Search results for: patient management

Authors: V. A. Adzika, D. Ayim-Aboagye, T. Gordh

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Background and aims: Prevalence of Sickle Cell Disease (SCD) is high in Ghana but not much is known in terms of research into non-medical strategies for managing and coping with the pain associated with SCD. This study was carried out to examine effective non-medical related strategies patients use to cope and manage their SCD condition. Methods: SCD patients (387) consisting of 180 males and 204 females between 18-65 years old years participated in the study. A cross-sectional research design was used in which participants completed questionnaires on pain, non-medical coping and management strategies, anxiety, and depression. Results of multiple regression analysis showed that socio-demographic characteristics contributed to the variance in the pain associated with SCD. Results: Over 90% of participants reported that pains associated with SCD were the main reason for seeking treatment in SCD crisis. In terms of non-medical related coping strategies, attending a place of worship and praying were the main coping strategies used in SCD crises, suggesting that patients’ beliefs, particularly in a supernatural being, served as a mitigating factor in the process of coping with the pain associated with SCD crisis. Also, avoidance and withdrawal from people and social activities were reported to be strategies used to cope effectively with the pain associated with SCD crisis. Conclusion: This indicates that it is imperative to incorporate non-medical related coping and management strategies, especially religious beliefs and psychosocial factors, to coping and management of the pain associated with SCD.

Keywords: anxiety, depression, sickle cell disease, quality of life, socio-demographic characteristics, Ghana

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Authors: Gulnara Moldasheva

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The research explores the relationship between management responsibility and corporate governance of listed companies in Kazakhstan. This research employs firm level data of randomly selected listed non-financial firms and firm level data “operational” financial sector, consisted from banking sector, insurance companies and accumulated pension funds using multivariate regression analysis under fixed effect model approach. Ownership structure includes institutional ownership, managerial ownership and private investor’s ownership. Management responsibility of the firm is expressed by the decision of the firm on amount of leverage. Results of the cross sectional panel study for non-financial firms showed that only institutional shareholding is significantly negatively correlated with debt to equity ratio. Findings from “operational” financial sector show that leverage is significantly affected only by the CEO/Chair duality and the size of financial institutions, and insignificantly affected by ownership structure. Also, the findings show, that there is a significant negative relationship between profitability and the debt to equity ratio for non-financial firms, which is consistent with pecking order theory. Generally, the found results suggest that corporate governance and a management responsibility play important role in corporate performance of listed firms in Kazakhstan.

Keywords: ownership, corporate governance, debt to equity ratio, corporate performance

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Authors: Shirekha Layangani, Suneth Dharmaparakrama

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When the manufacturing industry is concerned the Environment Management System (EMS) is a common term. Currently most organizations have obtained the environmental standard certification, ISO 14001. In the Sri Lankan context even though the organizations adopt Environmental Management, a very limited number of companies tend to calculate their Carbon Footprints. This research discusses the demotivating factors of manufacturing organizations in Sri Lanka to integrate calculation of carbon footprint into their supply chains. Further it also identifies the benefits that manufacturing organizations can gain by implementing calculation of carbon footprint. The manufacturing companies listed under “ISO 14001” certification were considered in this study in order to investigate the problems mentioned above. 100% enumeration was used when the surveys were carried out. In order to gather essential data two surveys were designed to be done among manufacturing organizations that are currently engaged in calculating their carbon footprint and the organizations that have not. The survey among the first set of manufacturing organizations revealed the benefits the organizations were able to gain by implementing calculation of carbon footprint. The latter set organizations revealed the demotivating factors that have influenced not to integrate calculation of carbon footprint into their supply chains. This paper has summarized the results obtained by the surveys and segregated depending on the market share of the manufacturing organizations. Further it has indicated the benefits that can be obtained by implementing carbon footprint calculation, depending on the market share of the manufacturing entity. Finally the research gives suggestions to manufacturing organizations on applicability of adopting carbon footprint calculation depending on the benefits that can be obtained.

Keywords: carbon footprint, environmental management systems (EMS), benefits of carbon footprint, ISO14001

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Authors: Jose Ramon Sanabria Navarro, Yahilina Silveira Perez, Valentin Molina Moreno, Digna Dionisia Perez Bravo

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The general objective of this research is to conceive a model of strategic direction for Latin American high-performance sports centers for the improvement of their results. The sample is 62 managers, 187 trainers, 2930 athletes and 62 expert researchers from centers in Cuba, Venezuela, Ecuador, Colombia and Argentina, for 3241. The measurement instrument includes 12 key variables in the process of management strategies which are consolidated with the factorial analysis and the ANOVA of a factor through the SPSS 24.0. The reliability of the scale obtained an alpha higher than 0.7 in each sample. In this sense, a model is obtained that taxes the deficiencies detected in the diagnosis, based on the needs of the members of these organizations, considering criteria and theories of the strategic direction in the improvement of the organizational results. The validation of the model for high performance sports centers of the countries analyzed aims to develop joint strategies to generate synergies in their operational mode, which leads to enhance the sports organization.

Keywords: sports organization, information management, decision making, control

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Authors: Catherine Mary Abou-Zaid, Sandra Goodwin

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This study was conducted in a cardiac center in Bahrain. The rise in the amount of obese patients’ both men and women, being admitted for surgical procedures has become an issue to the nurses and doctors as these patients pose a high risk of major complications arising from their problem. The cessation of obesity in the country is very high and obesity-related diseases has been the cause of concern among men and women, also related individual diseases such as cardiovascular, diabetes and chronic respiratory diseases are rising dramatically within Bahrain in the last 10 years. Rationale for the Study: The ontological approach will help to understand and assess the true nature of the social world and how the world looks at obesity. Obesity has to be looked at as being a realistic ongoing issue. The epistemological approach will look at the theory of the origins of the nature of knowledge, set the rule of validating and learning in the social world of what can be done to curb this concept and how this can help prevent otherwise preventable diseases. Design Methodology: The qualitative design methodology took the form of an ontological/epistemological approach using phenomenology as a framework. The study was based on a social research issue, therefore, ontological ‘realism and idealism’ will feature as the nature of the world from a social and natural context. Epistemological positions of the study will be how we as researchers will find the actual social world and the limiting of that knowledge. The one-to-one interviews will be transcribed and the taped verbatim will be coded and charted giving the thematic analytic results. Recommendations: The significance of the research brought many recommendations. These recommendations were taken from the themes and sub-themes and were presented to the centers management and the necessary arrangements for updating knowledge and attitudes towards obesity in cardiac patients was then presented to the in-service education department. Workshops and training sessions on promoting health education were organized and put into the educational calendar for the next academic year. These sessions would look at patient autonomy, the patients’ rights, healthy eating for patients and families and the risks associated with obesity in cardiac disease processes.

Keywords: cardiac patients, diabetes, education & training, obesity cessation, qualitative

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Authors: Shigenori Togashi, Kei Takenaka

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We developed new processes which can collect and detect rapidly airborne pathogens such as the avian flu virus for the pandemic prevention. The fluorescence antibody technique is known as one of high-sensitive detection methods for viruses, but this needs up to a few hours to bind sufficient fluorescence dyes to viruses for detection. In this paper, we developed a mist-labeling can detect substitution viruses in a short time to improve the binding rate of fluorescent dyes and substitution viruses by the micro reaction process. Moreover, we developed the rapid detection system with the above 'mist labeling'. The detection system set with a sampling bag collecting patient’s breath and a cartridge can detect automatically pathogens within 10 minutes.

Keywords: viruses, sampler, mist, detection, fluorescent dyes, microreaction

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Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavoured to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learner. Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: medical education, clinical education, andragogy, pedagogy

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Authors: Ehsan Eshtehardian, Saeed Khodaverdi

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This paper surveys the studies on construction change and reveals some of the potential future works. A full-scale investigation of change literature, including change definitions, types, causes and effects, and change management systems, is accomplished to explore some of the coming change trends. It is tried to pick up the critical works in each section to deduct a true timeline of construction changes. The findings show that leaping from best practice guides in late 1990s and generic process models in the early 2000s to very advanced modeling environments in the mid-2000s and the early 2010s have made gaps along with opportunities for change researchers in order to develop some more easy and applicable models. Another finding is that there is a compelling similarity between the change and risk prediction models. Therefore, integrating these two concepts, specifically from proactive management point of view, may lead to a synergy and help project teams avoid rework. Also, the findings show that exploitation of cause-effect relationship models, in order to facilitate the dispute resolutions, seems to be an interesting field for future works.

Keywords: construction change, change management systems, dispute resolutions, change literature

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Authors: Vanlounni Sibounheuang, Wanarat Anusornsangiam, Pattarin Kittiboonyakun, Chanthanom Manithip

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In worldwide, one of the most common use of oral anticoagulant is warfarin. Its margin between therapeutic inhibition of clot formation and bleeding complications is narrow. Mahosot Hospital, warfarin clinic had not been established yet. The descriptive study was conducted by investigating drug-related problems of outpatients using warfarin, the value of the international normalized ratio (INR) higher than normal ranges (25.40 % of the total 272 outpatients) were mostly identified at Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. This result led to the present study conducting qualitative interviews in order to help establish a warfarin clinic at Mahosot Hospital for the better outcomes of patients using warfarin. The purpose of this study was to explore perspectives of healthcare professional providing services for outpatients using warfarin. The face to face, in-depth interviews were undertaken among nine healthcare professionals (doctor=3, nurse=3, pharmacist=3) working at out-patient clinic, Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. The interview guides were developed, and they were validated by the experts in the fields of qualitative research. Each interview lasted approximately 20 minutes. Three major themes emerged; healthcare professional’s experiences of current practice problems with warfarin therapy, healthcare professionals’ views of medical problems related to patients using warfarin, and healthcare professionals’ perspectives on ways of service improvement. All healthcare professionals had the same views that it’s difficult to achieve INR goal for individual patients because of some important patient barriers especially lack of knowledge about to use warfarin properly and safety, patients not regularly follow-up due to problems with transportations and financial support. Doctors and nurses agreed to have a pharmacist running a routine warfarin clinic and provided counselling to individual patients on the following points: how to take drug properly and safety, drug-drug and food-drug interactions, common side effects and how to manage them, lifestyle modifications. From the interviews, some important components of the establishment of a warfarin clinic included financial support, increased human resources, improved the system of keeping patients’ medical records, short course training for pharmacists. This study indicated the acceptance of healthcare professionals on the important roles of pharmacists and the feasibility of setting up warfarin clinic by working together with the multidisciplinary health care team in order to help improve health outcomes of patients using warfarin at Mahosot Hospital, Lao PDR.

Keywords: perspectives, healthcare professional, warfarin therapy, Mahosot Hospital

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Authors: Chien-Wen Chen, Nguyen Duong Thuy Trang, Yu-Hsuan Chang

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With the development of information technology, social networking sites are inseparable from life and have become an important way for people to communicate. Nonetheless, privacy issues are raised by the presence of personal information on social networking sites. However, users can benefit from using the functions of social networking sites, which also leads to users worrying about the leakage of personal information without corresponding privacy protection behaviors, which is called the privacy paradox. However, previous studies have questioned the viewpoint of the privacy paradox, believing that users are not so naive and that people with privacy concerns will conduct privacy management. Consequently, this study is based on the view of privacy calculation perspective to investigate the privacy behavior of users on social networking sites. Among them, social benefits and privacy concerns are taken as the expected benefits and costs in the viewpoint of privacy calculation. At the same time, this study also explores the antecedents, including positive feedback, self-presentation, privacy policy, and information sensitivity, and the consequence of privacy behavior of weighing benefits and costs, including self-disclosure and three privacy management strategies by interpersonal boundaries (Preventive, Censorship, and Corrective). The survey respondents' characteristics and prior use experience of social networking sites were analyzed. As a consequence, a survey of 596 social network users was conducted online to validate the research framework. The results show that social benefit has the greatest influence on privacy behavior. The most important external factors affecting privacy behavior are positive feedback, followed by the privacy policy and information sensitivity. In addition, the important findings of this study are that social benefits will positively affect privacy management. It shows that users can get satisfaction from interacting with others through social networking sites. They will not only disclose themselves but also manage their privacy on social networking sites after considering social benefits and privacy management on social networking sites, and it expands the adoption of the Privacy Calculus Perspective framework from prior research. Therefore, it is suggested that as the functions of social networking sites increase and the development of social networking sites, users' needs should be understood and updated in order to ensure the sustainable operation of social networking.

Keywords: privacy calculus perspective, self-disclosure, privacy management, social benefit, privacy concern

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Authors: Masood Roohi, Amir Taghavipour

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This paper describes a strategy to develop an energy management system (EMS) for a charge-sustaining power-split hybrid electric vehicle. This kind of hybrid electric vehicles (HEVs) benefit from the advantages of both parallel and series architecture. However, it gets relatively more complicated to manage power flow between the battery and the engine optimally. The applied strategy in this paper is based on nonlinear model predictive control approach. First of all, an appropriate control-oriented model which was accurate enough and simple was derived. Towards utilization of this controller in real-time, the problem was solved off-line for a vast area of reference signals and initial conditions and stored the computed manipulated variables inside look-up tables. Look-up tables take a little amount of memory. Also, the computational load dramatically decreased, because to find required manipulated variables the controller just needed a simple interpolation between tables.

Keywords: hybrid electric vehicles, energy management system, nonlinear model predictive control, real-time

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Authors: Reda Moussa Massoud Embark

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Tourism and hospitality graduate development is key to the future state of the tourism and hospitality industry. Meanwhile, Information and Communication Technology is increasingly becoming the engine for improving productivity and business opportunities in the travel and hospitality industry. Given the challenges and fierce global competition that have arisen in today's hospitality industry, it was important to shed light on strategic management. In addition, five-star hotels play a key role in supporting the tourism industry and investments in Egypt. Therefore, this study aims to examine the extent to which strategic management practices are implemented in five-star hotels in Egypt and to examine the differences between resort and inner-city hotels in terms of the implementation of strategic management processes. The influence of different hotel types on the implementation of the strategic management process is examined. A simple random sampling technique is used to select a sample of the target population, including hotels in the cities of Sharm el-Sheikh, Cairo and Hurghada. The data collection tool used in this study is an interviewer-administered questionnaire. Finally, combining the study results with the literature review allowed to present a set of recommendations to be addressed to hoteliers in the area of strategic management practices. Education and training in tourism and hospitality must take these changes into account in order to improve the ability of future managers to use a variety of tools and strategies to make their organizations more efficient and competitive. Therefore, this study aims to examine the types and effectiveness of training courses offered by tourism and hospitality departments in Egypt and to assess the importance of these training courses from the perspective of the graduate. The survey is aimed at graduates who have completed three different majors in the past decade: tourism and hospitality. Findings discussed the nature, level and effectiveness of the training provided at these faculties and the extent to which the training programs were valued by graduates working in different fields, and finally recommended specific practices to improve learning effectiveness increase and increase perceived employee benefits in the tourism and hospitality industry.

Keywords: marketing channels, crisis, hotel, international, tour, operators, online travel agencies, e-tourism, hotel websites, tourism, web-tourism, strategic-management, strategic tools, five-star hotels, resorts, downtown hotels, Egyptian Markets.

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Authors: Souheila Zemmouchi

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Introduction: Diabetes is currently the leading cause of end-stage chronic kidney disease and dialysis, so it adds additional complexity to the management of chronic hemodialysis patients. These patients are extremely fragile because of their multiple cardiovascular and metabolic comorbidities. Clear and complete description of the experience: the management of a diabetic on hemodialysis is particularly difficult due to frequent hypoglycaemia and significant inter and perdialyticglycemic variability that is difficult to predict. The aim of our study is to describe the clinical-biological profile and to assess the cardiovascular risk of diabetics undergoing chronic hemodialysis, and compare them with non-diabetic hemodialysis patients. Methods: This cross-sectional, descriptive, and analytical study was carried out between January 01 and December 31, 2018, involving 309 hemodialysis patients spread over 4 centersThe data were collected prospectively then compiled and analyzed by the SPSS Version 10 software The FRAMINGHAM RISK SCORE has been used to assess cardiovascular risk in all hemodialysis patients Results: The survey involved 309 hemodialysis patients, including 83 diabetics, for a prevalence of 27% The average age 53 ± 10.2 years. The sex ratio is 1.5. 50% of diabetic hemodialysis patients retained residual diuresis against 32% in non-diabetics. In the group of diabetics, we noted more hypertension (70% versus 38% non-diabetics P 0.004), more intradialytichypoglycemia (15% versus 3% non-diabetics P 0.007), initially, vascular exhaustion was found in 4 diabetics versus 2 non-diabetics. 70% of diabetics with anuria had postdialytichyperglycemia. The study found a statistically significant difference between the different levels of cardiovascular risk according to the diabetic status. Conclusion: There are many challenges in the management of diabetics on hemodialysis, both to optimize glycemic control according to an individualized target and to coordinate comprehensive and effective care.

Keywords: hemodialysis, diabetes, chronic renal failure, glycemic control

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Authors: Fatih Frank Alparslan

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The aviation industry is at a crucial turning point due to modern technologies, environmental concerns, and changing ways of transporting people and goods globally. The paper examines these challenges and opportunities comprehensively. It emphasizes the role of innovative management and advanced technology in shaping the future of air travel. This study begins with an overview of the current state of the aviation industry, identifying key areas where innovation and technology could be highly beneficial. It explores the latest advancements in airplane design, propulsion, and materials. These technological advancements are shown to enhance aircraft performance and environmental sustainability. The paper also discusses the use of artificial intelligence and machine learning in improving air traffic control, enhancing safety, and making flight operations more efficient. The management of these technologies is critically important. Therefore, the research delves into necessary changes in organization, culture, and operations to support innovation. It proposes a management approach that aligns with these modern technologies, underlining the importance of forward-thinking leaders who collaborate across disciplines and embrace innovative ideas. The paper addresses challenges in adopting these innovations, such as regulatory barriers, the need for industry-wide standards, and the impact of technological changes on jobs and society. It recommends that governments, aviation businesses, and educational institutions collaborate to address these challenges effectively, paving the way for a more innovative and eco-friendly aviation industry. In conclusion, the paper argues that the future of aviation relies on integrating new management practices with innovative technologies. It urges a collective effort to push beyond current capabilities, envisioning an aviation industry that is safer, more efficient, and environmentally responsible. By adopting a broad approach, this research contributes to the ongoing discussion about resolving the complex issues facing today's aviation sector, offering insights and guidance to prepare for future advancements.

Keywords: aviation innovation, technology integration, environmental sustainability, management strategies, multidisciplinary approach

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Authors: Subhash Nerella, Ziyuan Guan, Azra Bihorac, Parisa Rashidi

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Intensive care units (ICUs) provide care to critically ill patients in severe and life-threatening conditions. However, patient monitoring in the ICU is limited by the time and resource constraints imposed on healthcare providers. Many critical care indices such as mobility are still manually assessed, which can be subjective, prone to human errors, and lack granularity. Other important aspects, such as environmental factors, are not monitored at all. For example, critically ill patients often experience circadian disruptions due to the absence of effective environmental “timekeepers” such as the light/dark cycle and the systemic effect of acute illness on chronobiologic markers. Although the occurrence of delirium is associated with circadian disruption risk factors, these factors are not routinely monitored in the ICU. Hence, there is a critical unmet need to develop systems for precise and real-time assessment through novel enabling technologies. We have developed the mobility and circadian disruption quantification system (Mobi-DiQ) by augmenting biomarker and clinical data with pervasive sensing data to generate mobility and circadian cues related to mobility, nightly disruptions, and light and noise exposure. We hypothesize that Mobi-DiQ can provide accurate mobility and circadian cues that correlate with bedside clinical mobility assessments and circadian biomarkers, ultimately important for delirium risk assessment and prevention. The collected multimodal dataset consists of depth images, Electromyography (EMG) data, patient extremity movement captured by accelerometers, ambient light levels, Sound Pressure Level (SPL), and indoor air quality measured by volatile organic compounds, and the equivalent CO₂ concentration. For delirium risk assessment, the system recognizes mobility cues (axial body movement features and body key points) and circadian cues, including nightly disruptions, ambient SPL, and light intensity, as well as other environmental factors such as indoor air quality. The Mobi-DiQ system consists of three major components: the pervasive sensing system, a data storage and analysis server, and a data annotation system. For data collection, six local pervasive sensing systems were deployed, including a local computer and sensors. A video recording tool with graphical user interface (GUI) developed in python was used to capture depth image frames for analyzing patient mobility. All sensor data is encrypted, then automatically uploaded to the Mobi-DiQ server through a secured VPN connection. Several data pipelines are developed to automate the data transfer, curation, and data preparation for annotation and model training. The data curation and post-processing are performed on the server. A custom secure annotation tool with GUI was developed to annotate depth activity data. The annotation tool is linked to the MongoDB database to record the data annotation and to provide summarization. Docker containers are also utilized to manage services and pipelines running on the server in an isolated manner. The processed clinical data and annotations are used to train and develop real-time pervasive sensing systems to augment clinical decision-making and promote targeted interventions. In the future, we intend to evaluate our system as a clinical implementation trial, as well as to refine and validate it by using other data sources, including neurological data obtained through continuous electroencephalography (EEG).

Keywords: deep learning, delirium, healthcare, pervasive sensing

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Authors: Atousa Khodadadyan, Gabe Mythen, Hirbod Assa, Beverley Bishop

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Risk assessment and the knowledge provided through this process is a crucial part of any decision-making process in the management of risks and uncertainties. Failure in assessment of risks can cause inadequacy in the entire process of risk management, which in turn can lead to failure in achieving organisational objectives as well as having significant damaging consequences on populations affected by the potential risks being assessed. The choice of tools and techniques in risk assessment can influence the degree and scope of decision-making and subsequently the risk response strategy. There are various available qualitative and quantitative tools and techniques that are deployed within the broad process of risk assessment. The sheer diversity of tools and techniques available to practitioners makes it difficult for organisations to consistently employ the most appropriate methods. This tools and techniques adaptation is rendered more difficult in public risk regulation organisations due to the sensitive and complex nature of their activities. This is particularly the case in areas relating to the environment, food, and human health and safety, when organisational goals are tied up with societal, political and individuals’ goals at national and international levels. Hence, recognising, analysing and evaluating different decision support tools and techniques employed in assessing risks in public risk management organisations was considered. This research is part of a mixed method study which aimed to examine the perception of risk assessment and the extent to which organisations practise risk assessment’ tools and techniques. The study adopted a semi-structured questionnaire with qualitative and quantitative data analysis to include a range of public risk regulation organisations from the UK, Germany, France, Belgium and the Netherlands. The results indicated the public risk management organisations mainly use diverse tools and techniques in the risk assessment process. The primary hazard analysis; brainstorming; hazard analysis and critical control points were described as the most practiced risk identification techniques. Within qualitative and quantitative risk analysis, the participants named the expert judgement, risk probability and impact assessment, sensitivity analysis and data gathering and representation as the most practised techniques.

Keywords: decision-making, public risk management organisations, risk assessment, tools and techniques

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Authors: L. Korpinen, P. Taskinen, P. Rautio

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This study aimed to describe procedures that we developed to use in the quantitative, bone-specific SPECT/CT at our hospital. Our procedures included the following questions for choosing imaging protocols, which were based on a clinical doctor's referral: (1) Is she/he a cancer patient or not? (2) Are there any indications of inflammatory rheumatoid arthritis? We performed about 1,106 skeletal scintigraphies over two years. About 394 patients were studied with quantitative bone-specific single-photon emission computed tomography/computerized tomography (SPECT/CT) (i.e., about 36% of all bone scintigraphies). Approximately 64% of the patients were studied using the conventional Anterior-Posterior/Posterior-Anterior imaging. Our procedure has improved efficiency and decreased cycle times.

Keywords: skeletal scintigraphy, SPECT/CT, imaging, procedure

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Authors: Edi Artono, Budi Tamtomo, Gema Wahyudi Purnama

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The world energy demand increasing extreamly high time by time, including domestic demand. That is impossible to avoid because energy a country demand proportional to surge in the number of residents, economic growth and addition of industrial sector. Domestic Oil and gas conventional reserves depleted naturally while production outcome from reservoir also depleted time to time. In the other hand, new reserve did not discover significantly to replace it all. Many people are investigating to looking for new alternative energy to answer the challenge. There are several option to solve energy fossil needed problem using Unconventional Hydrocarbon. There are four aspects to consider as a management reference in order that Unconventional Hydrocarbon business can work properly, divided to: 1. Legal aspect, 2. Environmental aspect, 3. Technical aspect and 4. Economy aspect. The economic aspect as the key to whether or not a project can be implemented or not in Oil and Gas business scheme, so do Unconventional Hydorcarbon business scheme. The support of regulation are needed to buttress Unconventional Hydorcarbon business grow up and make benefits contribute to Government.

Keywords: alternative energy, unconventional hydrocarbon, regulation support, management strategy

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Authors: Nabila Farhin, Israt Jahan

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Despite the feminisation of the global health force, women mostly engage in nursing, midwifery and community health workers (HWs), and the posts like surgeons, doctors, and specialists are generally male-dominated. It is also prominent in Bangladesh, where female HWs witness systematic workplace inequalities, discrimination, and underpayment. The Covid-19 pandemic put unsurmountable pressure on HWs as they had to serve in high-risk workplaces as frontliners. The already disadvantaged female HWs shouldered the same burden, were overworked without adequate occupational health and safety measures (OSH) and risked their lives. Acknowledging their vulnerable workplace conditions, the World Health Organization (WHO) and International Labour Organization (ILO) circulated a few specialised guidelines amid the peril. Bangladesh tried to adhere to international guidelines while formulating pandemic management strategies. In reality, the already weak and understaffed health sector collapsed with the patient influx and many HWs got infected and died in the line of duty, exposing the high-risk nature of the work. Unfortunately, the gender-segregated data of infected HWs are absent. This qualitative research investigates whether the existing laws of Bangladesh are adequate in protecting female HWs as frontliners in high-risk workplaces during the Covid-19 pandemic. The paper first examines international labour laws safeguarding female frontline HWs. It also analyses the specialised Covid-19 pandemic guidelines protecting their interests. Finally, the research investigates the compliance of Bangladesh as per international legal guidance during the pandemic. In doing so, it explores the domestic laws, professional guidelines for HWs and pandemic response strategies. The paper critically examines the primary sources like international and national statutes, rules, regulations and guidelines. Secondary sources like authoritative journal articles, books and newspaper reports are contextually analysed in line with the objective of the paper. The definition of HW is ambiguous in the labour laws of Bangladesh. It leads to confusion regarding the extent of legal protection rendered to female HWs at private hospitals in high-risk situations. The labour laws are not applicable in Public hospitals, as the employees follow the public service rules. Unfortunately, the country has no specialised law to protect HWs in high-risk workplaces, and the professional guidelines for HWs also remain inadequate in this regard. Even though the pandemic management strategies highlight some protective measures in high-risk situations, they only deal with HWs who are pregnant or have underlying health issues. No specialised protective guidelines can be found for female HWs as frontliners. Therefore, the laws are insufficient and failed to render adequate legal protection to female frontline HWs during the pandemic. The country also lacks comprehensive health legislation and uniform institutional and professional guidelines, preventing them from accessing grievance mechanisms. Hence, the female HWs felt victimised while duty-bound to serve in high-risk workplaces without adequate safeguards. Bangladesh should clarify the definition of HWs and standardise the service rules for providing medical care in high-risk workplaces. The research also recommends adequate health legislation and specialised legal protection to safeguard female HWs in future emergencies.

Keywords: female health workers (HWs), high-risk workplaces, Covid-19 pandemic, Bangladesh

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Authors: P. Uma Devi, S. Sujith, K. Rahul, T. S. Dipu, V. Anil Kumar , Vidya Menon

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Introduction: Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The epidemiology of Candida infection is also changing, mainly in relation to the number of episodes caused by species Candida non-albicans. However, in India, the true burden of candidemia is not clear. Thus, this study was conducted to evaluate the clinical characteristics, species distribution, antifungal susceptibility and outcome of candidemia at our hospital. Methodology: Between January 2012 and April 2014, adult patients with at least one positive blood culture for Candida species were identified through the microbiology laboratory database (for each patient only the first episode of candidemia was recorded). Patient data was collected by retrospective chart review of clinical characteristics including demographic data, risk factors; species distribution, resistance to antifungals and survival. Results: A total of 165 episodes of Candida BSI were identified, with 115 episodes occurring in adult patients. Most of the episodes occurred in males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive care unit (65.2%) at the time of diagnosis. On admission, 26.1% and 18.3% patients had pneumonia and urinary tract infection, respectively. Majority of the candidemia episodes were found in the general medicine department (23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & haematology (13%). Risk factors identified were prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinary catheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilation (43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C. albicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C. krusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans). Mortality was noted in 51 patients (44.3%). Early mortality (within 7 days) was noted in 32 patients while late mortality (between 7 and 30 days) was noted in 19 patients. Conclusion: In recent years, candidemia has been flourishing in critically ill patients. Comparison of data from our own hospital from 2005 shows a doubling of the incidence. Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious BSI. High index of suspicion and sensitive diagnostics are essential to improve outcomes in resource limited settings with emergence of non-albicans Candida.

Keywords: antifungal susceptibility, candida albicans, candidemia, non-albicans candida

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Authors: Malek Jamaliah, Robert Powell

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In spite of the influence of climate change on tourism destinations, particularly those rely heavily on natural resources, little attention paid to study the appropriate adaptation efforts to cope with, moderate and benefit from the impacts of climate change. The existing literature indicated that the research of climate change adaptation in the tourism and outdoor recreation field is at least 5-7 years behind other sectors such as water resources and agriculture. In Jordan, there are many observed changes in climate patterns such as higher temperatures, decreased precipitation and increased severity and frequency of drought. Dana Biosphere Reserve (DBR), the largest protected area and the major eco-tourism destination in Jordan, is facing climate change, which gradually degrading environment, shifting tourism seasons and changing livelihood and lifestyle of local communities. This study aims to assess climate change adaptation practices and policies used in DBR to cope with climate change related-risks. We conducted qualitative semi-structured interviews with key informants in DBR to assess climate change adaptation practices. Direct content analysis (or a priori content analysis) was used to determine the components and indicators of climate change adaptation. The results found that DBR has implemented a wide range of adaptation practices, including infrastructure development, diversification of tourism products, environmentally-friendly practices, visitor management, land use management, rainwater collection, environmental monitoring and research, environmental education and collaboration with stakeholders. These diverse practices implicitly and explicitly play an important role in coping with the social, economic and environmental impacts caused by climate change. Finally, this study demonstrated that climate change adaptation is closely related to sustainable management of eco-tourism.

Keywords: climate change adaptation, dana biosphere reserve, ecotourism, sustainable management

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Authors: Yusuf Ziya Ayık, Ferhat Kahveci

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Currently, database management systems have various tools such as backup and maintenance, and also provide statistical information such as resource usage and security. In terms of query performance, this paper covers query optimization, views, indexed tables, pre-computation materialized view, query performance analysis in which query plan alternatives can be created and the least costly one selected to optimize a query. Indexes and views can be created for related table columns. The literature review of this study showed that, in the course of time, despite the growing capabilities of the database management system, only database administrators are aware of the need for dealing with archival and transactional data types differently. These data may be constantly changing data used in everyday life, and also may be from the completed questionnaire whose data input was completed. For both types of data, the database uses its capabilities; but as shown in the findings section, instead of repeating similar heavy calculations which are carrying out same results with the same query over a survey results, using materialized view results can be in a more simple way. In this study, this performance difference was observed quantitatively considering the cost of the query.

Keywords: cost of query, database management systems, materialized view, query performance

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Authors: C. Akhras

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Change is the life blood of business. Dynamic factors inspire change yet may act as barriers, influencing the company’s position in the market and challenging its organizational mission and culture. Today, the business context has globalized with business enterprises in the North and South joint in mergers and the East forges a strategic alliance with the West. Moreover, given that very little remains stable in certain industries, national business goals in the millennial marketplaces might be rapid, accelerated, and differentiated growth while distinctive competitive advantage might mark new qualitative excellence in others. In a new age culture marked by change, organizations, leaders, and followers are impacted; indigenous business leaders seem to have a very important role to play in change management. This case study was carried out on 178 business employees employed in local industry to evaluate perceptions of indigenous business leadership, workplace assessment, and organizational change management in the Middle East and North Africa. Three research questions were posed: (1) In your work context, do you think business leaders are essentially changing agents? (2) In your work context, is workplace change more effective in business leaders perceived as a hierarchical change agent rather than those perceived as an empowering change agent? (3) In your work context, is workplace change more efficient in business leaders perceived as a hierarchical change agent rather than those perceived as an empowering change agent? The results of the study and its limitations imposed by time and space indicate that more comprehensive research is required in this area.

Keywords: catalyst, change management, business enterprise, workplace assessment

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Authors: Natthiya Nuchanang, Pannarunsri Inpayung

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The study of participation in student affair activity, Faculty of Management Science of Suan Sunandha Rajabhat University, these objective were 1) to study of need and attention activity of SUT student 2) to study of participation and sufficient of student affair activity and advantage of student participation. The populations were 400 undergrad students year 1st-4th. The data were analyzed by descriptive statistics. The result found that; 1. The need of participate activity of students was medium level. Environment Conservation club and Badminton club were high level of experience for student. 2. The need and attention of activity were sufficient for student. Almost problems were not having enough time. 3. The advantages of activity were high level.4. The satisfaction of students for student affair unit was high level. Major problem that students do not attend, the tired from studying, Where the activity is not permitting, activities are not interesting and activity implementation overhead.

Keywords: faculty of management science, Suan Sunandha Rajabhat university, satisfaction in activities of student affairs, students’ participation

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Authors: Anisa Suraya Ab Razak, Izza Hayat

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Introduction: The diagnosis and management of severe hyponatremia in neuropsychiatric patients present a significant challenge to physicians. Several factors contribute, including diagnostic shadowing and attributing abnormal behavior to intellectual disability or psychiatric conditions. Hyponatraemia is the commonest electrolyte abnormality in the inpatient population, ranging from mild/asymptomatic, moderate to severe levels with life-threatening symptoms such as seizures, coma and death. There are several documented fatal case reports in the literature of severe hyponatremia secondary to psychogenic polydipsia, often diagnosed only in autopsy. This paper presents a case study of acute severe hyponatremia in a neuropsychiatric patient with early diagnosis and admission to intensive care. Case study: A 21-year old Caucasian male with known epilepsy and learning disability was admitted from residential living with generalized tonic-clonic self-terminating seizures after refusing medications for several weeks. Evidence of superficial head injury was detected on physical examination. His laboratory data demonstrated mild hyponatremia (125 mmol/L). Computed tomography imaging of his brain demonstrated no acute bleed or space-occupying lesion. He exhibited abnormal behavior - restlessness, drinking water from bathroom taps, inability to engage, paranoia, and hypersexuality. No collateral history was available to establish his baseline behavior. He was loaded with intravenous sodium valproate and leveritircaetam. Three hours later, he developed vomiting and a generalized tonic-clonic seizure lasting forty seconds. He remained drowsy for several hours and regained minimal recovery of consciousness. A repeat set of blood tests demonstrated profound hyponatremia (117 mmol/L). Outcomes: He was referred to intensive care for peripheral intravenous infusion of 2.7% sodium chloride solution with two-hourly laboratory monitoring of sodium concentration. Laboratory monitoring identified dangerously rapid correction of serum sodium concentration, and hypertonic saline was switched to a 5% dextrose solution to reduce the risk of acute large-volume fluid shifts from the cerebral intracellular compartment to the extracellular compartment. He underwent urethral catheterization and produced 8 liters of urine over 24 hours. Serum sodium concentration remained stable after 24 hours of correction fluids. His GCS recovered to baseline after 48 hours with improvement in behavior -he engaged with healthcare professionals, understood the importance of taking medications, admitted to illicit drug use and drinking massive amounts of water. He was transferred from high-dependency care to ward level and was initiated on multiple trials of anti-epileptics before achieving seizure-free days two weeks after resolution of acute hyponatremia. Conclusion: Psychogenic polydipsia is often found in young patients with intellectual disability or psychiatric disorders. Patients drink large volumes of water daily ranging from ten to forty liters, resulting in acute severe hyponatremia with mortality rates as high as 20%. Poor outcomes are due to challenges faced by physicians in making an early diagnosis and treating acute hyponatremia safely. A low index of suspicion of water intoxication is required in this population, including patients with known epilepsy. Monitoring urine output proved to be clinically effective in aiding diagnosis. Early referral and admission to intensive care should be considered for safe correction of sodium concentration while minimizing risk of fatal complications e.g. central pontine myelinolysis.

Keywords: epilepsy, psychogenic polydipsia, seizure, severe hyponatremia

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Authors: Niloofar Mobasem, Kambiz Heidarzadeh Hanzaee

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Purpose: The study aimed to measure the customer satisfaction with service recovery through the conflict management framework, especially assessing the role of pre-existing attitudes for measuring the customer response to the service failure. Design/ methodology/ approach: The study is based on the experimental research method. The factorial designs are used in the research that measures the variables in two separate studies. In the first study, the factorial design is 3 conflict management style: cooperative, competitive, avoiding; - 3 service performance: exceed expectation, meet expectation, fail to meet expectation; and in the second study includes: - 3 conflict management style: cooperative, competitive, avoiding; - 2 service performance: exceed expectation, fail to meet expectation; - 2 pre-existing attitude: positive, negative. Finding: The results of study based on a scenario indicate that the conflict management style affected on customer satisfaction by service recovery efforts as well as the pre-existing attitudes affected the customer interpretation for service providers (conflict management style) and those who have positive pre-existing attitudes are interested to response to the cooperative approach in dealing with service failure. Research limitation/ implication: According to all researches, the study has several limitations. The nature of scenario in this study may cause to hit the reality of life. Although, the similar scenario approaches commonly are used for such researches, but the approaches are not without criticism. Practical implications: Given the importance of service recovery, companies can understand the importance of creating customer satisfaction achieved by the positive results due to the service recovery during the shortness or service failure by the mentioned companies. Originality/ value: The study highlights the importance of service failure and providing the education in relation to the service recovery.

Keywords: service recovery, pre-existing attitude, service failure, customer satisfaction

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Authors: Yasith Mindula Saipath Wickramasinghe

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Augmented reality applications require a high processing power to load, render and live stream high-definition AR models and virtual scenes; it also requires device sensors to work excessively to coordinate with internal hardware, OS and give the expected outcome in advance features like object detection, real time tracking, as well as voice and text recognition. Excessive thermal generation due to these advanced functionalities has become a major research problem as it is unbearable for smaller mobile devices to manage such heat increment and battery drainage as it causes physical harm to the devices in the long term. Therefore, effective thermal management is one of the major requirements in Augmented Reality application development. As this paper discusses major causes for this issue, it also provides possible solutions in the means of operating system adaptations as well as further research on best coding practises to optimize the application performance that reduces thermal excessive thermal generation.

Keywords: augmented reality, device thermal management, GPU, operating systems, device I/O, overheating

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Authors: Andrew Enaifoghe

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The study examined the role of public management development in enhancing public service delivery in the South African local government. The study believes that the ultimate empowerment of the third tier sphere of governments in South Africa remains the instrument required to enhance both national and continental development. This over the year has been overwhelmed with problems and imbalance related to ethical practice, accountability and the functional local government system and the machinery itself. The study finds that imbalances are being strengthened by a lack of understanding and unanimity as to what a public management development in a democratic system is and how it should work to achieve the dividends of democracy in delivering public goods. Studies indicated that the magnitudes are widespread corruption and misrepresentations of government priorities; both of which weaken the ability of governments to enhance broad-based economic growth and social well-being of the people. This study addressed the problem of public management and accountable local government. The study indicates the need for citizens’ participation in the decision-making process in delivering public service in South Africa and how its accountability mechanism supports good governance. The study concludes that good and ethical watersheds in South Africa have since reached such proportions that social pressure, the pressure from the government and various institutions have to re-consider where they stand regarding ethics, ethical behaviour, accountability and professionalism in delivering public goods to the people at the local municipal government.

Keywords: accountability, development, democratic system, South Africa

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Authors: Benghezel Hichem

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Thyroid dysfunction in hemodialysis subjects is represented mainly by hypothyroidism. The objective of our work is to determine the thyroid profile of our hemodialysis patients and to highlight the prevalence of different thyroid disorders. Methods: This is a retrospective study performed on a mono centric 2 months (February and March 2013) on 42 hemodialysis patients (11 male and 31 female). We made the dosage of thyroid hormones Thyrotropin (TSH) ((free thyroxin ) FT4 and free Triodothyronin ) FT3) by chemiluminescence immunoassay method on cobas 6000 Roche Diagnostics. The results: The prevalence of biological hypothyroidism was 18% (7% with a high TSH isolated and a mean +/- SD 9.44 +/- 6.29, 5% with high TSH, and with low FT4 a mean +/- SD is 8.18 +/- 0.53 for TSH and 9.69 +/- 0.22 for FT4, One patient with a high TSH, and low FT4, FT3. 4% of patients with a low T3 syndrome with a mean +/- SD of 3.93 +/- 0,3 for FT3), we notice that 5% of patients with hyperthyroidism TSH collapsed and mean +/- SD of TSH is 0.017 +/- 0,001. Conclusion: The biological Hypothyroidism is a common endocrine disorder in chronic hemodialysis.

Keywords: hypothyroidism, hemodialysis, thyréostimulin, free thyroxin, triodothyronin

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Authors: Gargi Ghosh

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Municipal solid waste management (MSWM) is an obligatory function of the local self-government as per the Indian constitution, and this paper gives a glimpse of the system in Indian towns focusing on its present state and use of technology in the system. The paper analyses the MSWM characteristics in 35 towns in the southern state of Karnataka. The lifestyle in these towns was found to be very sustainable with minimal disposal and considerable reuse. Average per capita waste generated in the towns ranged from 300 gm/person to 500 gm/person. The waste collection efficiency varied from 60% to 80%. The waste shows equal share of organic and non-organic waste composition with a low calorific value. Lack of capacity of the municipal body in terms of manpower, assets & knowledge and social consciousness were found to be two major issues in the system. Technical solutions in use in India at present are composting, organic re-reprocessing, bio-methanation, waste to energy etc. The tonnage of waste generated ranged from 8 TPD to 80 TPD. The feasibility of technology has been analysed in the context of the above characteristics. It was found that low calorific value and mixed nature of waste made waste to energy and bio methanation processes unsuitable. Composting – windrow and closed door was found best to treat the bulk of the waste. Organic–re-processors was planned for phase 2 of MSWM program in the towns with effective implementation of segregation at source. GPS and RFID technology was recommended for monitoring the collection process and increasing accountability of the citizens for effective implementation.

Keywords: solid waste management, Indian towns, waste management technology, waste charateristics

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