Studies have proven that client satisfaction (CS) is greatly affected by the nature of construction practices on site. However, not much attention has been given to CS in projects that adopt green construction practices (GCPs). This study examines the effect of GCPs on CS, and the means by which CS can be achieved through health and safety performance (HSP). This study also analyses how the relationship between HSP and CS could vary depending on the level of GCPs adopted. A questionnaire with 27 items drawn from literature was used in collecting data from class A contractors in Nigeria. The study's hypotheses were tested using the partial least squares structural equation modelling (PLS-SEM) technique. The findings of the study reveal that GCPs have a positive effect on CS. HSP proved to only partially mediate the relationship between GCPs and CS. The findings also show that the effect of HSP on CS is moderated by GCPs with the stronger effect from projects with low adoption of GCPs. The study's findings highlight the pivotal role of HSP in ensuring CS in construction projects that adopt GCPs. This study makes practical contributions to the body of existing knowledge by highlighting the need for concerted efforts by contractors such as investing in health and safety training and ensuring site workers wear personal protective equipment aimed at adhering to acceptable health and safety standards. This can be achieved through provision of funds for safety activities, monitoring, and supervision of workers to guarantee HSP which translates to CS while adopting GCPs. However, the obstacles to these are the lack of safety culture by construction organizations, lack of enlightenment on the part of construction site workers, and poor safety climate on the construction project site. Additionally, the study provides greater insight on the practice of green construction among contractors by showing that the effect of HSP on CS would differ considerably on account of the level of GCPs adopted.
BACKGROUND: Adjuvant chemotherapy improves survival in Dukes C colon cancers post-curative resection. However, the evidence for a role with Dukes B lesions remains unproven despite frequent use for disease characterized by poor prognostic features. In view of limited Asia-specific data, this study aimed to determine survival outcomes and identify prognostic factors in a tertiary teaching hospital in Malaysia.
MATERIALS AND METHODS: A total of 116 subjects who underwent curative surgery with and without adjuvant chemotherapy for Duke B and C primary colon adenocarcinomas diagnosed from 2004-2009 were recruited and data were collected retrospectively. Five-year overall survival (OS) and disease free survival (DFS) were analysed using Kaplan-Meier survival analysis and log-rank (Mantel-Cox) test. Prognostic factors were determined using Cox proportional hazards regression with both univariate and multivariate analyses.
RESULTS: The survival analysis demonstrated a 5-year OS of 74.0% for all patients, with 74.9% for Dukes C subjects receiving chemotherapy compared to 28.6% in those not receiving chemotherapy (p=0.001). For Dukes B disease, the 5-year survival rate was 82.6% compared to 75.0% for subjects receiving and not receiving chemotherapy, respectively (p=0.17). Independent prognostic factors identified included a CEA level more than 3.5 ng/ml (hazard ratio (HR)=4.78; p=0.008), serosal involvement (HR=3.75; p=0.028) and completion of chemotherapy (HR= 0.20; p=0.007).
CONCLUSIONS: In a regional context, this study supports current evidence from the West that adjuvant chemotherapy improves survival in Dukes C colon cancers post curative surgery. However, although a clear benefit has yet to be proven for Dukes B disease, our results suggest survival improvement in selected cases.
Schedule overrun is one of the greatest hindrances to construction project performance, thereby making schedule management an integral part of construction project management. The aim of this study is to examine how the effect of sustainable energy management (SEM) and sustainable waste management (SWM) on schedule performance (SP) is mediated by technological complexity (TC) and moderated by project size (PS). Data were obtained by means of a questionnaire survey of 168 completed construction projects in Nigeria. The partial least squares structural equation modelling (PLS-SEM) technique was adopted in analysing the collected data. The results show that TC partially mediates the relationship between SWM and SP, while TC fully mediates the relationship between SEM and SP. Also, the findings of the study indicate that the negative effect of SWM on SP will be greater with large PS. This study contributes to previous studies in the area of schedule management, by providing empirical proof to explain the means through which SWM and SEM could lead to SP through TC, and how this would vary depending on PS. The study proffers ways for contractors to improve the SP of their projects considering PS and TC.
The adoption of green construction practices (GCP) has been on the increase in recent years as a means of reducing the negative effects of construction on the natural environment. However, GCP have been discovered to expose the construction workers to numerous health and safety (HS) risks, resulting from a decline in safety investment due to the economic burden associated with its adoption. This study explores the means through which GCP influence the HS performance of construction projects through economic performance. To obtain the views of contractors, a survey questionnaire was developed, and data was collected from project managers and site managers of "class A" contractors, with a response rate of 81.55%. The partial least squares structural equation modeling (PLS-SEM) technique was adopted to analyze the data. The results show that the effect of GCP on HS performance is fully mediated by economic performance. The study concludes that for projects that adopt GCP to have high levels of HS performance, they are required to have an optimal economic performance. Efforts should be intensified by the government in providing subsidies, tax waivers, and other incentives for adopters of GCP to ensure the economic performance of their projects since it guarantees high HS performance.
Ocular surface infections that include infections of conjunctiva, adnexa, and cornea have the potential risk of causing blindness within a given population. Empirical antibiotic therapy is usually initiated based on epidemiological data of common causative agents. Thus, the aims of this study were to determine the bacterial agents and their susceptibility patterns of isolates from ocular surface specimens in our hospital.