CM4 Term Paper Brief
Option 2: Critically evaluate the potential of economic theory of construction
procurement as a decision-making tool in the selection of procurement systems.
In this assignment, you are required to draw on a solid theoretical and evidential ground to
critically review the transaction cost theory of construction procurement. You are expected to
meet the following requirements:
1. Show a thorough understanding of TCE and its application to construction procurement
(i.e., explain the theory in your own way).
2. You can choose a context of interest, including non-private finance delivery systems
(traditional method, design-build, management system), Public-Private Partnerships or
collaborative delivery systems.
3. Conduct a literature review that is broad enough to cover most of the important techniques
suitable for procurement system selection and discuss their limitations.
4. Develop a framework to compare the strengths and limitations of existing techniques (TC
based and non-TC based approaches).
5. Building on the result of point 4, you should make a proposal for the way the TC based
theory can be transformed into a decision-aiding tool.
6. Apply the tool you propose to a real-life project and explore the additional insights, if any,
one might gain from the application of TC theory to procurement system selection (for
this, you can consider contrasting the suggestions made by the TC approach and other
methods and explain the disparity, if any.)
See the key papers of transaction cost theory of construction procurement in the bibliography
section. Read as many as you can.
Useful information sources/references
1. Your literature review is expected to cover important papers on construction procurement
from the leading project/construction/engineering management journals, including:
ASCE Journal of Construction Engineering and Management (A*)
International Journal of Project Management (A)
Construction Management and Economics (A)
ASCE Journal of Management in Engineering (A)
Building Research and Information (A)
IEEE Transactions on Engineering Management (A)
Project Management Journal (B)
2. Conventional delivery systems
1) The Bartlett library has many textbooks on construction procurement systems, such
A. Franks, J. 1998, Building Procurement Systems: A Client’s Guide, 3rd edition,
B. Masterman, J.W.E. 2001, An Introduction to Building Procurement Systems, E&FN
Spon, London, UK.
2) The following studies on procurement system selection could be useful
A. Sidwell, T. 2001, Literature Review- Value Alignment Process For Project
B. Love, P.E.D., R.M.Skitmore and G.Earl, 1998, Selecting A Suitable
Procurement Method for A Building Project, Construction Management and
Economics, 16, 221-233.
C. Skitmore R.M. and D.E. Marsden, 1988, Which Procurement System?
Towards A Universal Procurement Selection Technique, Construction
Management and Construction, 6, 71-89.
3) HM Treasury’s Procurement Guide
4) HM Treasury’s Green Book
3. Public-Private Partnerships
1) World Bank (2014). Public-Private Parnterships: Reference Guide (Version 2).
2) UK Private Finance 2 (PF2) procurement guides
4. Collaborative delivery system
Cabinet Office (2014). New Models of Construction Procurement. London, HMSO.
• Cost Led Procurement
• Integrated Project Insurance
• Two Stage Open Book
Bibliography: Transaction cost theory of construction procurement
All papers are downloadable from my ResearchGate webpages.
1. Chang, C. & Shi Chen (2016) An Analysis of Transitional Public-Private Partnerships Model
in China: Contracting with little recourse to contracts. Journal of Construction Engineering and
2. Chang, C., & Qian, Y. (2015). An Econometric Analysis of Holdup Problems in
Construction Projects. Journal of Construction Engineering and Management. doi:
3. Chang, C., & Chou, H.Y. (2014). Transaction-Cost Approach to the Comparative Analysis
of User-Pay and Government-Pay Public-Private Partnership Systems. Journal of Construction
Engineering and Management. doi:10.1061/(ASCE)CO.1943-7862.0000883
4. Chang, C. (2013). When Might A Project Company Break Up? The Perspective of
Risk-Bearing Capacity. Construction Management and Economics, 31(12), 1186-1198.
5. Chang, C. (2013). Principal-Agent Model of Risk Allocation in Construction Contracts and
Its Critique. Journal of Construction Engineering and Management.
6. Chang, C. (2013). A Critical Analysis of Recent Advances in the Techniques for the
Evaluation of Renewable Energy Projects. International Journal of Project Management, 31(7),
7. Chang, C. (2013). A Critical Review of the Application of TCE in the Interpretation of
Risk Allocation in PPP Contracts. Construction Management and Economics, 31(2), 99-103.
8. Park, A., & Chang, C. (2013). Impacts of Construction Events on the Project Equity Value
of the Channel Tunnel Project. Construction Economics and Management, 31(3), 223-237.
9. Chang, C. (2013). Understanding the Hold-up Problem in the Management of
Megaprojects: The Case of the Channel Tunnel Rail Link Project. International Journal of
Project Management, 31, 628-637. doi:10.1016/j.ijproman.2012.10.012
10. Chang, C., Ive., & G. (2007). Reversal of Bargaining Power in Construction Project:
meaning, existence and implications. Construction Management and Economics, 25(8), 845-855.
11. Ive, G., & Chang, C. Y. (2007). The principle of inconsistent trinity in the selection of
procurement systems. Construction Management and Economics, 25(7), 677-690.
12. Chang, C. Y., & Ive, G. (2007). The hold-up problem in the management of construction
projects: A case study of the Channel Tunnel. International Journal of Project Management,
25(4), 394-404. doi:10.1016/j.ijproman.2007.01.001
13. Chang, C., Chou, H., & Wang, M. (2006). Characterising Corporate Governance of the
UK Listed Construction Companies. Construction Management and Economics, 24(6), 647-656.
14. Chang, C. (2006). The determinants of the vertical boundaries of the construction firm:
Comment. Construction Management and Economics, 24(3), 229-232.
15. Chang, C., & Ive, G. (2003). Discussion of “Model for Understanding, Preventing, and
Resolving Project Disputes” by Panagiotis Mitropoulos and Gregory Howell. Journal of
Construction Engineering and Management, 129(2), 231-233.
16. Chang, C., & Ive, G. (2002). Rethinking the multi-attribute approach based procurement
selection technique. Construction Management and Economics, 20(3), 275-284.
M6 Assignment 2 Submission
Assignment 2: Analyzing and Interpreting Data
This module taught you about analyzing and interpreting data. In addition, this module taught you how to plan the data collection process and how analyzing data for qualitative research, analyzing data for quantitative research, and analyzing data for mixed methods applied research studies differ. Using your textbook, the Argosy University online library resources, and other scholarly sources, create a data collection and analysis plan. Specifically, discuss the type of applied research study you plan to conduct (qualitative, quantitative, or mixed methods) and why you selected the data analysis technique.
In the last module, you listed your plan for data collection. After restating the purpose of the study, your data collection methods should have been organized and described by research question. In this module, you will add the analysis portion to your plan following your data collection plan for each research question.
- Assuming that you have collected the data identified in your plan, how will you analyze and interpret the findings?
- Describe the analysis process that will be used for each research question. In some cases, analysis may include more than one method (e.g., descriptive and inferential statistics). Describe the full analysis process anticipated for each research question.
- If any statistical tests are needed to analyze the data of any of your research questions, identify the appropriate test and your rationale for its selection.
- If the data collected produces qualitative findings, describe the analysis process and how you will narrow and interpret the findings so as to answer your research questions.
- Identify the resources and/or software that will be required to analyze your data.
- Use at least two scholarly citations and cite the sources in the body of your work as per APA standards.
- Prepare a reference list.
Support your rationale and analysis by using at least two resources from professional literature in your response. Professional literature may include the Argosy University online library resources; relevant textbooks; peer-reviewed journal articles; and websites created by professional organizations, agencies, or institutions (websites ending in .edu or .gov).
- By the due date assigned, save your document as M6_A2_LastName_FirstInitial.doc and submit the document to the Submissions Area.
The Role of Post -Thyroidectomy PTH in Predicting Hypocalcaemia
Category: Case series
Hypocalcemia is the most common complication after total thyroidectomy. It is also the leading cause for prolonged hospitalization after thyroidectomy. The purpose of this study is to determine the validity of PTH monitoring six and twelve hours after total thyroidectomy in predicting hypocalcaemia. Nineteen patients who underwent total thyroidectomy alone or with neck dissection were included. PTH levels and calcium levels were monitored for all patients at two major points: at 6 and 12 hours post-operatively. In all patients, corrected calcium level was calculated.
At 6 hours post-operatively, 47% of patients had calculated calcium level< 8, with normal PTH level in 5 of them. At 12 hour post-operatively 37% of patients had calculated calcium level< 8, with normal PTH level in 3 of them. The validity of low serum PTH in predicting the post-operative hypocalcaemia and of normal serum PTH in predicting the normocalcemia were calculated.
We conculude that there is a strong correlation of postoperative PTH with post thyroidectomy hypocalcaemia. A single serum PTH level 12 hours post-operatively is an accurate predictor of normocalcaemia. Patients with normal PTH and normal calcium level 12 hours postoperatively can be considered for discharge.
Key Words: Thyroidectomy, hypocalcemia, parathyroid hormone, surgery
Thyroid cancer is the most common endocrine malignancy accounting for approximately 1% of all human cancers and causing approximately 0.5% of all cancer deaths. Total thyroidectomy is the treatment of choice for clinically significant thyroid cancers. Transient hypocalcaemia after total thyroidectomy is reported at 20%-30% in most studies . The search for a blood test that identifies patients who will become hypocalcaemic after total thyroidectomy versus those who will remain normocalcaemic in the early postoperative period has evolved since the late 1980s (1-5) . Transient hypocalcaemia after total thyroidectomy is reported at 20-30% in most studies (2,7). Hypocalcaemia after total thyroidectomy is multi-factorial, but parathyroid dysfunction is the main cause.The incorporation of parathyroid hormone (PTH) levels as a monitor for hypoparathyroidism leading to hypocalcaemia has been the next step in the evolution of this field of research (2). Serum PTH has a half life of 1 to 4 minutes. Any insult to parathyroid glands with impaired PTH secretion leads to an immediate decline in PTH levels.
Serum calcium homeostasis by PTH occurs through a variety of mechanisms:
- It promotes distal tubule calcium re-absorption.
- Bone re-absorption.
- 1,25(OH)2D mediated intestinal calcium absorption.
The nadir of serum calcium post total thyroidectomy is 24-48h postoperatively and it may be delayed as the 4th postoperative day (6). Thus, monitoring calcium levels postoperatively, might lead to patients being hospitalized for longer time than otherwise necessary. The risk of hemorrhage and hematoma is mostly in the early postoperative period, and warrant 24 h in hospital observation.
Inpatient stay beyond 24 h after Total thyroidectomy, in the absence of complications, is not warranted because patients suffer minimal pain (8).
Grodski found that postoperative PTH can be used to stratify the risk of patients developing hypocalcaemia after thyroidectomy (1). In addition, the routine use of oral calcium supplements was shown to lead to decreased incidence and severity of post-thyroidectomy hypocalcaemia (1) .
In this work we aimed to investigate the role and best timing of PTH monitoring post total thyroidectomy in predicting hypocalcaemia.
MATERIALS AND METHODS
In this study we included patients (men and women) that underwent different thyroidectomy procedures: total thyroidectomy or total thyroidectomy with central neck dissection. PTH levels were monitored for all patients at two major points: at 6 and 12 hours postoperatively. Calcium levels were measured twice a day. Corrected calcium level was calculated using the next formula:
Corrected Ca. = serum calcium + 0.8 (4 – serum albumin)
We defined two different points for hypocalcaemia:
While the corrected calcium level was less than 8 mg/dl
While the PTH level was less than 1.6 Pcmoll/l (8).
Nineteen patients were included (13 women and 6 men). Age of patients ranged from 20 to 76, with a mean age of 45 years. Patients underwent total thyroidectomy and 4 patients underwent total thyroidectomy with central neck dissection.
Mean time of hospitalization for these patients was 5.05 days (SD 0.97). The PTH levels, and corrected calcium levels (calculated) at three measurements are shown in Table I.
At 6 hours post-operatively, 47% (9 from 19) of patients had calculated calcium level< 8, with normal PTH level in 5 of them. At 12 hours post-operatively 37% (7 from 19) of patients had calculated.
calcium level< 8, with normal PTH level in 3 of them. At 48 h post-operatively, 2 of those 3 patients, had a normal calculated calcium level and were asymptomatic without calcium supplementation.
Seven of our patients (36.8%) received intravenous calcium treatment after the operation. Six of them received also the calcium supplementation. Five from these patients were symptomatic. Furthermore, one patient who underwent thyroidectomy with central neck dissection required 5 month calcium supplementation.
We calculated the validity of low serum PTH in predicting the post-operative hypocalcaemia and of normal serum PTH in predicting the normocalcaemia. For low serum PTH, the sensitivity of this test was 55% at 6 hours after the operation, and 71% at 12 hours after the operation. The specificity of this test was 90% at 6 hours after the operation, and 100% at 12 hours after the operation.
The sensitivity of normal serum PTH level as a predictor of normocalcaemia was 91% at 6 hours after the operation and 100% at 12 hours after the operation. The specificity of this test was 44% at 6 hours after the operation and 75 % at 12 hours after the operation.
Hypocalcemia is the most frequent complication of total thyroidectomy. The reported incidence in the literature varies from 1-50% (1). The risk of hypoparathyroidism increases in reoperative thyroid surgery and when central neck is associated (11). Patients symptoms and serum calcium levels dictate the necessity for calcium and vitamin D supplementation. The need of monitoring hypocalcemia is the leading reason for patients’ hospitalizaion beyond 23 hours (7) . Within the last decade, numerous studies have been conducted to predict the factors involved in the early prediction of hypocalcemia following thyroidectomy. Parathyroid hormone assay was one of the most reliable tool to predict postoperative hypocalcemia within hours of total thyroidectomy or completion thyroidectomy ( 11-13).
Several published reports have demonstrated the marked utility of the PTH assay in predicting patients who will develop hypocalcemia after thyroidectomy. However, there is a substantial
variability among these reports about the sensitivity and specificity of PTH in accurately predicting hypocalcemia. Lam and ker found that all patients with PTH values less than 8pg/mL measured one hour after surgery became hypocalcemic, and all patients with PTH level greater than 9pg/mole did not (14) . Higgins and his colleagues demonstrated that 64% of those patients who subsequently required calcium supplementation had more than 75% decrease in PTH levels from baseline 20minutes post surgery. Another finding was that most of patients who did not need calcium supplementation (74%) had a decrease of less than 75% from baseline (15). For Lombardi and colleague. PTH less than 10 pg/mL measured four or six hours after surgery predicted hypocalcemia with an overall accuracy of 98% (3). Pattou and colleagues reported that a postoperative PTH level of 12 pg/mL or less was a good predictor of hypocalcemia, but did not state how long after surgery PTH values were obtained (6). Payne and his colleagues found that 6 hours post-operation PTH level is the most accurate predictor for hypocalcaemia and accurately predicts also the normocalcaemia (7).
As we saw earlier, most of the studies are discussing the correct timing of taking the measurements of PTH levels post-operatively. In our study we performed the measurements at 6 and 12 hours after the operation. We saw that the sensitivity of low PTH as a predictor of hypocalcaemia was higher at the 12 hours measurement. Despite this no absolute PTH levels or percentage decline has 100% sensitivity or specificity. Sensitivity of normal PTH levels predicting normocalcaemia was higher than sensitivity of low PTH levels predicting hypocalcaemia.
There are a few limitations to the study. First, it is a retrospective non-random review, which may result in selection bias. Secondly, a small number of participants. Further randomised controlled are required.
In our study we saw that a single serum PTH level 12 hours postoperatively is an accurate predictor of normocalcaemia. Thus, patients with normal PTH and normal calcium level 12 hours post-operatively can be considered for discharge reducing unnecessary hospitalization and patients’ discomfort.
- Grodski, S., Serpell, J. Evidence for the Role of Perioperative PTH Measurement after Total Thyroidectomy as a Predictor of Hypocalcemia. World Journal of Surgery 2008; 32: 1367–1373.
- LoGerfo, P., Gates R., Gazetas, P. Outpatient and Short-stay Thyroid Surgery. Head and Neck;2006; 13 (2): 97 – 101.
- Lombardi, C.., Raffaelli, M., Princi, P. et al. Early prediction of postthyroidectomyhypocalcemia by one single iPTH measurement. Surgery;2006; 136: 1236-1241.
- Marohn M.R, LaCivita K.A. Evaluation of total/near-total thyroidectomy in a short-stay hospitalization: safe and cost-effective. Surgery;2006; 118:943–948.
- McHenry C. R. ‘‘Same-day’’ thyroid surgery: an analysisof safety, cost savings, and outcome. American Surgery:1997: 63:586–589.
- Pattou, F., Combemale, F., Fabre. et al. Hypocalcemia following Thyroid Surgery: Incidence and Prediction of Outcome. World Journal of Surgery:1998: 22, 718–724.
- Payne, R. J., Hier, M. P., Tamilia, M. et al. Same-Day Discharge After Total Thyroidectomy: The Value of 6-hour Serum Parathyroid Hormone and Calcium Levels. Head and Neck:2004; 27: 1 – 7.
- Kalmovich LM1, Cote V, Sands N, Thyroidectomy: Excatly how painful is it? J otology head and neck surgery; 2010:39(3),277-83.
- Payne, R. J., Tewfik, M. A., Hier, M. et al. Benefits Resulting from 1-and 6-Hour Parathyroid Hormone and Calcium Levels After Thyroidectomy. Otolaryngology — Head and Neck Surgery;2005; 133: 386-390.
- Sywak, M. S., Palazzo, F. F., Yeh, M. et al. Parathyroid hormone assay predicts hypocalcaemia after total thyroidectomy. ANZ Journal of Surgery;2007; 77: 667–670.
- McLeod IK, Arciero C, Noordzij JP, et al. The use of rapid parathyroid hormone assay in predicting postoperative hypocalcemia after total or completion thyroidectomy. Thyroid. 2006;16:259–65
- Noordzij JP, Lee SL, Bernet VJ, et al. Early prediction of hypocalcemia after thyroidectomy using parathyroid hormone: an analysis of pooled individual patient data from nine observational studies. J Am Coll Surg. 2007;205:748–54
- Khafif A, Pivoarov A, Medina JE et al. Parathyroid hormone: A sensitive predictor of hypocalcemia following total Otolaryngol Head Neck Surg. 2006;134:907–10).
- Lam A, Kerr P. Parathyroid hormone: an early predictor of postthyroidectomy hypocalcemia. Laryngoscope. 2003;113(12):2196-200.
- Higgins KM, Mandell DL, Govindaraj S et al. The role of intraoperative rapid parathyroid hormone monitoring for predicting thyroidectomy-related hypocalcemia. Arch Otolaryngol Head Neck Surg. 2004;130(1):63-7
Table I. PTH and calcium level measurements at two different post-operation time points
|6 hours after the operation||12 hours after the operation|
|3.36 (2.58)||3.27 (2.47)|
|8.04 (0.42)||8.04 (0.55)|
A = 70, B = 0.95, C = 1000
A typical fish farming process might involve placing small fish (fingerlings) in a dam, waiting for them to grow, and then harvesting all of the remaining fish.
People who rely on growing fish as a source of food are faced with the problem of working out when is the best time to harvest the fish, because although the fish grow bigger as time passes, unfortunately some of them die before they are harvested for food.
Data was collected and analysed for a particular species of fish. The following information was obtained:
The following formula gives a relationship between the fish length (L) in centimetres and time elapsed (t) in months since the fingerlings were placed in the dam:
L = A (1 – Bt )
The following weight-length data is available for the species concerned:
Length of Life
For every ‘C’ fingerlings of this species of fish placed in the dam, the number, n, still alive after t months is given by the formula:
N = C x Bt
Based on this information, find the best time to harvest all of the fish remaining in the dam in order to get the maximum weight of live fish. Validate your solution using technology.
- Due to the growth and sophistication of cyber-attacks against organizations, the client and software developers need to agree on security definitions derived from the client’s business goals. As a software engineer, you have explored the concept of System Quality Requirements Engineering (SQUARE). Now you need to convince your team to build security and quality concepts into the early stages of the development life cycles. Your job is to discuss SQUARE methodology or SQUARE steps to show your team the advantages of using SQUARE methodology in the development stage. How will you accomplish this? What are some things you might do to get the team on board with your plan?
- Note: The Security Quality Requirements Engineering (SQUARE) project is identifying and assessing processes and techniques to improve requirements identification, analysis, specification, and management. The project is also focusing on management issues associated with the development of good security requirements.
For our assignment this week, you may choose either Option A or Option B. Regardless of the option you choose, be sure to read through the entire assignment directions before crafting your essay.
Additionally, use the Week Six Assignment Organization Guide to help you organize your paper.
HU260 W6 Assignment Organization Guide
Using the Eight Elements of Reasoning that were outlined in week two (purpose, problem, information, concepts, assumptions, inferences, points of view, implications, or consequences) choose a news article and break it down according to those elements. Make sure you address each of these elements. If one of these elements does not apply to your article (rare), address that in your essay and explain how the article could have been improved by including it or how the author is justified in leaving it out.
Describe how each of the Eight Intellectual Standards (clarity, accuracy, precision, relevance, depth, breadth, logic, and fairness) were used or not used in the article, supported by an example. If one of these standards does not apply to your article (rare), address that in your essay and explain how the article could have been improved by including it or how the author is justified in leaving it out.
For either option you choose:
Write an introduction identifying the reasons for choosing either Option A or Option B and justify your reasoning.
In the conclusion of your essay, describe how you feel the article is biased.
Keep in mind, for either option you are being asked to analyze the article/author itself/himself/herself, NOT the topic discussed. Do not include your own opinion/position on the topic being addressed.