Search results for: clinical leadership
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4442

Search results for: clinical leadership

4142 Clinical Application of Mesenchymal Stem Cells for Cancer Therapy: A Review of Registered Clinical Trials

Authors: Tuong Thi Van Thuy, Dao Van Toan, Nguyen Duc Phuc

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Mesenchymal stem cells (MSCs) were discovered in the 1970s with their unique properties of differentiation, immunomodulation, multiple secreting, and homing factors to injured organs. MSC-based therapies have emerged as a promising strategy for various diseases such as cancer, tissue regeneration, or immunologic/inflammatory-related diseases. This study evaluated the clinical application of MSCs for cancer therapy in trials registered on Clinical Trial as of July 2022. The results showed 40 clinical trials used MSCs in various cancer conditions. 62% of trials used MSCs for therapeutic purposes to minimize the side effects of cancer treatment. Besides, 38% of trials were focused on using MSCs as a therapeutic agent to treat cancer directly. Most trials (38/40) are ongoing phase I/II, and 2 are entering phase III. 84% of trials used allogeneic MSCs compared with 13% using autologous sources and 3% using both. 25/40 trials showed participants received a single dose of MSCs, while the most times were 12 times in a pancreatic cancer treatment trial. Conclusion: MSC-based therapy for cancer in clinical trials should be applied to (1) minimize the side effects of oncological treatments and (2) directly affect the tumor via selectively delivering anti-cancer payloads to tumor cells. Allogeneic MSCs are a priority selected in clinical cancer therapy.

Keywords: mesenchymal stem cells, MSC-based therapy, cancer condition, cancer treatment, clinical trials

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4141 Fusing Mentorship, Leadership and Empowerment Among Young Women In STEM

Authors: Anne Bubriski

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Despite improvements in gender inequalities, women and girls continue to face glass ceilings, underrepresentation, and harmful stereotypes that can limit their aspirations and opportunities in STEM. While girls are taking similar high school math and science classes, boys are more likely to take physics and six times more likely to take an engineering course. The gap becomes even larger for minority or low-income girls. This gender gap is not due to biology; rather, it is due to cultural, social, and institutional forces. As girls get older, these forces often ‘teach’ them ‘STEM is more for boys’. The STEM gender gap widens in college, with only 20% of engineering degrees being awarded to women, and by the time women enter the workforce, they only occupy about 13% of engineering jobs. At the University of Central Florida, the Women’s and Gender Studies Program has developed a unique mentoring program to address these issues, Science Leadership and Mentoring (SLAM). What is unique about the approach of SLAM is that we look to address this problem through leadership and STEM. We look to help girls make connections between leadership and STEM—that young women can be leaders as scientists and that scientists are leaders making a change. This is particularly needed and relevant to our community because while there are mentoring programs to our knowledge, SLAM is one of the only, if not only, mentoring programs pairing college women and 7th-grade girls that includes a focus both on STEM and leadership in the United States. SLAM is a curriculum-based mentoring program pairing one 7th-grade girl with one UCF undergraduate STEM major. SLAM empowers young women to be assertive, brave, confident, independent, inquisitive and proud leaders in STEM. SLAM seeks to promote young women’s inspiration and excitement into STEM fields and careers while also building leadership abilities such as problem-solving, teamwork and cooperation, cultural identity and ethnic pride, advocacy for positive change, and goals for the future. SLAM serves about fifteen 7th-grade girls for the academic year and about 20 UCF students. SLAM holds weekly mentoring meetings lasting about 90 minutes, covering topics on leadership, STEM majors and careers, and STEM leadership. This past year, SLAM received a Community Action Grant from the American Association of University Women (AAUW) to run a sub-program, SLAM-Space. SLAM-Space focused on exposing SLAM participants to aerospace engineering and other space-related STEM fields, such as physics and astronomy, through guest speakers, workshops and field trips, including the Kenndy Space Center. The proposed paper presentation will present an overview of SLAM-Space and the data findings from pre and post-surveys, in-depth interviews and focus groups from the SLAM participants' experiences in the program.

Keywords: gender, leadership, STEM, empowerment

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4140 Culturally Adapting Videos to Involve Nigerian Patients with Cancer in Clinical Trials

Authors: Abiola Falilat Ibraheem, Akinyimika Sowunmi, Valerie Otti

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Background: Introduction of innovative cancer clinical trials to Nigeria is a critical step in addressing global inequities of cancer burden. Low health and clinical trial literacy among Nigerian patients have been sighted as a significant barrier to ensuring that patients enrolled in clinical trials are truly informed. Video intervention has been shown to be the most proactive method to improving patient’s clinical trial knowledge. In the US, video interventions have been successful at improving education about cancer clinical trials among minority patients. Thus, this study aimed to apply and adapt video interventions addressing attitudinal barriers peculiar to Nigerian patients. Methods: A hospital-based representative mixed-method study was conducted at the Lagos State University Teaching Hospital (LASUTH) from July to December 2020, comprising of cancer patients aged 18 and above. Patients were randomly selected during every clinic day, of which 63 patients volunteered to participate in this study. We first administered a cancer literacy survey to determine patients’ knowledge about clinical trials. For patients who had prior knowledge, a pre-intervention test was administered, after which a 15-minute video (attitudes and intention to enroll in therapeutic clinical trials (AIET)) to improve patients’ knowledge, perception, and attitudes towards clinical trials was played, and then ended by administering a post-intervention test to the patients. For patients who had no prior knowledge, the AIET video was played for them, followed by the post-intervention test. Results: Out of 63 patients sampled, 43 (68.3%) had breast cancer. On average, patients agreed to understand their cancer diagnosis and treatment very well. 84.1% of patients had never heard about cancer clinical trials, and 85.7% did not know what cancer clinical trials were. There was a strong positive relationship (r=0.916) between the pretest and posttest, which means that the intervention improved patients’ knowledge, perception, and attitudes about cancer clinical trials. In the focus groups, patients recommended adapting the video in Nigerian settings and representing all religions in order to address trust in local clinical trialists. Conclusion: Due to the small size of patients, change in clinical trial knowledge was not statistically significant. However, there is a trend suggesting that culturally adapted video interventions can be used to improve knowledge and perception about cancer clinical trials.

Keywords: clinical trials, culturally targeted intervention, patient education, video intervention

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4139 Ending the Gender Gap in Educational Leadership: A U.S. Goal for a Balanced Administration by 2030

Authors: S. Dodd

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This presentation examines the gender gap in leadership positions at colleges and universities within the United States. Despite the fact that women now outnumber men in earning doctorate degrees, women continue to hold far fewer positions of educational leadership, and still, earn less money than men do at every level. Considering the lack of female representation in positions of leadership, there are clearly outside variables preventing women from attaining these positions, despite their educational attainment. Following this study, the American Council on Education (ACE) set a goal to achieve an equal percentage of females holding college presidency positions by the year 2030. This goal is particularly ambitious, especially when considering the gender disparity at all ranks in higher education. Men still hold nearly 70% of all full professorships at degree-granting institutions. Even when women are equally represented in numbers, men typically hold a higher rank and are more likely to be tenured. Across all four-year colleges and universities in the United States, men earn more money than women at every rank and in every discipline. There are over twice as many men than women represented on governing boards, who help formed and uphold campus policies. The fact that the low percentage of female presidents has remained static for many years deepens the challenge for the ACE. Although emphasizing the need to create greater opportunities for women in educational administration is admirable, it is difficult to simplify the social forces that create and uphold the status quo of male leadership. When aiming to ensure 'women' hold 50% of all college presidency positions, it is important to consider how the intersections of race, social class, and other factors also correlate with lower job status. This presentation explores how gendered notions of leadership begin in a child’s early years and are carried into future careers, and how these conceptualizations impact the creation and upholding of educational policies at every academic level. Current research that emphasizes the importance establishing a bottom-up approach to a gender equity infrastructure for children early in their educational careers will be discussed. A top-down approach starting with female college presidents is incomplete and insufficient if the mindsets of the youth who will one day be entering those institutions of higher education are not also taken into consideration. Although ACE has established this lofty goal for female college presidencies by the year 2030, a road map for this will ensue, has not yet been provided. The talent pool of women who are educated and experienced for such positions is vast, but acknowledging the social barriers existing for women in these positions will be crucial to making the changes necessary for these leadership opportunities to be long lasting and successful.

Keywords: equity, higher education, leadership, women

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4138 Instructional Leadership, Information and Communications Technology Competencies and Performance of Basic Education Teachers

Authors: Jay Martin L. Dionaldo

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This study aimed to develop a causal model on the performance of the basic education teachers in the Division of Malaybalay City for the school year 2018-2019. This study used the responses of 300 randomly selected basic education teachers of Malaybalay City, Bukidnon. They responded to the three sets of questionnaires patterned from the National Education Association (2018) on instructional leadership of teachers, the questionnaire of Caluza et al., (2017) for information and communications technology competencies and the questionnaire on the teachers’ performance using the Individual Performance Commitment and Review Form (IPCRF) adopted by the Department of Education (DepEd). Descriptive statistics such as mean for the description, correlation for a relationship, regression for the extent influence, and path analysis for the model that best fits teachers’ performance were used. Result showed that basic education teachers have a very satisfactory level of performance. Also, the teachers highly practice instructional leadership practices in terms of coaching and mentoring, facilitating collaborative relationships, and community awareness and engagement. On the other hand, they are proficient users of ICT in terms of technology operations and concepts and basic users in terms of their pedagogical indicators. Furthermore, instructional leadership, coaching and mentoring, facilitating collaborative relationships and community awareness and engagement and information and communications technology competencies; technology operations and concept and pedagogy were significantly correlated toward teachers’ performance. Coaching and mentoring, community awareness and engagement, and technology operations and concept were the best predictors of teachers’ performance. The model that best fit teachers’ performance is anchored on coaching and mentoring of the teachers, embedded with facilitating collaborative relationships, community awareness, and engagement, technology operations, and concepts, and pedagogy.

Keywords: information and communications technology, instructional leadership, coaching and mentoring, collaborative relationship

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4137 Cultural Differences in Gender Stereotyping of Leaders

Authors: Maria Clapham, Krysta Thomason

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This study examined how age and gender of a leader affect characterizations of leaders across cultures. Participants from around the world were randomly assigned to rate one of the following types of leaders: successful leader, female leader over age 50, female leader under age 40, male leader over age 50, or male leader under age 40. Ratings of these leaders on communal, agentic, task-oriented, relationship-oriented, and transformational leadership characteristics were compared across four world regions: Asia, Europe, Latin America, and USA/Canada. Results suggest some similarities and differences in characterizations of leaders across cultures.

Keywords: culture, gender, leadership, stereotyping

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4136 A Conceptual Framework for Managing Municipal Finances in South Africa

Authors: Abongile Zweni

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As a post-apartheid strategy to redress the social imbalances of the past, local governments are tasked with the role of delivering crucial services to their constituents. Apart from political instability, evidence shows that managers in South African municipalities lack effective financial management skills and competencies. This resulted in a failure to fulfill its administrative obligations, particularly municipal financial management. Most municipalities have, however, failed in this role, which has led them to be placed under administration by the provincial government in terms of Section 139 of the constitution of the Republic of South Africa. Thus, this study proposed a leadership conceptual framework for effectively managing ever-eroding municipal finances in South Africa. The study adopted a desktop research approach to explore the key components of leadership and municipal financial management toward the development of the conceptual framework. The study fostered a better understanding of the need for transformation in relation to the current financial management practices and sustainability of a municipality. Moreover, the conceptual framework applies not only to municipalities but also to other government departments and public authorities in the country for financial management.

Keywords: leadership, municipal finance, financial performance, management skills, municipality

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4135 Leadership in the Era of AI: Growing Organizational Intelligence

Authors: Mark Salisbury

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The arrival of artificially intelligent avatars and the automation they bring is worrying many of us, not only for our livelihood but for the jobs that may be lost to our kids. We worry about what our place will be as human beings in this new economy where much of it will be conducted online in the metaverse – in a network of 3D virtual worlds – working with intelligent machines. The Future of Leadership was written to address these fears and show what our place will be – the right place – in this new economy of AI avatars, automation, and 3D virtual worlds. But to be successful in this new economy, our job will be to bring wisdom to our workplace and the marketplace. And we will use AI avatars and 3D virtual worlds to do it. However, this book is about more than AI and the avatars that we will work with in the metaverse. It’s about building Organizational intelligence (OI) -- the capability of an organization to comprehend and create knowledge relevant to its purpose; in other words, it is the intellectual capacity of the entire organization. To increase organizational intelligence requires a new kind of knowledge worker, a wisdom worker, that requires a new kind of leadership. This book begins your story for how to become a leader of wisdom workers and be successful in the emerging wisdom economy. After this presentation, conference participants will be able to do the following: Recognize the characteristics of the new generation of wisdom workers and how they differ from their predecessors. Recognize that new leadership methods and techniques are needed to lead this new generation of wisdom workers. Apply personal and professional values – personal integrity, belief in something larger than yourself, and keeping the best interest of others in mind – to improve your work performance and lead others. Exhibit an attitude of confidence, courage, and reciprocity of sharing knowledge to increase your productivity and influence others. Leverage artificial intelligence to accelerate your ability to learn, augment your decision-making, and influence others.Utilize new technologies to communicate with human colleagues and intelligent machines to develop better solutions more quickly.

Keywords: metaverse, generative artificial intelligence, automation, leadership, organizational intelligence, wisdom worker

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4134 The Contribution of Buddhist-Based Mindfulness Practices on Ethical Leadership: A Qualitative Study of Organizational Leaders in Thailand

Authors: Kunkanit Sutamchai, Kate E. Rowlands

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Recent public ethical scandals in many organizations around the world have raised concern about organizational ethics, which have, in turn, made ethical behaviors and conducts on the part of leaders become more critical topics in organizational studies. However, current research on the benefits of mindfulness within the workplace contexts has predominantly focused on stress reduction and work performance enhancement, while the aspects of ethical behavior development have been far less investigated in mindfulness research in the organizational and management fields. Only recently has there been an emerging call for organizational researchers and practitioners to study mindfulness concepts and practices from the original Buddhist perspectives given that ethics is regarded as a foundation for Buddhist mindfulness. Yet little, if any, empirical research on the contributions of mindfulness practices to ethical leadership has been done in Eastern Buddhist contexts. Therefore, this study aims to explore the extent to which and how Buddhist-based mindfulness practices can influence organizational leaders’ ethical values and practices. On this basis, Thailand was selected as a context of study due to a predominantly Buddhist society and culture. Qualitative data were gathered through in-depth semi-structured interviews with twenty executive leaders from various private organizations in Thailand, who practice Buddhist-based mindfulness meditation regularly. The findings from this study shed light on the role Buddhist-based mindfulness practices can play in promoting ethical behavior among executive leaders in Thailand. The results also suggest that ethical values and practices influenced by Buddhist-based mindfulness practices are well aligned with the elements appeared in the inter-disciplinary and cross-cultural ethical leadership framework, namely: humane, justice, sustainability and responsibility, and moderation. This study concludes that the integration of ethical dimensions to mindfulness practices may provide promising opportunities for ethical leadership development, particularly in the context of Thailand. This could contribute significantly to the future development of both organizations and society at large. The study also suggests that mindfulness interventions in organizational contexts should place more explicit emphasis on ethics. This may be done by relating the ethical principles underlying Buddhist-based mindfulness to other ethical systems in different contexts and cultures where they can be aligned.

Keywords: Buddhism, ethical leadership, leadership development, mindfulness, Thailand, training

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4133 African Horse Sickness a Possible Threat to Horses in Al-Baha

Authors: Ghanem Al-Ghamdi

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African Horse Sickness causes significant challenges to horse practitioners and owners in Africa and possibly in certain locations in the Arab Pensila. The aim of this work was to observe a hot spot of epidemic in Al-Baha, Southwestern of Saudi Arabia that could be AHS. A five year-old horse farm that had eight horses with no history of clinical problems was visited in late October 2014. In August 2014, horses showed clinical signs of severe pain, congestion of mucus membranes, foam oozing of the nose, recumbency, difficult breath and ultimately death. The course of the disease averaged 2 days. The farm had no previous history of this episode. Other animals including camel, sheep reside the same farm sharing feeding and water sources however no obvious similar clinical problems were noticed among the two species. Five horses showed the clinical disease and all horses were lost. Veterinary help was not available for diagnosis or treatment. A follow up visit to the farm after one year indicated that the three remaining horses were healthy but were relocated to a different facility out the Al-Baha Region. The most likely cause of such clinical problem is African Horse Sickness, however clinical exam and sampling of other horses in the region is absolute must as well as examining arthropods.

Keywords: African horse sickness, horses, Al-Baha, Saudi Arabia

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4132 Awakening in Nigerian Democracy: The Change of Government in 2015 General Election

Authors: Nura Suleiman

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The democratic dispensation in Nigeria witnessed allot of changes since its beginning up to the 2015 election. The issues of zoning formula, rigging, money politics, god fatherism, and political thuggery among the youths became the centre stage from 1999-2014. But 2015 came with new tune that brings about a little shift from the traditional politics mentioned above, the political socialisation and knowledge penetrated into the sense of electorate where people suddenly change and look for the better option. The paper will examine the democratic change in relation to the 2015 General election which brings General MohammaduBuhari on the mantle of leadership of Nigeria. Many reasons were attributed to the sudden change of government in Nigeria, but the major ones are lack of good governance, corruption, insecurity, political parties’ merger to formed APCand change in INEC leadership. Others are weakness of the leadership and undemocratic nature of PDP government at different level in the country. The glamor for change became necessary because People become more informs about the manifestation of good hope and better Nigeria from the major opposition party (APC). During 2015 election the electorate voted the incumbent government out and replaced it with their choice.

Keywords: democracy, election, insecurity, good governance

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4131 Fecal Immunochemical Testing to Deter Colon Cancer

Authors: Valerie A. Conrade

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Introduction: A large body of literature suggests patients who complete fecal immunochemical testing (FIT) kits are likely to identify colorectal cancer sooner than those who do not complete FIT kits. Background: Patients who do not participate in preventative measures such as the FIT kit are at a higher risk of colorectal cancer growing unnoticed. The objective was to see if the method the principal investigator (PI) uses to educate clinical staff on the importance of FIT kit administration provides an increased amount of FIT kit dissemination to patients post clinical education. Methodologies: Data collection via manual tallies took place before and after the clinical staff was educated on the importance of FIT kits. Results: The results showed an increase in FIT kit dissemination post clinical staff education. Through enhanced instruction to the clinical staff regarding the importance of FIT kits, expanding their knowledge on preventative measures to detect colorectal cancer positively impacted nurses and, in turn, their patients.

Keywords: colon cancer, education, fecal immunochemical testing, nursing

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4130 Clinical Advice Services: Using Lean Chassis to Optimize Nurse-Driven Telephonic Triage of After-Hour Calls from Patients

Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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4129 Transforming Educational Leadership With Innovative Administrative Strategies

Authors: Kofi Nkonkonya Mpuangnan, Samantha Govender, Hlengiwe Romualda Mhlongo

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Educational leaders are skilled architects crafting a vibrant environment where growth, creativity, and adaptability can flourish within schools. Their journey is one of transformation, urging them to explore administrative strategies that align seamlessly with evolving educational models and cater to the specific needs of students, educators, and stakeholders. Through this committed effort to innovate, they seek to enhance the effectiveness and influence of educational systems, paving the way for a more inclusive and forward-thinking educational environment. In this context, the authors explored the concept of transforming educational leadership with administrative strategies in alignment with the following research objectives. To find the strategies that can be adopted by transformation leaders to promote effective administrative practices in an educational setting and to explore the roles of educational leaders in promoting collaboration in education. To find answers to these questions, a systematic literature review underpinned by the transformational leadership model was adopted. Therefore, concepts integrated from a variety of outlets, including academic journals, conference proceedings, and reports found within SCOPUS, WoS, and IBSS databases. A search was aided using specific themes like innovative administrative practices, the roles of educational leaders, and interdisciplinary approaches to administrative practices. The process of conducting the search adhered to the five-step framework, which was subjected to inclusion and exclusion of studies. It was found that transformational leadership, agile methodologies, employee wellbeing, seminars and workshops could foster a culture of innovation and creativity among teachers and staff to transform administrative practices in education settings. It was recommended that professional development programs be organized periodically for educational leaders in educational institutions to help them revitalize their knowledge and skills in educational administration.

Keywords: educational leadership, innovative strategies, administrative practices, professional development, stakeholder engaement, student outcome

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4128 Understanding Team Member Autonomy and Team Collaboration: A Qualitative Study

Authors: Ayşen Bakioğlu, Gökçen Seyra Çakır

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This study aims to explore how research assistants who work in project teams experience team member autonomy and how they reconcile team member autonomy with team collaboration. The study utilizes snowball sampling. 20 research assistants who work the faculties of education in Marmara University and Yıldız Technical University have been interviewed. The analysis of data involves a content analysis MAXQDAPlus 11 which is a qualitative data analysis software is used as the data analysis tool. According to the findings of this study, emerging themes include team norm formation, team coordination management, the role of individual tasks in team collaboration, leadership distribution. According to the findings, interviewees experience team norm formation process in terms of processes, which pertain to task fulfillment, and processes, which pertain to the regulation of team dynamics. Team norm formation process instills a sense of responsibility amongst individual team members. Apart from that, the interviewees’ responses indicate that the realization of the obligation to work in a team contributes to the team norm formation process. The participants indicate that individual expectations are taken into consideration during the coordination of the team. The supervisor of the project team also has a crucial role in maintaining team collaboration. Coordination problems arise when an individual team member does not relate his/her academic field with the research topic of the project team. The findings indicate that the leadership distribution in the project teams involves two leadership processes: leadership distribution which is based on the processes that focus on individual team members and leadership distribution which is based on the processes that focus on team interaction. Apart from that, individual tasks serve as a facilitator of collaboration amongst team members. Interviewees also indicate that individual tasks also facilitate the expression of individuality.

Keywords: project teams in higher education, research assistant teams, team collaboration, team member autonomy

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4127 Clinical Signs of River Blindness and the Efficacy of Ivermectin Therapy in Idogun, Ondo State-Nigeria

Authors: Afolabi O.J, Simon-Oke I.A., Oniya M.O., Okaka C.E.

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River blindness is a skin, and an eye disease caused by Onchocerca volvulus and vectored by a female hematophagous blackfly. The study aims to evaluate the distribution of the clinical signs of river blindness and the efficacy of ivermectin in the treatment of river blindness in Idogun. Observational studies in epidemiology that involve the use of a structured questionnaire to obtain useful epidemiological information from the respondents, physical assessment via palpation from head to ankle was used to assess clinical signs from the respondents and skin snip test was used to evaluate the prevalence of the disease. The efficacy of the drug was evaluated and expressed in percentages. One hundred and ninety-two (192) out of the 384 respondents examined, showed various signs of river blindness. However, it was only 108 (28.1%) respondents with the clinical signs that demonstrated Onchocerca volvulus microfilariae in their skin snips. The clinical signs observed among the respondents include skin depigmentation such as dermatitis, leopard skin, papules, pruritus and self-inflicted injury, while ocular symptoms include cataract, ocular lesion and partial blindness. Among these clinical signs, papules, and pruritus were the most dominant in the community. The prevalence of the clinical signs was observed to vary significantly among the age groups and gender (P<0.05). The efficacy of the drug after 6 and 12 months of treatments shows that the drug is more effective at age groups 10-50 years than the age groups 51-90 years. Ivermectin is observed to be efficacious in the treatment of the disease. However, to achieve eradication of the disease, the drug may be administered at 0.15mg/kg twice a year.

Keywords: riverblindness, clinical signs, ivermectin, Idogun

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4126 Transformational Leadership and Self-Efficacy of Academic Heads in the Implementation of a Customized English Language Curriculum

Authors: Sonia Arradaza-Pajaron

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This study examined the relationship between transformational leadership (TL) and self-efficacy (SE) of academic heads in the implementation of a customized English language curriculum (CELC) among technological state universities and colleges in Leyte provinces and Biliran, Philippines. Results manifested that academic leaders practiced transformational leadership and are self-efficacious enough but with only moderate level in the effectiveness of CELC implementation. It was found out; further, that of the four identified transformational leadership components, except idealized influence, three of which demonstrated a significant relationship with CELC component variables, although in varying degree. Moreover, self-efficacy sources, especially vicarious experiences and verbal persuasion manifested moderate to high significant relationships with effective CELC curriculum implementation. Further, verbal persuasion and physiological/emotional condition manifested significant relationship with CELC-resource and CELC-contextual/community influence, respectively. Regression analysis showed that TL-individualized consideration component explained wider extent when correlated with CELC contextual/community components, while self-efficacy source-verbal persuasion demonstrated a wider extent with the three CELC components, namely; resource, process and physiological/emotional condition. Results further revealed that TL-individualized consideration manifested lesser influence with CELC implementation, while SE-verbal persuasion demonstrated stronger influence or effect on CELC-process, CELC-physiological/emotional, while lesser influence with CELC-resource. This implies that academic leaders, in order to carry out effective curriculum implementation, should provide more emphasis on school culture, its beliefs, practices and academic atmosphere but most of all empower human resources who are considered the backbone of the work place and can be directly affected by any curriculum shifts and challenges. To realize this, more values-skilled training programs must be designed for academic heads are needed to equip them with the necessary leadership skills, beliefs in their capacity to lead and their own enhance emotional well-being in leading subordinates and facilitating curriculum implementation.

Keywords: Customized English Language curriculum, CELC, self-efficacy, transformational leadership, values-skilled training

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4125 The Implications of the Lacanian Concept of 'Lalangue' for Lacanian Theory and Clinical Practice

Authors: Dries Dulsster

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This research we want to discuss the implications of the concept of ‘lalangue’ and illustrate its importance for lacanian psychoanalysis and its clinical practice. We will look at this concept through an in depth reading of Lacan’s later seminars, his lectures at the North-American universities and his study on James Joyce. We will illustrate the importance of this concept with a case study from a clinical practice. We will argue that the introduction of ‘lalangue’ has several theoretical and clinical implications that will radically change Lacans teachings. We will illustrate the distinction between language and lalangue. Language serves communication, but this is not the case with lalangue. We will claim that there is jouissance in language and will approach this by introducing the concept of ‘lalangue’. We will ask ourselves what the effect will be of this distinction and how we can use this in clinical practice. The concept of ‘lalangue’ will introduce a new way of thinking about the unconscious. It will force us to no longer view the unconscious as Symbolic, but as Imaginary or Real. Another implication will be the approach on the symptom, no longer approaching it as a formation of the unconscious. It will be renamed as ‘sinthome’, as function of the real. Last of all it will force us to rethink the lacanian interpretation and how we direct the treatment. The implications on a clinical level will be how we think about the lacanian interpretation and the direction of the treatment. We will no longer focus on language and meaning, but focus on jouissance and the ways in which the subject deals with this. We will illustrate this importance with a clinical case study. To summarize, the concept of lalangue forces us to radically rethink lacanian psychoanalysis, with major implications on a theoretical and clinical level. It introduces new concepts such as the real unconscious and the sinthome. It will also make us rethink the way we work as lacanian psychoanalysts.

Keywords: Lacan's later teaching, language, Lalangue, the unconscious

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4124 Creativity and Innovation in a Military Unit of South America: Decision Making Process, Socio-Emotional Climate, Shared Flow and Leadership

Authors: S. da Costa, D. Páez, E. Martínez, A. Torres, M. Beramendi, D. Hermosilla, M. Muratori

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This study examined the association between creative performance, organizational climate and leadership, affectivity, shared flow, and group decision making. The sample consisted of 315 cadets of a military academic unit of South America. Satisfaction with the decision-making process during a creative task was associated with the usefulness and effectiveness of the ideas generated by the teams with a weighted average correlation of r = .18. Organizational emotional climate, positive and innovation leadership were associated with this group decision-making process r = .25, with shared flow, r = .29 and with positive affect felt during the performance of the creative task, r = .12. In a sequential mediational analysis positive organizational leadership styles were significantly associated with decision-making process and trough cohesion with utility and efficacy of the solution of a creative task. Satisfactory decision-making was related to shared flow during the creative task at collective or group level, and positive affect with flow at individual level.This study examined the association between creative performance, organizational climate and leadership, affectivity, shared flow, and group decision making. The sample consisted of 315 cadets of a military academic unit of South America. Satisfaction with the decision-making process during a creative task was associated with the usefulness and effectiveness of the ideas generated by the teams with a weighted average correlation of r = .18. Organizational emotional climate, positive and innovation leadership were associated with this group decision-making process r = .25, with shared flow, r = .29 and with positive affect felt during the performance of the creative task, r = .12. In a sequential mediational analysis positive organizational leadership styles were significantly associated with decision-making process and trough cohesion with utility and efficacy of the solution of a creative task. Satisfactory decision-making was related to shared flow during the creative task at collective or group level, and positive affect with flow at individual level.

Keywords: creativity, innovation, military, organization, teams

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4123 The Preceptorship Experience and Clinical Competence of Final Year Nursing Students

Authors: Susan Ka Yee Chow

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Effective clinical preceptorship is affecting students’ competence and fostering their growth in applying theoretical knowledge and skills in clinical settings. Any difference between the expected and actual learning experience will reduce nursing students’ interest in clinical practices and having a negative consequence with their clinical performance. This cross-sectional study is an attempt to compare the differences between preferred and actual preceptorship experience of final year nursing students, and to examine the relationship between the actual preceptorship experience and perceived clinical competence of the students in a tertiary institution. Participants of the study were final year bachelor nursing students of a self-financing tertiary institution in Hong Kong. The instruments used to measure the effectiveness of clinical preceptorship was developed by the participating institution. The scale consisted of five items in a 5-point likert scale. The questions including goals development, critical thinking, learning objectives, asking questions and providing feedback to students. The “Clinical Competence Questionnaire” by Liou & Cheng (2014) was used to examine students’ perceived clinical competences. The scale consisted of 47 items categorized into four domains, namely nursing professional behaviours; skill competence: general performance; skill competence: core nursing skills and skill competence: advanced nursing skills. There were 193 questionnaires returned with a response rate of 89%. The paired t-test was used to compare the differences between preferred and actual preceptorship experiences of students. The results showed significant differences (p<0.001) for the five questions. The mean for the preferred scores is higher than the actual scores resulting statistically significance. The maximum mean difference was accepted goal and the highest mean different was giving feedback. The Pearson Correlation Coefficient was used to examine the relationship. The results showed moderate correlations between nursing professional behaviours with asking questions and providing feedback. Providing useful feedback to students is having moderate correlations with all domains of the Clinical Competence Questionnaire (r=0.269 – 0.345). It is concluded that nursing students do not have a positive perception of the clinical preceptorship. Their perceptions are significantly different from their expected preceptorship. If students were given more opportunities to ask questions in a pedagogical atmosphere, their perceived clinical competence and learning outcomes could be improved as a result.

Keywords: clinical preceptor, clinical competence, clinical practicum, nursing students

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4122 Contribution of Automated Early Warning Score Usage to Patient Safety

Authors: Phang Moon Leng

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Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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4121 The Factors Affecting the Operations of the Industrial Enterprises of Cassava in the Northeast of Thailand

Authors: Thanasuwit Thabhiranrak

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This research aims to study factors that affected the operations of the cassava industrial enterprises in northeast of Thailand. Hypothesis was tested by regress analysis and also the analysis in order to determine the relationship between variables with Pearson correlation and show a class action in cassava process including the owner of business executives and supervisors. The research samples were 400 people in northeast region of Thailand. The research results revealed that success of entrepreneurs related to transformation leadership and knowledge management in a positive way at statistical significance level of 0.01 and respondents also emphasized on the importance of transformational leadership factors. The individual and the use of intelligence affect the success of entrepreneurs in cassava industry at statistical significance level of 0.05. The qualitative data were also collected by interviewing with operational level staff, supervisors, executives, and enterprise owners in the northeast of Thailand. The result was found that knowledge management was important in their business operations. Personnel in the organizations should learn from working experience, develop their skills, and increase knowledge from education.

Keywords: transformational leadership, knowledge management (KM), cassava, northeast of Thailand, industrial

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4120 Synthesis, Antibacterial Activities, and Synergistic Effects of Novel Juglone and Naphthazarin Derivatives Against Clinical Methicillin-Resistant Staphylococcus aureus Strains

Authors: Zohra Benfodda, Valentin Duvauchelle, Chaimae Majdi, David Bénimélis, Catherine Dunyach-Remy, Patrick Meffre

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New antibiotics are necessary to treat microbial pathogens, especially ESKAPE pathogens that are becoming increasingly resistant to available treatment. Despite the medical need, the number of newly approved drugs continues to decline. The majority of antibiotics under clinical development are natural products or derivatives thereof. 43 juglone/naphthazarin derivatives were synthesized using Minisci-type direct C–H alkylation and evaluated for their antibacterial properties against various clinical and reference Gram-positive MSSA, clinical Gram-positive MRSA. Different compounds of the synthesized series showed promising activity against clinical and reference MSSA (MIC: 1–8 μg/ml) and good efficacy against clinical MRSA (MIC: 2–8 μg/ml) strains. The synergistic effects of active compounds were evaluated with reference antibiotics (vancomycin and cloxacillin), and it was found that the antibiotic combination with those active compounds efficiently enhanced the antimicrobial activity and consequently the MIC values of reference antibiotics were lowered up to 1/16th of the original MIC. These synthesized compounds did not present hemolytic activity on sheep red blood cells. In addition to the in silico prediction of ADME profile parameter which is promising and encouraging for further development.

Keywords: juglone, naphthazarin, antibacterial, clinical MRSA, synergistic studies, MIC determination

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4119 Followership Styles in the U.S. Hospitality Workforce: A Multi-Generational Comparison Study

Authors: Yinghua Huang, Tsu-Hong Yen

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The latest advance in leadership research has revealed that leadership is co-created through the combined action of leading and following. The role of followers is as important as leaders in the leadership process. However, the previous leadership studies often conceptualize leadership as a leader-centric process, while the role of followers is largely neglected in the literature. Until recently, followership studies receives more attention because the character and behavior of followers are as vital as the leader during the leadership process. Yet, there is a dearth of followership research in the context of tourism and hospitality industries. Therefore, this study seeks to fill in the gap of knowledge and investigate the followership styles in the U.S. hospitality workforce. In particular, the objectives of this study are to identify popular followership practices among hospitality employees and evaluate hospitality employees' followership styles using Kelley’s followership typology framework. This study also compared the generational differences in followership styles among hospitality employees. According to the U.S. Bureau of Labor Statistics, the workforce in the lodging and foodservice sectors consists of around 12% baby boomers, 29% Gen Xs, 23% Gen Ys, and 36% Gen Zs in 2019. The diversity of workforce demographics in the U.S. hospitality industry calls for more attention to understand the generational differences in followership styles and organizational performance. This study conducted an in-depth interview and a questionnaire survey to collect both qualitative and quantitative data. A snowball sampling method was used to recruit participants working in the hospitality industry in the San Francisco Bay Area, California, USA. A total of 120 hospitality employees participated in this study, including 22 baby boomers, 32 Gen Xs, 30 Gen Ys, and 36 Gen Zs. 45% of the participants were males, and 55% were female. The findings of this study identified good followership practices across the multi-generational participants. For example, a Gen Y participant said that 'followership involves learning and molding oneself after another person usually an expert in an area of interest. I think of followership as personal and professional development. I learn and get better by hands-on training and experience'. A Gen X participant said that 'I can excel by not being fearful of taking on unfamiliar tasks and accepting challenges.' Furthermore, this study identified five typologies of Kelley’s followership model among the participants: 45% exemplary followers, 13% pragmatist followers, 2% alienated followers, 18% passive followers, and 23% conformist followers. The generational differences in followership styles were also identified. The findings of this study contribute to the hospitality human resource literature by identifying the multi-generational perspectives of followership styles among hospitality employees. The findings provide valuable insights for hospitality leaders to understand their followers better. Hospitality leaders were suggested to adjust their leadership style and communication strategies based on employees' different followership styles.

Keywords: followership, hospitality workforce, generational diversity, Kelley’s followership topology

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4118 First Time Voters Representation of Leadership as Exemplified by 2016 Presidentiables

Authors: Fevy Kae Mateo, Kimberly Javier, Alyzza Marie Palles

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Leadership is a process of relationship involving interaction with other people. Leaders emphasise authority, which executes and implements regulations, maintains the rules and leads to a better future. The First Time voters are very significant because there are the stakeholders of the type of leader to be deployed. They also have the capacity of engaging the government and can be the agents of change. The objective of the study is to identify the strengths and weaknesses of leader. Moreover, the study identifies the qualities of a leader. Finally, the study determines first-time voter’s representation of a leader. Focus Group Discussion was carried out into two groups of first time voter’s ages 18 to 21 years old. Verbatim transcripts of the discussion were analyzed using Thematic Analysis. Overall results showed super ordinate themes for weaknesses of leader: Lace of transparency in the government, poor communication strategy, and valuing experience over potential and other contributory factor; for strength of a leader: analytical skill, emotional intelligence in political work, analytical ability and economic status on political participation; finally, in the representation of a leader: positive representation of a leader and negative representation of a leader.

Keywords: first time voters, focus group discussion, leadership, qualitative research design

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4117 A Script for Presentation to the Management of a Teaching Hospital on DXplain Clinical Decision Support System

Authors: Jacob Nortey

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Introduction: In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. According to the Ibero – American Study of Adverse Effects (IBEAS), about 10% of hospital patients suffer from secondary damage during the care process, and approximately 2% die from this process. Many clinical decision support systems have been developed to help mitigate some healthcare medical errors. Method: Relevant databases were searched, including ones that were peculiar to the clinical decision support system (that is, using google scholar, Pub Med and general google searches). The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of Dxplain Clinical decision support systems. Results: Inferences drawn from the articles showed high usage of Dxplain clinical decision support system for problem-based learning among students in developed countries as against little or no usage among students in Low – and Middle – income Countries. The results also indicated high usage among general practitioners. Conclusion: Despite the challenges Dxplain presents, the benefits of its usage to clinicians and students are enormous.

Keywords: dxplain, clinical decision support sytem, diagnosis, support systems

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4116 The Constitution of Kenya, 2010, and the Feminist Legal Theory

Authors: Tecla Rita Karendi, Andy Cons Matata

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Although before and at the advent of colonial administration, several women such as Mekatilili wa Menza and Muthoni Nyanjiru took up leadership positions in resisting the colonial administration. Kenya is generally considered a patriarchal society. Many women who tried to take up positions of leadership in postcolonial Kenya, such as the Nobel Prize winner Wangari Maathai, were branded as prostitutes or generally immoral women. However, the Constitution of Kenya, 2010, has since made a huge impact not only in the area of affirmative action but also in various aspects of the feminist legal theory such as the constitutional requirement that no more than two-thirds of the members of the elective or appointive bodies should be of the same gender. This favours women who are often sidelined in elective posts such as parliament or county assemblies and state-appointed posts in the parastatals and commissions. The constitution also recognizes the right to abortion, which was outrightly outlawed in the independence constitution. Certain practices adverse to women’s health, such as wife inheritance, female genital mutilation, and property rights, are either outlawed or framed to recognized women’s rights. The education of the girl-child is also now considered a priority, unlike in the past. Despite these developments, a lot remains to be done.

Keywords: feminist legal theory, constitution of Kenya, 2010, affirmative action, leadership

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4115 Comparisons of Depressive Symptoms and Cognitive Appraisals in Different Age Groups under Abusive Leadership

Authors: Shao-Ying Wang, Shin-I Shih, Chi-Cheng Wu

Abstract:

Background: By following to the maturity theory about age, the manifestation of depression in different age groups under occupational stressors still remains unclear. Therefore, the aim of this study was to examine the depression within four main symptoms clusters: cognition, affect, physical complaints and interpersonal difficulty among the different age groups. Additionally, this study also used the stress appraisal theory, through the examination of challenge and hindrance appraisals, the effects of cognitive factors were expected to give therapeutic indication for the future treatment of depression under abusive leadership. Methods (Participants and Procedure): The data were collected in two waves from employees of local companies in Taiwan. The participants (58 males and 167 females) were native Chinese speakers, ranging in age from 20 to 59 years (M= 36.51). Up to 80% educational level of participants were above senior high. The married population was approximately at 43%. Measures; 1. Abusive Leadership: To measure abusive leadership, we used 15-item scale of abusive supervision which anchored on a 7-point Likert-type scale. (α= .96) 2. Depression: We used Taiwanese Depression Scale to measure the 4 clusters (cognition, affect, physical complaints and interpersonal difficulty) of symptoms. Participants responded for depression anchored on a 7-point Likert-type scale (α= .96). 3. Stress Appraisal Scale: To measure challenge and hindrance types of appraisal, participants responded to 33-item measure anchored on a 7-point Likert-type scale. (Challenge appraisal; α= .90; hindrance appraisal α= .87). Results: The results of correlation showed that there was a significant and negative correlation between abusive leadership and age (r = - .21, p < .01). Abusive leadership was positive correlated significantly with hindrance appraisal (r = .52, p < .01) and depression (r = .20, p < .01). The results also showed that hindrance appraisal was correlated to depression positively (r = .36, p < .01). A one-way ANOVA was conducted to compare the effect of lower/middle/order age groups on each cluster of depressive symptoms. The results showed that the effect of age groups on cognition was significant F (2, 157) =3.66, P < .05. Older age group (M=13.43 SD=6.84) reported less cognitive symptoms of depression than the middle (M=16.77 SD=7.49) and lower age (M=16.91 SD=6.97) groups. Besides, the effect of age groups on affect was also significant F (2,157)= 4.09 P < .05. Older age group (M=18.68 SD=8.98) reported less affective symptoms of depression than the middle (M=22.01 SD=7.96) and lower age (M=23.56 SD=7.67) groups. Moreover, the main effect of hindrance appraisal was found F (2, 157) =3.81, P < .05. Older age group (M=9.44 SD=2.89) reported fewer score on hindrance appraisals than the middle (M=11.06 SD=4.02) and lower age (M=9.62 SD=3.17) groups. To conclude, the severity of depression symptoms varies across different age groups. Maturity seems to be the protective factor to depression, accompanying with lower hindrance appraisals.

Keywords: abusive leadership, affective commitment, depression symptoms, psychological well-being

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4114 The Impact of Internal and External CSR on Organizational Citizenship Behavior and Performance: Mediation of Organizational Identification and Moderation of Ethical Leadership. A Cross-Cultural Study

Authors: Huma Sarwar, Muhammad Ishtiaq Ishaq, Junaid Aftab

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The hospitality sector contributes significantly to the global economy but it is also responsible for imposing adverse influences both environmentally and socially. The objective of this research is two-fold: (1) examining the direct impact of internal CSR and external CSR and indirect impact via organizational identification on creative performance and organizational citizenship behavior (OCB), and (2) determining the moderating role of ethical leadership in the relationships of internal- and external- CSR with organizational identification in a cross-cultural context. The data was were collected using multi-respondents and time-lagged data from 260 Pakistani and 239 UK respondents working in upscale hotels of the United Kingdom and Pakistan. The results demonstrate significant differences in both cultures as external CSR has a more substantial impact on organizational identification in the UK, whereas organizational identification has a relatively stronger influence on OCB and creative performance in collectivistic culture (i.e., Pakistan). The findings also confirmed that ethical leadership significantly moderates the relationship of internal- and external - CSR on organizational identification.

Keywords: Huma Sarwar, Muhammad Ishtiaq Ishaq, Junaid Aftab

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4113 Developing Telehealth-Focused Advanced Practice Nurse Educational Partnerships

Authors: Shelley Y. Hawkins

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Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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