Adopting the BOT （build-operate-transfer） delivery method has brought opportunities and challenges in construction time and quality for urban infrastructure. Many studies investigate the upstream issues of BOT proje...Adopting the BOT （build-operate-transfer） delivery method has brought opportunities and challenges in construction time and quality for urban infrastructure. Many studies investigate the upstream issues of BOT projects such as concessionaire selection criteria and risk factors. But the project execution becomes complicated such as the escalated quality supervision organization and procedure at the construction stage. This extra supervision may have constituted hidden redundancies as waste to economic sustainability. This paper investigated construction quality supervision of BOT projects to pinpoint adequate degree of supervision and detect redundant organization and procedures. The study adopted ten subway construction projects as cases in which five were from the traditional design-bid-build （DBB） and five from the BOT methods. Thirty six project participants including owners, contractors, designers, and concessionaire managers of the ten projects were interviewed to tell their views on these issues. The quality supervision measures of the DBB projects were used as the baseline and compared with those of the BOT projects. The research results show that the construction quality seems no difference for the DBB and BOT projects. Construction quality comes out of supervision but excessive supervision organization and procedures do not necessarily improve quality. This finding indicates that adequate degree of supervision is enough to achieve required quality to save immense paperwork for large construction projects.展开更多
AIM： To complete a quality audit using recently pub- lished criteria from the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. METHODS： Consecutive colonoscopy reports of patients at averag...AIM： To complete a quality audit using recently pub- lished criteria from the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. METHODS： Consecutive colonoscopy reports of patients at average/high risk screening, or with a prior col6rectal neoplasia （CRN） by endoscopists who perform 11 000 procedures yearly, using a commercial computerized endoscopic report generator. A separate institutional da- tabase providing pathological results. Required documen- tation included patient demographics, history, procedure indications, technical descriptions, colonoscopy findings, interventions, unplanned events, follow-up plans, and pathology results. Reports abstraction employed a stan- dardized glossary with 10% independent data validation. Sample size calculations determined the number of re- ports needed.RESULTS： Two hundreds and fifty patients （63.2± 10.5 years, female： 42.8%, average risk： 38.5%, per- sonal/family history of CRN： 43.3%/20.2%） were scoped in June 2009 by 8 gastroenterologists and 3 surgeons （mean practice： 17.1 ± 8.5 years）. Procedural indica- tion and informed consent were always documented. 14% provided a previous colonoscopy date （past polyp removal information in 25%, but insufficient in most to determine surveillance intervals appropriateness）. Most procedural indicators were recorded （exam date： 98.4%, medications： 99.2%, difficulty level： 98.8%, prep quality： 99.6%）. All reports noted extent of visualization （cecum： 94.4%, with landmarks noted in 78.8% - photodocu- mentation： 67.2%）. No procedural times were recorded. One hundred and eleven had polyps （44.4%） with ana- tomic location noted in 99.1%, size in 65.8%, morphol- ogy in 62.2%; removal was by cold biopsy in 25.2% （cold snare： 18%, snare cautery： 31.5%, unrecorded： 20.7%）, 84.7% were retrieved. Adenomas were noted in 24.8% （advanced adenomas： 7.6%, cancer： 0.4%） in this population with varying previous colonic investigations. CONCLUSION： This audit reveals lacking reported ite- ms, justifying additional research to optimize quality of reporting.展开更多
One of the roles of nuctear regulators is to review population projections calculated by applicants for populations lying in the vicinity of nuclear power plants. This paper examines methods of calculating rates of gr...One of the roles of nuctear regulators is to review population projections calculated by applicants for populations lying in the vicinity of nuclear power plants. This paper examines methods of calculating rates of growth and thus calculating future population growth. This paper is concerned about regulators making sure that nuclear power plants are not located near densely populated centers and that population centers located near nuclear power plants do not become densely populated. In the case of El Dabaa city in the north coast of Egypt, south west of the nominated plant site, three rates of growth 1.5%, 2.5% and 3% were identified. The first is the current population growth rate of the city, the second is the average national growth rate and the third is the expected growth rate of the city when the nuclear power plant gets constructed and operated. In all three cases, this city is a population center and rules of distance from the nuclear power plant shall apply. Thus the further natural growth of this city should be controlled and directed away from the downwind of the plant.展开更多
文摘Adopting the BOT （build-operate-transfer） delivery method has brought opportunities and challenges in construction time and quality for urban infrastructure. Many studies investigate the upstream issues of BOT projects such as concessionaire selection criteria and risk factors. But the project execution becomes complicated such as the escalated quality supervision organization and procedure at the construction stage. This extra supervision may have constituted hidden redundancies as waste to economic sustainability. This paper investigated construction quality supervision of BOT projects to pinpoint adequate degree of supervision and detect redundant organization and procedures. The study adopted ten subway construction projects as cases in which five were from the traditional design-bid-build （DBB） and five from the BOT methods. Thirty six project participants including owners, contractors, designers, and concessionaire managers of the ten projects were interviewed to tell their views on these issues. The quality supervision measures of the DBB projects were used as the baseline and compared with those of the BOT projects. The research results show that the construction quality seems no difference for the DBB and BOT projects. Construction quality comes out of supervision but excessive supervision organization and procedures do not necessarily improve quality. This finding indicates that adequate degree of supervision is enough to achieve required quality to save immense paperwork for large construction projects.
基金Supported by The Research Scholar (Chercheur National) of the Fonds de la Recherche en Santé du Québec
文摘AIM： To complete a quality audit using recently pub- lished criteria from the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. METHODS： Consecutive colonoscopy reports of patients at average/high risk screening, or with a prior col6rectal neoplasia （CRN） by endoscopists who perform 11 000 procedures yearly, using a commercial computerized endoscopic report generator. A separate institutional da- tabase providing pathological results. Required documen- tation included patient demographics, history, procedure indications, technical descriptions, colonoscopy findings, interventions, unplanned events, follow-up plans, and pathology results. Reports abstraction employed a stan- dardized glossary with 10% independent data validation. Sample size calculations determined the number of re- ports needed.RESULTS： Two hundreds and fifty patients （63.2± 10.5 years, female： 42.8%, average risk： 38.5%, per- sonal/family history of CRN： 43.3%/20.2%） were scoped in June 2009 by 8 gastroenterologists and 3 surgeons （mean practice： 17.1 ± 8.5 years）. Procedural indica- tion and informed consent were always documented. 14% provided a previous colonoscopy date （past polyp removal information in 25%, but insufficient in most to determine surveillance intervals appropriateness）. Most procedural indicators were recorded （exam date： 98.4%, medications： 99.2%, difficulty level： 98.8%, prep quality： 99.6%）. All reports noted extent of visualization （cecum： 94.4%, with landmarks noted in 78.8% - photodocu- mentation： 67.2%）. No procedural times were recorded. One hundred and eleven had polyps （44.4%） with ana- tomic location noted in 99.1%, size in 65.8%, morphol- ogy in 62.2%; removal was by cold biopsy in 25.2% （cold snare： 18%, snare cautery： 31.5%, unrecorded： 20.7%）, 84.7% were retrieved. Adenomas were noted in 24.8% （advanced adenomas： 7.6%, cancer： 0.4%） in this population with varying previous colonic investigations. CONCLUSION： This audit reveals lacking reported ite- ms, justifying additional research to optimize quality of reporting.
文摘One of the roles of nuctear regulators is to review population projections calculated by applicants for populations lying in the vicinity of nuclear power plants. This paper examines methods of calculating rates of growth and thus calculating future population growth. This paper is concerned about regulators making sure that nuclear power plants are not located near densely populated centers and that population centers located near nuclear power plants do not become densely populated. In the case of El Dabaa city in the north coast of Egypt, south west of the nominated plant site, three rates of growth 1.5%, 2.5% and 3% were identified. The first is the current population growth rate of the city, the second is the average national growth rate and the third is the expected growth rate of the city when the nuclear power plant gets constructed and operated. In all three cases, this city is a population center and rules of distance from the nuclear power plant shall apply. Thus the further natural growth of this city should be controlled and directed away from the downwind of the plant.
