Project governance in Malaysia hillside developments

Hillsides in urban areas around the world are being developed at an accelerating rate, to accommodate population growth and rapid urbanization. Developments at hillside are attractive places to live because of the views, fresh air, exclusivity and the sense of being close to nature. Despite its attractiveness, hillside developments are prone to natural hazards such as landslides that can have environmental, social and economic consequences. To minimise these risks, it is necessary to consider the concerns of all stakeholders during the project review stage. This paper proposes that project governance concept can be used for this purpose by defining the rights, responsibilities and interests of the key stakeholders. It can also provide a framework within which decisions are made in order to minimise risks associated with natural hazards.

Sustainability criteria for Industrialised Building System (IBS) in Malaysia

As the sustainability awareness rises globally, the construction industry is under increasing pressure to improve efficiency and project delivery. The implementation of Industrialised Building Systems (IBS), for which utility components are built offsite, has the potential of promoting sustainability deliverables. This can be achieved by better control of production environment, minimising construction waste, using efficient building material energy, and stabilising work conditions. As a unique building technology, IBS has not been effectively implemented in Malaysia. Possible reasons may include limited understanding among stakeholders on the IBS potential and its relevance to sustainability. This warrants studies on the sustainability issues of IBS design, construction, operation and maintenance, A framework is being developed through research to assess performance criteria related to sustainability, which should be considered during IBS design and application in the most consistent and systematic way. This paper discusses how these sustainability performance criteria are examined in a continuing research project and the processes conducive to implementing sustainable IBS in Malaysia. Existing tools, indicators and guidelines are reviewed, analysed and grouped according to characteristics and application. The research also hopes to produce guidelines for stakeholders to incorporate sustainability issues and concepts into IBS applications.

Malnutrition and clinical outcomes in elderly patients from a Singapore acute hospital

Older adults, especially those acutely ill, are vulnerable to developing malnutrition due to a range of risk factors. The high prevalence and extensive consequences of malnutrition in hospitalised older adults have been reported extensively. However, there are few well-designed longitudinal studies that report the independent relationship between malnutrition and clinical outcomes after adjustment for a wide range of covariates. Acutely ill older adults are exceptionally prone to nutritional decline during hospitalisation, but few reports have studied this change and impact on clinical outcomes. In the rapidly ageing Singapore population, all this evidence is lacking, and the characteristics associated with the risk of malnutrition are also not well-documented. Despite the evidence on malnutrition prevalence, it is often under-recognised and under-treated. It is therefore crucial that validated nutrition screening and assessment tools are used for early identification of malnutrition. Although many nutrition screening and assessment tools are available, there is no universally accepted method for defining malnutrition risk and nutritional status. Most existing tools have been validated amongst Caucasians using various approaches, but they are rarely reported in the Asian elderly and none has been validated in Singapore. Due to the multiethnicity, cultural, and language differences in Singapore older adults, the results from non-Asian validation studies may not be applicable. Therefore it is important to identify validated population and setting specific nutrition screening and assessment methods to accurately detect and diagnose malnutrition in Singapore. The aims of this study are therefore to: i) characterise hospitalised elderly in a Singapore acute hospital; ii) describe the extent and impact of admission malnutrition; iii) identify and evaluate suitable methods for nutritional screening and assessment; and iv) examine changes in nutritional status during admission and their impact on clinical outcomes. A total of 281 participants, with a mean (+SD) age of 81.3 (+7.6) years, were recruited from three geriatric wards in Tan Tock Seng Hospital over a period of eight months. They were predominantly Chinese (83%) and community-dwellers (97%). They were screened within 72 hours of admission by a single dietetic technician using four nutrition screening tools [Tan Tock Seng Hospital Nutrition Screening Tool (TTSH NST), Nutritional Risk Screening 2002 (NRS 2002), Mini Nutritional Assessment-Short Form (MNA-SF), and Short Nutritional Assessment Questionnaire (SNAQ©)] that were administered in no particular order. The total scores were not computed during the screening process so that the dietetic technician was blinded to the results of all the tools. Nutritional status was assessed by a single dietitian, who was blinded to the screening results, using four malnutrition assessment methods [Subjective Global Assessment (SGA), Mini Nutritional Assessment (MNA), body mass index (BMI), and corrected arm muscle area (CAMA)]. The SGA rating was completed prior to computation of the total MNA score to minimise bias. Participants were reassessed for weight, arm anthropometry (mid-arm circumference, triceps skinfold thickness), and SGA rating at discharge from the ward. The nutritional assessment tools and indices were validated against clinical outcomes (length of stay (LOS) >11days, discharge to higher level care, 3-month readmission, 6-month mortality, and 6-month Modified Barthel Index) using multivariate logistic regression. The covariates included age, gender, race, dementia (defined using DSM IV criteria), depression (defined using a single question “Do you often feel sad or depressed?”), severity of illness (defined using a modified version of the Severity of Illness Index), comorbidities (defined using Charlson Comorbidity Index, number of prescribed drugs and admission functional status (measured using Modified Barthel Index; MBI). The nutrition screening tools were validated against the SGA, which was found to be the most appropriate nutritional assessment tool from this study (refer section 5.6) Prevalence of malnutrition on admission was 35% (defined by SGA), and it was significantly associated with characteristics such as swallowing impairment (malnourished vs well-nourished: 20% vs 5%), poor appetite (77% vs 24%), dementia (44% vs 28%), depression (34% vs 22%), and poor functional status (MBI 48.3+29.8 vs 65.1+25.4). The SGA had the highest completion rate (100%) and was predictive of the highest number of clinical outcomes: LOS >11days (OR 2.11, 95% CI [1.17- 3.83]), 3-month readmission (OR 1.90, 95% CI [1.05-3.42]) and 6-month mortality (OR 3.04, 95% CI [1.28-7.18]), independent of a comprehensive range of covariates including functional status, disease severity and cognitive function. SGA is therefore the most appropriate nutritional assessment tool for defining malnutrition. The TTSH NST was identified as the most suitable nutritional screening tool with the best diagnostic performance against the SGA (AUC 0.865, sensitivity 84%, specificity 79%). Overall, 44% of participants experienced weight loss during hospitalisation, and 27% had weight loss >1% per week over median LOS 9 days (range 2-50). Wellnourished (45%) and malnourished (43%) participants were equally prone to experiencing decline in nutritional status (defined by weight loss >1% per week). Those with reduced nutritional status were more likely to be discharged to higher level care (adjusted OR 2.46, 95% CI [1.27-4.70]). This study is the first to characterise malnourished hospitalised older adults in Singapore. It is also one of the very few studies to (a) evaluate the association of admission malnutrition with clinical outcomes in a multivariate model; (b) determine the change in their nutritional status during admission; and (c) evaluate the validity of nutritional screening and assessment tools amongst hospitalised older adults in an Asian population. Results clearly highlight that admission malnutrition and deterioration in nutritional status are prevalent and are associated with adverse clinical outcomes in hospitalised older adults. With older adults being vulnerable to risks and consequences of malnutrition, it is important that they are systematically screened so timely and appropriate intervention can be provided. The findings highlighted in this thesis provide an evidence base for, and confirm the validity of the current nutrition screening and assessment tools used among hospitalised older adults in Singapore. As the older adults may have developed malnutrition prior to hospital admission, or experienced clinically significant weight loss of >1% per week of hospitalisation, screening of the elderly should be initiated in the community and continuous nutritional monitoring should extend beyond hospitalisation.

Multicultural education : the understandings of preschool teachers in Singapore

For multicultural education to be effective, it must be introduced in the early years and reinforced throughout the school years. It is important for teachers of young children to be equipped with the appropriate knowledge, skills and positive attitudes to promote multiculturalism in their classrooms. This paper reports on a survey involving preschool teachers in Singapore who were participating in an in-service training course. The teachers completed a questionnaire to indicate their understandings of multicultural education and their perceptions of its importance in early childhood education. The findings indicated that the teachers endorsed the need for multicultural education in preschools and the importance of children learning tolerance and understanding of other cultures in the Singaporean context. However, while preschool teachers held positive attitudes towards multicultural education, there was limited understanding of the challenges in implementing an anti-bias teaching and curriculum approach. The implications of these findings for preschool teacher education programs in Singapore and in other countries focus on supporting teachers in developing more critical and deeper understandings of multiculturalism.

Distribution trade sector output and productivity performance : a case study of Singapore and Hong Kong 2001-2008

This paper employs the industry of origin approach to compare value added and productivity of Singapore and Hong Kong's Distribution Trade Sector for the period 2001-2008. The direct comparison between these two economies was motivated by the statements of the Singapore government: Its services sector, especially in Retail Trade, lags behind Hong Kong's productivity levels. The results show that since 2005, Singapore's Distribution performance in terms of labour productivity was below Hong Kong's level, which was largely due to poor performance in its Retail Trade sector arising from an influx of foreign workers. Results from total factor productivity (TFP) between these two economies also suggest that Hong Kong's better performance (since 2005) was largely due to its ability to employ more educated and trained workers with limited use of capital. The results suggest that polices that worked in Hong Kong may not work for Singapore because its population is more diverse which poses a challenge to policy-makers in raising its productivity level.

Journeys to health services in Great Britain : an analysis of changing travel patterns 1985-2006

This paper examines changing patterns in the utilisation and geographic access to health services in Great Britain using National Travel Survey data (1985-2006). The utilisation rate was derived using the proportion of journeys made to access health services. Geographic access was analysed by separating the concept into its accessibility and mobility dimensions. Regression analyses were conducted to investigate the differences between different socio-spatial groups in these indicators over the period 1985-2006. This study found that journey distances to health facilities were significantly shorter and also gradually reduced over the period in question for Londoners, females, those without a car or on low incomes, and older people. However, most of their rates of utilisation of health services were found to be significantly lower because their journey times were significantly longer and also gradually increased over the periods. These findings indicate that the rate of utilisation of health services largely depends on mobility level although previous research studies have traditionally overlooked the mobility dimension.

Planning for knowledge based urban development in Malaysia : Cyberjaya @ Multimedia Super Corridor

Knowledge based urban development (KBUD) is a new paradigm in urban planning tailoring to the era of knowledge economy. It aims mainly to assist a contemporary city to promote a more sustainable socio-spatial order. The paper reports on the investigation of KBUD initiative in Malaysia which is manifested through the establishment of a project called Multimedia Super Corridor (MSC). MSC Malaysia aims to attract knowledge workers and industries to invest and operate within the area by creating a world class urban corridor with state-of-the-art multimedia infrastructure, efficient transportation system and an attractive living environment. Based on documents analysis and interviews, this paper analyses the strategies, implementations, and achievements of KBUD initiative in Cyberjaya, being the leading intelligent city of the unique Malaysia’s KBUD project-MSC Malaysia. A critical evaluation is made to assess the achievements of MSC, by looking at the physical changes after about ten years since its official launching. The findings recommend some valuable lessons for other cities that strive to develop KBUD strategies, strengthen their sustainable socio-spatial policies, and seek a global recognition.

Value management : an extension of quantity surveying services in Malaysia

Value Management (VM) initially started in early 1940s in the US manufacturing industry has increasingly becoming popular within the construction industry community internationally. It has been widely accepted as an important tool in the management of projects. The structured, systematic and multi-disciplinary approach in decision making process is a niche for VM in delivering better value for money project to the client investment. It would appear to be gaining some momentum as an essential management tool in the Malaysian construction sector especially in the quantity surveying practice. Quantity surveyors increasing involvement in VM provides an opportunity for the profession to re-model some of its traditional services in a more positive light and develop leading-edge skills and promote the profession. International practice has associated VM to be part of services offered in the quantity surveying practice; especially in UK has proven to be a natural progression of QS profession. The introduction of VM as early 1980’s in Malaysia combined with increasing demand for construction project to facilitate nation progress is shedding a positive light for quantity surveying profession to take lead in developing VM as one of their niche area. Therefore, the quantity surveying profession having the opportunity to take lead of this service which reflect their traditional attributes for providing the best value-for-money advise to the client. This paper shall discuss on the development of VM in Malaysia and the challenges VM face services in QS firm to remain ahead of their competitors.

A survey on six sigma implementation in Singapore service industries

The concept of Six Sigma was initiated in the 1980s by Motorola. Since then it has been implemented in several manufacturing and service organizations. In case of services, health care and finance were major beneficiaries till now. The application of Six Sigma is gradually picking up in other services like; call centers, utilities and public services. This paper provides empirical evidence on Six Sigma implementation in service industries in Singapore. By using a sample size of 50 service organizations (10 responses are from organizations which have implemented Six Sigma), the paper helps in understanding the status of Six Sigma in service organizations in Singapore. The findings confirm the inclusion of critical success factors, critical to quality characteristics, tools and key performance indicators as observed from the literature. The revelation of “not relevant” as a reason for not implementing Six Sigma shows the need for understanding specific requirements of service organizations before its application.

Case study analysis of six sigma in Singapore service organizations

This paper presents a Six Sigma case study analysis involving three service organizations of Singapore. The organizations are a local hospital, a construction and related engineering service, and a consultancy service. These organizations embarked on their Six Sigma journey around 2003-2004. Though the hospital was slightly ahead than the other two in beginning Six Sigma. These organizations have since achieved significant service improvements through implementation of Six Sigma to their different divisions. Through a series of structured interviews with Six Sigma project champions, team leaders, and members; project reports; public archives; and observations; this study explores the Six Sigma journey of these organizations. The results portray a list of success factors which led to the Six Sigma initiatives, the process of Six Sigma implementation through proper identification of critical-to-quality characteristics, tools and techniques, and the performance indicators which display the improvements due to Six Sigma.

Facilitating Malaysia towards innovative society : arguing the case for open access policy

The Malaysian National Innovation Model blueprint states that there is an urgent need to pursue an innovation-oriented economy to improve the nation’s capacity for knowledge, creativity and innovation. In nurturing a pervasive innovation culture, the Malaysian government has declared the year 2010 as an Innovative Year whereby creativity among its population is highly celebrated. However, while Malaysian citizens are encouraged to be creative and innovative, scientific data and information generated from publicly funded research in Malaysia is locked up because of rigid intellectual property licensing regimes and traditional publishing models. Reflecting on these circumstances, this paper looks at, and argue why, scientific data and information should be made available, accessible and re-useable freely to promote the grassroots level of innovation in Malaysia. Using innovation theory as its platform of argument, this paper calls for an open access policy for publicly funded research output to be adopted and implemented in Malaysia. Simultaneously, a normative analytic approach is used to determine the types of open access policy that ought to be adopted to spur greater innovation among Malaysians.