Joint European masters awards in construction management and construction economics : a positive step for surveying education?

The Royal Institution of Chartered Surveyors (RICS) 5th European Conference in November 2004 focussed on enhancing collaboration at master's level in real estate education across Europe. In a context of increased global economic activity and increasing ties within the EU, there are benefits to business and to students in offering this type of educational provision. But is this paradigm true for construction economics (CE) and construction management (CM)? This paper examined the potential for collaboration and joint European awards in CM and CE. There is a political will for collaboration in HE based on economic drivers for the growth of the EU and changes are being implemented to enhance transparency and mobility for students. Professional bodies are expanding their European presence. Globalisation has resulted in greater opportunities for international real estate, and construction and there is growth in these sectors for practitioners. The difficulties with joint European collaboration are short course duration and the need to cover extensive subject matter. Other barriers are university structures, quality assurance procedures, costs and finances issues as well as IT, student services and support issues. The survey revealed that there are no RICS accredited CM / CE courses outside of the UK which inhibits collaboration. The sample was split in perceived demand for collaboration and the European focus within the courses is limited, as are field trips outside the UK. Student exchange on courses is rare. Generally there is a lag between the political will to greater student mobility and collaboration and the market, which is showing growth in multinational organisations and demand for pan European construction services and a professional body keen to deliver and support this growth. Within academia the barriers and current economic climate in HE preclude the widespread adoption of greater collaboration and development of joint awards, however this position may change.

Quantifying the impact of transient joint symptoms, chronic joint symptoms, and arthritis : a population-based approach

Objective : To estimate the prevalence and co-occurrence of self-reported doctor-diagnosed arthritis, chronic joint symptoms (pain, aching, stiffness, or swelling on most days for a month), and transient joint symptoms (pain, aching, stiffness, or swelling but not on most days for a month), and to compare the sociodemographic characteristics, activity limitations, and health-related quality of life (HRQOL) of people with joint conditions with those who have no self-reported doctor-diagnosed arthritis and no joint symptoms.
Methods : Data from the 2004 population-based South Australian Health Omnibus Survey (n = 2,840, ages 18-96 years) were used in the study. Activity limitations were assessed using 10 activity limitations questions from the Short Form 36 health survey. HRQOL was assessed using the Assessment of Quality of Life scale.
Results : Half of all respondents reported having joint problems, with 26%, 11%, and 13% reporting self-reported doctor-diagnosed arthritis, chronic joint symptoms, and transient joint symptoms, respectively. Chronic joint conditions (self-reported doctor-diagnosed arthritis and chronic joint symptoms) accounted for 74% of all joint problems and were associated with higher odds of activity limitations and poorer HRQOL. The frequency of transient and chronic joint symptoms was highest among middle-aged participants (ages 45-54 years for transient and 45-64 years for chronic joint symptoms) and those who had a body mass index in the obese range. Prevalence of self-reported doctor-diagnosed arthritis increased with age and was higher among women and those who were overweight or obese.
Conclusion : This study documented the high prevalence and impact of joint conditions in the community. Chronic joint conditions affect daily life and are substantial barriers for effective public health interventions aimed at reducing obesity and inactivity.

Inter-firm complementarities in R&D : a re-examination of the relative performance of joint ventures

We compare duopoly outcomes between two alternative modes of research and development (R&D), viz. independent R&D and non-cooperative research joint ventures (RJVs), when there are complementarities between firm-specific R&D resources. When complementarity is high, RJVs lead to higher technological improvement and the reverse holds for low complementarity. In the intermediate range, the comparison depends on the relative imperfection in spillovers afflicting independent R&D. In sharp contrast to results on cooperative RJVs, non-cooperative RJVs lead to higher technological improvement when spillovers affecting independent R&D are low; the reverse holds for high spillovers. When RJVs yield higher technological improvement, they also yield higher industry profit and social welfare.

Improving the communication between care providers of individuals who may require joint replacement surgery (JRS) a framework for referral

Aims & rationale/Objectives : The objective of the project was to specify the information required in referrals to public hospital orthopaedic outpatient departments in order to streamline the care and prioritisation of individuals who may require JRS. It was envisaged that an evidence-based GP-Orthopaedic derived referral system would assist in ensuring that the right person accessed the right care at the right time.

Methods : In collaboration with the RACGP and the Commonwealth Department of Health and Ageing, a national stakeholder working group was convened. A scoping document was prepared with input from key stakeholders. A review of primary research was undertaken as well as a review of relevant guidelines. Information on the implementation and evaluation of similar programs in Australia and overseas also informed the referral specification.

Principal findings : The initial scoping processes with key stakeholders provided clear information on core components of the referral. These were the use of standardised and respected assessment tools to determine the severity of arthritis, fitness for surgery and willingness of affected individuals to undergo surgery.

Discussion : About 20,000 JRS occur each year in public hospitals which emanate from 5 to 10 fold number of referrals. Arthritis and musculoskeletal diseases are a national health priority area reflecting the high burden of disease associated with these conditions. Various initiatives are being undertaken to address the quality of life of affected individuals. This project has revealed areas of potential improvement in the communication between care providers of individuals who may need JRS.

Implications : The project will result in the development of a standard referral form and guidelines to assist referring practitioners to communicate more effectively with the multidisciplinary care team, in particular orthopaedic care providers. The guidelines will be piloted in a large rural setting.

Severely compromised quality of life in women and those of lower socioeconomic status waiting for joint replacement surgery

Objective
To determine health-related quality of life (HRQOL), psychological distress, physical function, and self efficacy in persons waiting for lower-limb joint replacement surgery.

Methods
A total of 214 patients on a waiting list for unilateral primary total knee or hip replacement at a large Australian public teaching hospital completed questionnaires after entry to the list. HRQOL and psychological distress were compared with available population norms.

Results
Average HRQOL was extremely poor (mean ± SD 0.39 ± 0.24) and much lower (>2 SD) than the population norm. Near death-equivalent HRQOL or worse than death-equivalent HRQOL were reported by 15% of participants. High or very high psychological distress was up to 5 times more prevalent in the waiting list sample (relative risk 5.4 for participants ages 75 years and older; 95% confidence interval 3.3, 9.0). Women had significantly lower HRQOL, self efficacy, and physical function scores than men. After adjusting for age and sex, significant socioeconomic disparities were also found. Participants who received the lowest income had the poorest HRQOL; those with the least education or the lowest income had the highest psychological distress. Low self efficacy was moderately associated with poor HRQOL (r = 0.49, P < 0.001) and more strongly associated with high psychological distress (r = -0.55, P < 0.001).

Conclusion
Patients waiting for joint replacement have very poor HRQOL and high psychological distress, especially women and those from lower socioeconomic backgrounds. Lengthy waiting lists mean patients can experience extended and potentially avoidable morbidity. Interventions to address psychological distress and self efficacy could reduce this burden and should target women and lower socioeconomic groups.