Determining Controllability Level of Project Issues in Malaysian Landscape Architectural Project

The study aims to examine current project issues and the level of controllability in Malaysian landscape architecture projects. The data collection fieldwork was conducted via a semi-structured interview with twenty-four landscape architect professionals based in Klang Valley region. Content and thematic analysis were used to analyse the collected data. Found that project issues are controllable if the project is capable of anticipating and treating them in advance. Nonetheless, issues continue to occur as a result of insufficient action taken in response to predicted issues affecting project outcomes. Study recommends developing a process for systematically forecasting, evaluating, and treating future issues. Keywords: landscape architecture; project issues; controllability; Malaysia eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v6i18.3053

Early Coronary Angiography Is Associated with Improved 30-Day Outcomes among Patients with out-of-Hospital Cardiac Arrest

We evaluated the association between early coronary angiography (CAG) and outcomes in resuscitated out-of-hospital cardiac arrest (OHCA) patients, by linking data from the Singapore Pan-Asian Resuscitation Outcomes Study, with a national registry of cardiac procedures. The 30-day survival and neurological outcome were compared between patients undergoing early CAG (within 1-calender day), versus patients not undergoing early CAG. Inverse probability weighted estimates (IPWE) adjusted for non-randomized CAG. Of 976 resuscitated OHCA patients of cardiac etiology between 2011–2015 (mean(SD) age 64(13) years, 73.7% males), 337 (34.5%) underwent early CAG, of whom, 230 (68.2%) underwent PCI. Those who underwent early CAG were significantly younger (60(12) vs. 66(14) years old), healthier (42% vs. 59% with heart disease; 29% vs. 44% with diabetes), more likely males (86% vs. 67%), and presented with shockable rhythms (69% vs. 36%), compared with those who did not. Early CAG with PCI was associated with better survival and neurological outcome (adjusted odds ratio 1.91 and 1.82 respectively), findings robust to IPWE adjustment. The rates of bleeding and stroke were similar. CAG with PCI within 24 h was associated with improved clinical outcomes after OHCA, without increasing complications. Further studies are required to identify the characteristics of patients who would benefit most from this invasive strategy.

Effect of Metformin and Lifestyle Interventions on Mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

<b>Objective: </b>To determine whether metformin or lifestyle modification can lower rates of all-cause and cause-specific mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study. <p><b>Research Design and Methods: </b>From 1996-1999,<b> </b>3234 adults at high risk for type 2 diabetes were randomized to an intensive lifestyle intervention, masked metformin or placebo. Placebo and lifestyle interventions stopped in 2001, and a modified lifestyle program was offered to everyone, but unmasked study metformin continued in those originally randomized.<b> </b>Causes of deaths through December 31, 2018 were adjudicated by blinded reviews. All-cause and cause-specific mortality hazard ratios were estimated from Cox-proportional hazard regression models and Fine-Gray models, respectively.</p> <p><b>Results:</b> Over a median of 21 (IQR 20-21) years, 453 participants died. Cancer was the leading cause of death (n=170), followed by cardiovascular disease (n=131). Compared to placebo, metformin did not influence mortality from all causes (HR 0.99, 95% CI 0.79, 1.25), cancer (HR 1.04, 95% CI 0.72, 1.52) or cardiovascular disease (HR 1.08, 95% CI 0.70, 1.66). Similarly, lifestyle modification did not impact all-cause (HR 1.02, 95% CI 0.81, 1.28), cancer (HR 1.07, 95% CI 0.74, 1.55) or cardiovascular disease (HR 1.18, 95% CI 0.77, 1.81) mortality. Analyses adjusted for diabetes status and duration, body mass index, cumulative glycemic exposure, and cardiovascular risks yielded similar results for all-cause mortality.</p> <p><b>Conclusions: </b>Cancer was the leading cause of mortality among adults at high risk for type 2 diabetes. Although metformin and lifestyle modification prevented diabetes, neither strategy reduced all-cause, cancer, or cardiovascular mortality rates.</p>

Effect of Metformin and Lifestyle Interventions on Mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

<b>Objective: </b>To determine whether metformin or lifestyle modification can lower rates of all-cause and cause-specific mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study. <p><b>Research Design and Methods: </b>From 1996-1999,<b> </b>3234 adults at high risk for type 2 diabetes were randomized to an intensive lifestyle intervention, masked metformin or placebo. Placebo and lifestyle interventions stopped in 2001, and a modified lifestyle program was offered to everyone, but unmasked study metformin continued in those originally randomized.<b> </b>Causes of deaths through December 31, 2018 were adjudicated by blinded reviews. All-cause and cause-specific mortality hazard ratios were estimated from Cox-proportional hazard regression models and Fine-Gray models, respectively.</p> <p><b>Results:</b> Over a median of 21 (IQR 20-21) years, 453 participants died. Cancer was the leading cause of death (n=170), followed by cardiovascular disease (n=131). Compared to placebo, metformin did not influence mortality from all causes (HR 0.99, 95% CI 0.79, 1.25), cancer (HR 1.04, 95% CI 0.72, 1.52) or cardiovascular disease (HR 1.08, 95% CI 0.70, 1.66). Similarly, lifestyle modification did not impact all-cause (HR 1.02, 95% CI 0.81, 1.28), cancer (HR 1.07, 95% CI 0.74, 1.55) or cardiovascular disease (HR 1.18, 95% CI 0.77, 1.81) mortality. Analyses adjusted for diabetes status and duration, body mass index, cumulative glycemic exposure, and cardiovascular risks yielded similar results for all-cause mortality.</p> <p><b>Conclusions: </b>Cancer was the leading cause of mortality among adults at high risk for type 2 diabetes. Although metformin and lifestyle modification prevented diabetes, neither strategy reduced all-cause, cancer, or cardiovascular mortality rates.</p>