Public-Private Partnership (PPP) projects success is the ultimate goal of practitioners and government organizations. In this regard, the last decade has seen considerable research into the critical success factors (CSFs) for PPP projects. However, a very important subject which has received very little attention in the normative literature is the success criteria for PPP projects. This paper examines the general perception of purposively sampled international PPP experts on a set of 15 PPP projects success criteria derived from literature. The survey results show that all the success criteria are critical; however seven are very critical. These include: effective risk management; meeting output specifications; reliable and quality service operations; adherence to time; satisfying the need for public facility/service; long-term relationship and partnership; and profitability. The findings of this study are impactful because they inform practitioners on the key measures to consider when evaluating the success of PPP projects. More research should be conducted to further develop a composite success index that could be used to objectively assess the success levels of different PPP projects. In addition, the perceptions of different stakeholders on PPP projects success criteria and the causal relationship between CSFs and success criteria for PPP projects should be investigated.
In many countries, it is common practice to attract and employ ethnic minority (EM) or migrant workers in the construction industry. This primarily occurs in order to alleviate the labor shortage caused by an aging workforce with a lack of new entrants. Statistics show that EM construction workers are more likely to have occupational fatal and nonfatal injuries than their local counterparts; however, the mechanism underlying accidents and injuries in this vulnerable population has been rarely examined. This study aims to investigate relationships among safety climate, safety behavior, and safety outcomes for EM construction workers. To this end, a theoretical research model was developed based on a comprehensive review of the current literature. In total, 289 valid questionnaires were collected face-to-face from 223 Nepalese construction workers and 56 Pakistani construction workers working on 15 construction sites in Hong Kong. Structural equation modelling was employed to validate the constructs and test the hypothesized model. Results show that there were significant positive relationships between safety climate and safety behaviors, and significant negative relationships between safety behaviors and safety outcomes for EM construction workers. This research contributes to the literature regarding EM workers by providing empirical evidence of the mechanisms by which safety climate affects safety behaviors and outcomes. It also provides insights in order to help the key stakeholders formulate safety strategies for EM workers in many areas where numerous EM workers are employed, such as in the U.S., the UK, Australia, Singapore, Malaysia, and the Middle East.
We reviewed the clinical outcome of arthroscopic femoral osteochondroplasty for cam femoroacetabular impingement performed between August 2005 and March 2009 in a series of 40 patients over 60 years of age. The group comprised 26 men and 14 women with a mean age of 65 years (60 to 82). The mean follow-up was 30 months (12 to 54). The mean modified Harris hip score improved by 19.2 points (95% confidence interval 13.6 to 24.9; p < 0.001) while the mean non-arthritic hip score improved by 15.0 points (95% confidence interval 10.9 to 19.1, p < 0.001). Seven patients underwent total hip replacement after a mean interval of 12 months (6 to 24 months) at a mean age of 63 years (60 to 70). The overall level of satisfaction was high with most patients indicating that they would undergo similar surgery in the future to the contralateral hip, if indicated. No serious complications occurred. Arthroscopic femoral osteochondroplasty performed in selected patients over 60 years of age, who have hip pain and mechanical symptoms resulting from cam femoroacetabular impingement, is beneficial with a minimal risk of complications at a mean follow-up of 30 months.
Data on COPD-related healthcare resources use are rarely documented in developing countries. This article presents data on COPD-related healthcare resource consumption in the Middle East, North Africa and Pakistan and addresses the association of this variable with illness severity. A large survey of COPD was conducted in eleven countries of the region, namely Algeria, Egypt, Jordan, Lebanon, Morocco, Pakistan, Saudi-Arabia, Syria, Tunisia, Turkey and United Arab Emirates, using a standardised methodology. A total of 62,086 subjects were screened. This identified 2,187 subjects fulfilling the "epidemiological" definition of COPD. A detailed questionnaire was administered to document data on COPD-related healthcare consumption. Symptom severity was assessed using the COPD Assessment Test (CAT). 1,392 subjects were analysable. Physician consultations were the most frequently used healthcare resource, ranging from 43,118 [95% CI: 755-85,548] consultations in UAE to 4,276,800 [95% CI: 2,320,164-6,230,763] in Pakistan, followed by emergency room visits, ranging from 15,917 [95% CI: 0-34,807] visits in UAE to 683,697 [95% CI: 496,993-869,737] in Turkey and hospitalisations, ranging from 15,563 [95% CI: 7,911-23,215] in UAE to 476,674 [95% CI: 301,258-652,090] in Turkey. The use of each resource increased proportionally with the GOLD 2011 severity groups and was significantly (p < 0.0001) higher in subjects with more symptoms compared to those with lower symptoms and in subjects with exacerbations to those without exacerbations. The occurrence of exacerbations and the CAT score were independently associated with use of each healthcare resource. In conclusion, the BREATHE study revealed that physician consultation is the most frequently COPD-related healthcare resource used in the region. It showed that the deterioration of COPD symptoms and the frequency of exacerbations raised healthcare resource consumption.
The authors evaluated the effect of the foot on the loading axis of the lower limb measured from radiographs in 30 pediatric patients. Deviation at the knee was calculated for the hip-ankle (traditional) and the hip-foot lines (heel lined up with a metal wire). A trigonometric model of the limb loading axis was developed with predicted mechanical axis deviations at the knee. Statistics were based on the methods of Bland and Altman. Mechanical axis deviation at the knee in the frontal plane varies with foot height, foot-tibial angle, and genu valgum. The predicted trigonometric model was found to be in agreement with measured radiographic values. Including the foot in the radiographic measurement of limb alignment may increase validity of surgical planning for correction of malalignment and for evaluation of degenerative arthritis risk at the knee level.
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