Facilitating a no-blame culture through project alliancing

Innovation occurs within the safety of a no-blame culture yet we see surprisingly scant literature on how this is facilitated within a construction project management context. The purpose of this paper is to demonstrate how innovation and promotion of innovative thinking in action is enabled through a no-blame culture in project alliances in Australia. We argue that innovation is dependent upon collaboration and true collaboration is inextricable linked to behavioural drivers. Foremost of these is a culture of openness and willingness to share the pain and gain from experimentation. Further, this culture requires that collaborators be protected from the threat of being blamed and held accountable for experimental failure. We draw upon theory and data gathered over several recent research studies on the experience of project alliances in Australia. The project alliance procurement form has a unique ‘no-blame’ behavioural contract clause that is crucial in developing a collaborative culture where innovation can evolve through a process of trial and error

One plus one equals three; proactive partnering multiplies CSR benefits

With companies now linking corporate social responsibility to their aggressive business strategies to achieve a competitive market advantage (Porter and Kramer, 2006), non profit organisations should also extract shared value from this strategic corporate social responsibility movement (Eweje and Palakshappa, 2009). Questions arise, however, as to the actual role which should be played by the non profit organisation (Muthuri, Chapple and Moon, 2009). This conceptual paper firstly provides evidence that corporate social responsibility (CSR) from the perspective of the non profit requires investigation. Secondly, by integrating two existing CSR frameworks, a new CSR framework is proposed which will redefine the role of the non profit organisation in marketing itself and proactively working with business. This collaborative approach is likely to ensure mutual CSR benefits for non profit organisations and small businesses in particular, plus the broader community in which they both operate.<br /

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p&lt;0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p&lt;0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p&lt;0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP &gt;5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

She'll be right mate - Inclusivity experiences of men and women working in projects

Occupational segregation is a major source of labour market rigidity and economic inefficiency due to a waste of human resources. Organisations are repeatedly recognised as gendered constructs exhibiting sustained work segregation, income and status inequality, as well as cultural and individual images of gender, and these are perpetuated through their processes, practices and pressures (Acker, 1990). A large percentage of Australia’s workforce is now employed in project-based or project-oriented organisations, leading to the claim that Australia is a project-based economy. For a continued strong performance in this economy, organisations that employ project personnel will need to consider how they address inclusivity and equality in diversity in project based temporary organisations to ensure the supply of high quality project professionals into the future. This paper investigates the inclusion processes experienced and exercised by men and women working in temporary organisations in project situations through a review of reports on the inclusion processes experienced by 60 project managers and project workers in three project based industries in Australia. Results indicate that temporary organisations are not implementing equality and diversity management strategies at the macro level and project workers are accepting this lack of recognition. However inclusivity and equality at the micro level of the team is seen as vital

Career choice and the experience of project-based work

The nature and context of project-based work combines with sector characteristics to present both barriers and benefits that influence career choices and experiences. Using social cognitive career theory (SCCT) as a lens, this paper contributes to understanding of the relative involvement of women and men in project roles by exploring the ways they perceive the experience and opportunities of project based work. With such diverse outcomes for men and women on almost all measures it is obvious projects can be a nightmare of different treatment and different experiences for men and women. The question of how organisations can ensure equal opportunity of the benefits and the burdens of work in projects continues to grow

Authentic leadership for 21st century project delivery

Project leadership has to adapt to meet changing needs of this 21st century if it is to remain relevant. The 21st century world has changed from that of the previous century with the global financial crisis (GFC) marking a point of inflection in this change. At the same time generational change and particularly in Australia, a move to project alliance contracting, combine to require a re-examination of project leadership. Results of a pilot study and preliminary results of research into characteristics required for successful alliance project leadership are presented. Characteristics identified by this research relate closely to those of authentic leadership. A capability maturity model (CMM) to track the development of authentic leadership attributes in project leaders is proposed. Research by others in a range of project based environments would further test the usefulness of this CMM for project managers and leaders

Changing times, persistent paradigms: women and men at work in projects

The Australian economy is currently supported by a resources boom and work opportunities in traditionally male dominated fields of construction and engineering and information technology are at a premium. Yet despite more than 25 years of anti discrimination and equal employment opportunity legislation these industries still employ few women in operational or management roles. This paper investigates the issue of the low representation of women in project management and their different work and career experiences through interviews with male and female project managers

Career implications of multi-layered institutional settings

Project work has grown significantly in volume and recognition in recent decades as projects have ‘become a common form of work organization in all sectors of the economy’ (Lindgren &amp; Packendorff, 2006: 841). This increase in project-based work is just one of the many changes that have been affecting the nature of work, the employment relationship and the associated conceptualization and experience of careers (Baruch, 2004b; Söderlund &amp; Bredin, 2006). A career can be defined as a process of development along a path of work experience and roles in one or more organizations (Baruch &amp; Rosenstein, 1992), and careers involving project-based work take place within multi layered institutional settings. Projects are generally undertaken by small temporary organizations (Ekstedt, Lundin, Söderholm &amp; Wirdenius, 1999; Pettigrew, 2003; Söderlund, 2012) which in turn may form part of larger, permanent entities; involve people drawn from a number of disciplines and organizations; or be formed as partnerships, joint ventures or strategic alliances between two or more organizations (Scott, 2007)