worker and patient, particularly to explain the capabilities of the test and management of RDT negative cases, may both manage patient expectations and promote patient demand for test-driven diagnoses

The malaria testing and treatment landscape in mainland Tanzania, 2016

Abstract Background Understanding the key characteristics of malaria testing and treatment is essential to the control of a disease that continues to pose a major risk of morbidity and mortality in mainland Tanzania, with evidence of a resurgence of the disease in recent years. The introduction of artemisinin combination therapy (ACT) as the first-line treatment for malaria, alongside policies to promote rational case management following testing, highlights the need for evidence of anti-malarial and testing markets in the country. The results of the most recent mainland Tanzania ACTwatch outlet survey are presented here, including data on the availability, market share and price of anti-malarials and malaria diagnosis in 2016. Methods A nationally-representative malaria outlet survey was conducted between 18th May and 2nd July, 2016. A census of public and private outlets with potential to distribute malaria testing and/or treatment was conducted among a representative sample of administrative units. An audit was completed for all anti-malarials, malaria rapid (RDT) diagnostic tests and microscopy. Results A total of 5867 outlets were included in the nationally representative survey, across both public and private sectors. In the public sector, availability of malaria testing was 92.3% and quality-assured (QA) ACT was 89.1% among all screened outlets. Sulfadoxine–pyrimethamine (SP) was stocked by 51.8% of the public sector and injectable artesunate was found in 71.4% of all screened public health facilities. Among anti-malarial private-sector stockists, availability of testing was 15.7, and 65.1% had QA ACT available. The public sector accounted for 83.4% of the total market share for malaria diagnostics. The private sector accounted for 63.9% of the total anti-malarial market, and anti-malarials were most commonly distributed through accredited drug dispensing outlets (ADDOs) (39.0%), duka la dawa baridi (DLDBs) (13.3%) and pharmacies (6.7%). QA ACT comprised 33.1% of the national market share (12.2% public sector and 20.9% private sector). SP accounted for 53.3% of the total market for anti-malarials across both private and public sectors (31.3 and 22.0% of the total market, respectively). The median price per adult equivalent treatment dose (AETD) of QA ACT in the private sector was $1.40, almost 1.5 times more expensive than the median price per AETD of SP ($1.05). In the private sector, 79.3% of providers perceived ACT to be the most effective treatment for uncomplicated malaria for adults and 88.4% perceived this for children. Conclusions While public sector preparedness for appropriate malaria testing and case management is showing encouraging signs, QA ACT availability and market share in the private sector continues to be sub-optimal for most outlet types. Furthermore, it is concerning that SP continues to predominate in the anti-malarial market. The reasons for this remain unclear, but are likely to be in part related to price, availability and provider knowledge or preferences. Continued efforts to implement government policy around malaria diagnosis and case management should be encouraged

Reflecting on Hybrid Events: Learning from a Year of Hybrid Experiences

The COVID-19 pandemic led to a sudden shift to virtual work and events, with the last two years enabling an appropriated and rather simulated togetherness - the hybrid mode. As we return to in-person events, it is important to reflect on not only what we learned about technologies and social justice, but about the types of events we desire, and how to re-design them accordingly. This SIG aims to reflect on hybrid events and their execution: scaling them across sectors, communities, and industries; considering trade-offs when choosing technologies; studying best practices and defining measures of "success"for hybrid events; and finally, identifying and charting the wider social, ethical, and legal implications of hybrid formats. This SIG will consolidate these topics by inviting participants to collaboratively reflect on previous hybrid experiences and what can be learned from them

HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

This paper is part of the Special Issue : INDEPTH Network Cause-Specific MortalityAs the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the pandemic from individual data.To present standardised comparisons of HIV/AIDS-related mortality at sites across Africa and Asia, including closely related causes of death such as pulmonary tuberculosis (PTB) and pneumonia.Deaths related to HIV/AIDS were extracted from individual demographic and VA data from 22 INDEPTH sites across Africa and Asia. VA data were standardised to WHO 2012 standard causes of death assigned using the InterVA-4 model. Between-site comparisons of mortality rates were standardised using the INDEPTH 2013 standard population.The dataset covered a total of 10,773 deaths attributed to HIV/AIDS, observed over 12,204,043 person-years. HIV/AIDS-related mortality fractions and mortality rates varied widely across Africa and Asia, with highest burdens in eastern and southern Africa, and lowest burdens in Asia. There was evidence of rapidly declining rates at the sites with the heaviest burdens. HIV/AIDS mortality was also strongly related to PTB mortality. On a country basis, there were strong similarities between HIV/AIDS mortality rates at INDEPTH sites and those derived from modelled estimates.Measuring HIV/AIDS-related mortality continues to be a challenging issue, all the more so as anti-retroviral treatment programmes alleviate mortality risks. The congruence between these results and other estimates adds plausibility to both approaches. These data, covering some of the highest mortality observed during the pandemic, will be an important baseline for understanding the future decline of HIV/AIDS.P. Kim Streatfield ... Yohannes A. Melaku ... et.al

In vitro anti-malarial interaction and gametocytocidal activity of cryptolepine

YesBackground: Discovery of novel gametocytocidal molecules is a major pharmacological strategy in the elimination and eradication of malaria. The high patronage of the aqueous root extract of the popular West African anti-malarial plant Cryptolepis sanguinolenta (Periplocaceae) in traditional and hospital settings in Ghana has directed this study investigating the gametocytocidal activity of the plant and its major alkaloid, cryptolepine. This study also investigates the anti-malarial interaction of cryptolepine with standard anti-malarials, as the search for new anti-malarial combinations continues. Methods: The resazurin-based assay was employed in evaluating the gametocytocidal properties of C. sanguinolenta and cryptolepine against the late stage (IV/V) gametocytes of Plasmodium falciparum (NF54). A fixed ratio method based on the SYBR Green I fluorescence-based assay was used to build isobolograms from a combination of cryptolepine with four standard anti-malarial drugs in vitro using the chloroquine sensitive strain 3D7. Results: Cryptolepis sanguinolenta ( IC50 = 49.65 nM) and its major alkaloid, cryptolepine ( IC50 = 1965 nM), showed high inhibitory activity against the late stage gametocytes of P. falciparum (NF54). In the interaction assays in asexual stage, cryptolepine showed an additive effect with both lumefantrine and chloroquine with mean ΣFIC50s of 1.017 ± 0.06 and 1.465 ± 0.17, respectively. Cryptolepine combination with amodiaquine at therapeutically relevant concentration ratios showed a synergistic effect (mean ΣFIC50 = 0.287 ± 0.10) whereas an antagonistic activity (mean ΣFIC50 = 4.182 ± 0.99) was seen with mefloquine. Conclusions: The findings of this study shed light on the high gametocytocidal properties of C. sanguinolenta and cryptolepine attributing their potent anti-malarial activity mainly to their effect on both the sexual and asexual stages of the parasite. Amodiaquine is a potential drug partner for cryptolepine in the development of novel fixed dose combinations