Search results for: practices on pain management

Authors: Ahmed Torad

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Background: Knee osteoarthritis (OA) is a prevalent musculoskeletal condition characterized by pain and functional impairment. While various rehabilitation approaches have been employed, the effectiveness of high-intensity interval training (HIIT) compared to traditional rehabilitation exercises remains unclear. Objective: This randomized controlled trial aimed to compare the effects of HIIT and traditional rehabilitation exercises on pain reduction, functional improvement, and quality of life in individuals with knee OA. Methods: A total of 120 participants diagnosed with knee OA were randomly allocated into two groups: the HIIT group (n=60) and the traditional rehabilitation group (n=60). The HIIT group participated in a 12-week supervised program consisting of high-intensity interval exercises, while the traditional rehabilitation group followed a conventional physiotherapy regimen. Outcome measures included visual analog scale (VAS) pain scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form-36 Health Survey (SF-36) at baseline and after the intervention period. Results: Both groups showed significant improvements in pain scores, functional outcomes (WOMAC), and quality of life (SF-36) after 12 weeks of intervention. However, the HIIT group demonstrated superior pain reduction (p<0.001), functional improvement (p<0.001), and physical health-related quality of life (p=0.002) compared to the traditional rehabilitation group. No significant differences were observed in mental health-related quality of life between the two groups. Conclusion: High-intensity interval training appears to be a more effective rehabilitation approach than traditional exercises for individuals with knee osteoarthritis, resulting in greater pain reduction, improved function, and enhanced physical health-related quality of life. These findings suggest that HIIT may represent a promising intervention strategy for managing knee OA and enhancing the overall well-being of affected individuals.

Keywords: knee osteoarthritis, high-intensity interval training, traditional rehabilitation exercises, randomized controlled trial, pain reduction, functional improvement, quality of life

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Authors: M. Jonathan D. Morales, R. Ramón Silva

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The purpose of this project is to carry out an analysis and determine the profile of actual lean manufacturing processes in the Metropolitan Area of Bucaramanga. Through the analysis of qualitative and quantitative variables it was possible to establish how these manufacturers develop production practices that ensure their competitiveness and productivity in the market. In this study, a random sample of metallurgic and wrought iron companies was applied, following which a quantitative focus and analysis was used to formulate a qualitative methodology for measuring the level of lean manufacturing procedures in the industry. A qualitative evaluation was also carried out through a multivariate analysis using the Numerical Taxonomy System (NTSYS) program which should allow for the determination of Lean Manufacturing profiles. Through the results it was possible to observe how the companies in the sector are doing with respect to Lean Manufacturing Practices, as well as identify the level of management that these companies practice with respect to this topic. In addition, it was possible to ascertain that there is no one dominant profile in the sector when it comes to Lean Manufacturing. It was established that the companies in the metallurgic and wrought iron industry show low levels of Lean Manufacturing implementation. Each one carries out diverse actions that are insufficient to consolidate a sectoral strategy for developing a competitive advantage which enables them to tie together a production strategy.

Keywords: production line management, metallurgic industry, lean manufacturing, productivity

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Authors: Fatima El Zahra Amin, Emine Efe

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This study was carried out to evaluate the effect of the education program for parents of children with Sickle Cell Anemia, on the knowledge level of parents and the reduction of pain relief by non-pharmacological methods used by parents at home. In Turkey, 54 parents and 109 from Chad agreed to participate in the survey. The data were collected by the researcher using a face-to-face interview method. Non-pharmacological treatment information form for parents, face expressions rating scale, and parent education program for non-pharmacological methods used in children with sickle cell anemia were used. It was determined that there was a statistically significant difference between the educational status, occupation, disease status, place of residence, family structure and age of parents of Chad and Turkey. According to the ratings of facial expressions scale, it was concluded that there was no significant difference between the children’s average degree of pain before and after administration of non-pharmacological methods by the groups of Chad and Turkey. It was determined that the educational programs prepared for parents of children with sickle cell anemia in both Turkey and Chad were effective in increasing the knowledge level of parents and also in reducing pain crisis with non-pharmacological methods parents used at home.

Keywords: Chad, child, non-pharmacological treatment methods, nurse, sickle cell anemia, Turkey

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Authors: Hebert Sihle Ntuli

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Traditional cultural practices mirror or replicate the values and beliefs held by members of the community. Throughout the world, every social grouping has specific traditional practices, some of which are beneficial to all, while others have become harmful to specific group such as women. Like in some African states, these traditional cultural practices are performed in South Africa and are violating women’s rights. Women’s rights are human rights. The South African Constitution is one of the most progressive in the world, and notable includes the Bill of Rights which provides protection of socio-economic and cultural rights. Cultural rights are protected in Section 30 and 31 of the constitution, although such protection is not without limitation. This highly complex interplay and competition between human rights and cultural rights, which are manifested through cultural practices, is the golden thread that traces through this paper. The paper argues that there is conflict and the lack of balance between diverse cultural and legal or constitutional framework which promotes the value of human dignity and equality, especially for women. These practices are reviewed in connection with the South African government laws. This work adopted qualitative research method.

Keywords: cultural practices, conflict, South African constitution, laws

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Authors: Samuel Owoade, Zainab Idowu, Idris Ajibade, Abel Uzoka

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Cloud computing adoption continues to soar, with 83% of enterprise workloads estimated to be in the cloud by 2022. However, this rapid migration raises security concerns, needing strong security management solutions to safeguard sensitive data and essential applications. This paper investigates the critical role of technical project managers in orchestrating security management initiatives for cloud environments, evaluating their responsibilities, challenges, and best practices for assuring the resilience and integrity of cloud infrastructures. Drawing from a comprehensive review of industry reports and interviews with cloud security experts, this research highlights the multifaceted landscape of security management in cloud environments. Despite the rapid adoption of cloud services, only 25% of organizations have matured their cloud security practices, indicating a pressing need for effective management strategies. This paper proposes a strategy framework adapted to the demands of technical project managers, outlining the important components of effective cloud security management. Notably, 76% of firms identify misconfiguration as a major source of cloud security incidents, underlining the significance of proactive risk assessment and constant monitoring. Furthermore, the study emphasizes the importance of technical project managers in facilitating cross-functional collaboration, bridging the gap between cybersecurity professionals, cloud architects, compliance officers, and IT operations teams. With 68% of firms seeing difficulties integrating security policies into their cloud systems, effective communication and collaboration are critical to success. Case studies from industry leaders illustrate the practical use of security management projects in cloud settings. These examples demonstrate the importance of technical project managers in using their expertise to address obstacles and generate meaningful outcomes, with 92% of firms reporting improved security practices after implementing proactive security management tactics. In conclusion, this research underscores the critical role of technical project managers in safeguarding cloud environments against evolving threats. By embracing their role as guardians of the cloud realm, project managers can mitigate risks, optimize resource utilization, and uphold the trust and integrity of cloud infrastructures in an era of digital transformation.

Keywords: cloud security, security management, technical project management, cybersecurity, cloud infrastructure, risk management, compliance

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Authors: Emily Arangote

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This paper defined the association between the indigenous knowledge, cultural practices and the ecosystem its implication to the environmental education to the farmers. Farmers recognize the need for sustainability of the ecosystem they inhabit. The cultural practices of farmers on use of indigenous pest control, use of insect-repellant plants, soil management practices that suppress diseases and harmful pests and conserve soil moisture are deemed to be ecologically-friendly. Indigenous plant materials that were more drought- and pest-resistant were grown. Crop rotation was implemented with various crop seeds to increase their disease resistance. Multi-cropping, planting of perennial crops, categorization of soil and planting of appropriate crops, planting of appropriate and leguminous crops, alloting land as watershed, and preserving traditional palay seed varieties were found to be beneficial in preserving the environment. The study also found that indigenous knowledge about crops are still relevant and useful to the current generation. This ensured the sustainability of our environment and incumbent on policy makers and educators to support and preserve for generations yet to come.

Keywords: cultural practices, ecosystem, environmental education, indigenous knowledge

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Authors: Esther Simpson, Evans Addo Tetteh

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One of the most important sectors in Ghana’s economy is the oil and gas sector. Effective supply chain management is required to ensure the timely delivery of these products to the end users, given the rise in nationwide demand for petroleum products. Contrarily, freight forwarding plays a crucial role in facilitating intra- and intra-country trade, particularly the movement of oil goods. Nevertheless, there has not been enough scientific study done on how marketing, supply chain management, and freight forwarding are integrated in the oil business. By highlighting possible areas for development in the supply chain management of petroleum products, this article seeks to close this gap. The study was predominantly qualitative and featured semi-structured interviews with influential figures in the oil and gas sector, such as marketers, distributors, freight forwarders, and regulatory organizations. The purpose of the interviews was to determine the difficulties and possibilities for enhancing the management of the petroleum products supply chain. Thematic analysis was used to examine the data obtained in order to find patterns and themes that arose. The findings from the study revealed that the oil sector faced a number of issues in terms of supply chain management. Inadequate infrastructure, insufficient storage facilities, a lack of cooperation among parties, and an inadequate regulatory framework were among the obstacles. Furthermore, the study indicated significant prospects for enhancing petroleum product supply chain management, such as the integration of more advanced digital technologies, the formation of strategic alliances, and the adoption of sustainable practices in petroleum product supply chain management. The study's conclusions have far-reaching ramifications for the oil and gas sector, freight forwarding, and Ghana’s economy as a whole. Marketing, supply chain management, and freight forwarding has high prospects from being integrated to improve the efficiency of the petroleum product supply chain, resulting in considerable cost savings for the industry. Furthermore, the use of sustainable practices will improve the industry's sustainability and lessen the environmental effect of the petroleum product supply chain. Based on the findings, we propose that stakeholders in Ghana’s oil and gas sector work together and collaborate to enhance petroleum supply chain management. This collaboration should include the use of digital technologies, the formation of strategic alliances, and the implementation of sustainable practices. Moreover, we urge that governments establish suitable rules to guarantee the efficient and sustainable management of petroleum product supply chains. In conclusion, the integration and combination of marketing, supply chain management, and freight forwarding in the oil business gives a tremendous opportunity for enhancing petroleum product supply chain management. The study's conclusions have far-reaching ramifications for the sector, freight forwarding, and the economy as a whole. Using sustainable practices, integrating digital technology, and forming strategic alliances will improve the efficiency and sustainability of the petroleum product supply chain. We expect that this conference paper will encourage more study and collaboration among oil and gas sector stakeholders to improve petroleum supply chain management.

Keywords: collaboration, logistics, sustainability, supply chain management

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Authors: N. Anusree, P. Sughosh, G. L. Sivakumar Babu

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Municipalities throughout the world are marred with serious issues related to the Municipal Solid Waste (MSW) collection, treatment, and safe disposal. While the Waste Management sector contributes around 3-9 % of the overall anthropogenic methane emission, measures towards mitigating these emissions are rarely given attention in developing countries. In the case of Bangalore, India, around 5680 tons of MSW is generated in a day, and its collection and treatment efficiency are around 90-95 % and 26.4 %, respectively. About 33.4 % of the waste collected is directly landfilled without any treatment, further aggravating the situation. The potential of reducing the emissions emanating from the MSW of Bangalore city without any severe consequences on the current MSW management practices is evaluated in this study. Three emission scenarios consisting of the baseline condition (current practices – Case-1), the application of biocovers for methane oxidation in the dumpsites (case-2), and the diversion of Organic Fraction of MSW (OFMSW) along with the application of biocovers (case-3) are evaluated and compared with each other. The emissions are calculated based on the aerobic and anaerobic stochiometric relations for the three scenarios. Laboratory scale column studies are carried out to determine the methane oxidation potential of three different biocover material (digested MBT (mechanically biologically treated) waste, Fresh MBT waste, and charcoal amended with fresh MBT waste). The results shown that around 40 % and 83 % reduction in carbon emissions can be achieved in case 3 and 2 in comparison to the baseline condition. The study clearly shows that with minor changes in the waste management practices, substantial reductions in the carbon emissions can be attained in Bangalore City.

Keywords: MSW, biocover, composting, carbon emission

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Authors: Raman Sharma, S. K. Jain

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Aims and Objectives: Fixation of the mesh during laparoscopic total extraperitoneal (TEP) repair of inguinal hernia is thought to be necessary to prevent recurrence. However, mesh fixation may increase surgical complications and postoperative pain. Our objective was to compare the outcomes of nonfixation with fixation of polypropylene mesh by metal tacks during TEP repair of inguinal hernia. Methods: Forty patients aged 18 to72 years with inguinal hernia were included who underwent laparoscopic TEP repair of inguinal hernia with (n=20) or without (n=20) fixation of the mesh. The outcomes were operative duration, postoperative pain score, cost, in-hospital stay, time to return to normal activity, and complications. Results: Patients in whom the mesh was not fixed had shorter mean operating time (p < 0.05). We found no difference between groups in the postoperative pain score, incidence of recurrence, in-hospital stay, time to return to normal activity and complications (P > 0.05). Moreover, a net cost savings was realized for each hernia repair performed without stapled mesh. Conclusions: TEP repair without mesh fixation resulted in the shorter operating time and lower operative cost with no difference between groups in the postoperative pain score, incidence of recurrence, in-hospital stay, time to return to normal activity and complications. All this contribute to make TEP repair without mesh fixation a better choice for repair of uncomplicated inguinal hernia, especially in developing nations with scarce resources.

Keywords: postoperative pain score, inguinal hernia, nonfixation of mesh, total extra peritoneal (TEP)

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Authors: Mohammed Aman Kassim

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This study explored the attitudes of hotel managers toward climate change adaption and mitigation practices in resort hotels located in Bishoftu town, Ethiopia. Weak resource management in the area causes serious environmental problems. So sustainable way forward is needed for the destination in order to reduce environmental damage. Six resorts were selected out of twelve resort hotels in Bishoftu City by using the systematic sampling method, and a total of fifty-six managers were taken for the study. The data analyzed came from self-administered questionnaires, site observation, and a short face-to-face interview with general managers. The results showed that 99% of hotel managers possess positive attitudes toward climate change adaptation and mitigation practices. But they did not show a high commitment to adopting all adaptation and mitigation practices in their hotel’s actions and day-to-day operation. Key adoption influencing factors identified were: owners' commitment toward sustainability, the applicability of government rules and regulations, and incentives for good achievement. The findings also revealed that the attitudes of resort hotel managers toward climate change adaption and mitigation practices are more significantly influenced by their social factors, such as level of education and age, in this study. The study demonstrated that in order to increase managers' commitment and hotels become green: government led-education and training programs, green certification actions, and application of government environmental regulation are important.

Keywords: climate change, climate change adaptation and mitigation practices, environmental attitude, resort hotels

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Authors: Zakari Mustapha, Clinto Aigbavboa, Wellinton Didi Thwala

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Occupational Health and Safety (OHS) issues has been a major challenge to the Ghanaian government. The purpose of the study was to examine OHS practices in Ghana. The study looked at various views from different scholars about OHS practices in order to achieve the objective of the study. Literature review was conducted on OHS in Ghana. Findings from the study shows Ministry of Roads and Transport (MRT) and Ministry of Water Resources, Works and Housing (MWRWH) are two government ministries in charge of construction and implementation of the construction sector policy. The Factories, Offices and Shops Act 1970, Act 328 and the Mining Regulations 1970 LI 665 are the two major edicts. The study presents a strong background on OHS practices in Ghana and contribute to the body of knowledge on the solution to the current trends and challenges of OHS in the construction sector.

Keywords: ILO convention, OHS challenges, OHS practices, OHS improvement

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Authors: Prakash Singh

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The question that arises is whether a theory such as the Collegial Leadership Model of Emancipation (COLME) has the potency to introduce leadership change by empowering and emancipating their employees. It is a fallacy to simply assume that experience alone, in the absence of theory, will contribute to this knowledge base to develop collegial leaders. The focus of this study is to therefore ascertain whether the COLME can serve as a conceptual framework to transform traditional bureaucratic management practices (TBMPs) in order to promote shared decision-making in organizations such as schools. All the respondents in this exploratory qualitative study embraced collegiality to transform TBMPs in their organizations. For the positive effects to be sustained, the collegial practices need to be evolutionary and emancipatory in order to evoke the values of collegial leadership as elucidated by the findings of this study. Interviewees affirmed that the COLME provides an astute framework to develop commendable collegial leadership practices as it clearly outlines procedures to develop and use the leadership potential of all the employees in order to foster joint accountability. They acknowledged that when the principles of collegiality are flexibly applied, they contribute to the creation of a holistic milieu in which all employees are able to express themselves freely, without fear of failure, and thus feel that they are part of the democratic decision-making process. Evidently, a conceptual framework such as the COLME can serve as a benchmark for leadership effectiveness because organizational outcomes need to be measured against standards of excellence in meeting both employee and customer expectations.

Keywords: collegial leadership model, employee empowerment, shared decision-making, traditional bureaucratic management practices

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Authors: Abhijit Trailokya, Kamlesh Patel

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Background: Hypertension is a common disease seen in clinical practice and is associated with high morbidity and mortality. Many patients require combination therapy for the management of hypertension. Objective: To evaluate co-morbidities, risk factors and management practices of hypertension in Indian population. Material and methods: A total of 1596 hypertensive adult patients received anti-hypertensive medications were studied in a cross-sectional, multi-centric, non-interventional, observational registry. Statistical analysis: Categories or nominal data was expressed as numbers with percentages. Continuous variables were analyzed by descriptive statistics using mean, SD, and range Chi square test was used for in between group comparison. Results: The study included 73.50% males and 26.50% females. Overweight (50.50%) and obesity (30.01%) was common in the hypertensive patients (n=903). A total of 54.76% patients had history of smoking. Alcohol use (33.08%), sedentary life style (32.96%) and history of tobacco chewing (17.92%) were the other lifestyle habits of hypertensive patients. Diabetes (36.03%) and dyslipidemia (39.79%) history was common in these patients. Family history of hypertension and diabetes was seen in 82.21% and 45.99% patients respectively. Most (89.16%) patients were treated with combination of antihypertensive agents. ARBs were the by far most commonly used agents (91.98%) followed by calcium channel blockers (68.23%) and diuretics (60.21%). ARB was the most (80.35%) preferred agent as monotherapy. ARB was also the most common agent as a component of dual therapy, four drug and five drug combinations. Conclusion: Most of the hypertensive patients need combination treatment with antihypertensive agents. ARBs are the most preferred agents as monotherapy for the management of hypertension. ARBs are also very commonly used as a component of combination therapy during hypertension management.

Keywords: antihypertensive, hypertension, management, ARB

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Authors: Larry Audet

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Creativity is suddenly and fortunately a new educational focus in the United Arab Emirates and around the world. Yet still today many leaders of creativity are not sure how to introduce it to their teachers. It is impossible to simultaneously introduce every aspect of creativity into a work climate and reach any degree of organizational coherence. The number of alternatives to explore is so great; the information teachers need to learn is so vast, that even an approximation to including every concept and theory of creativity into the school organization is hard to conceive. Effective leaders of creativity need evidence-based and practical guidance for introducing and stimulating creativity in others. Machine learning models reveal new findings from KEYS Survey© data about teacher perceptions of stimulants and barriers to their individual and collective creativity. Findings from predictive and causal models provide leaders with a rational for decision-making when introducing creativity into their organization. Leaders should focus on management practices first. Analyses reveal that creative outcomes are more likely to occur when teachers perceive supportive management practices: providing teachers with challenging work that calls for their best efforts; allowing freedom and autonomy in their practice of work; allowing teachers to form creative work-groups; and, recognizing them for their efforts. Once management practices are in place, leaders should focus their efforts on modeling risk-taking, providing optimal amounts of preparation time, and evaluating teachers fairly.

Keywords: creativity, leadership, KEYS survey, teaching, work climate

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Authors: Nuran Öze

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With the rapid changes occurring in the last twenty five years, mobile phone technology has influenced every aspect of life. Technological developments within the Internet and mobile phone areas have not only changed communication practices; it has also changed the everyday life practices of individuals. This article has focused on understanding how people’s communication practices and everyday life practices have changed with the smartphone usage. The study was conducted by using in-depth interview method and the research was conducted on twenty Turkish Cypriots who live in Northern Cyprus. According to the research results, communicating via Internet has rapidly replaced face to face communication in recent years. However, results have changed according to generations. Younger generations can easily adapt themselves to technological changes because they are already gaining everyday life practices right now. However, the older generations practices are already present in their everyday life.

Keywords: face to face communication, internet, mobile technologies, north Cyprus

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Authors: E. Hegazy, S. Anderberg, J. Krook

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The city's wire-based infrastructure systems (WBIS) are responsible for the delivery of electricity, telecommunications, sanitation, drainage, and district heating and are a necessity for sustainable modern urban life. Maintaining the functionality of these structures involves high costs and, brings disturbance to the local community and effects on the environment. One key reason for this is that the cables and pipes are placed under streets, making system parts easily worn and their service lifetime reduced, and all maintenance and renewal rely on recurrent needs for excavation. In Sweden, a significant part of wire-based infrastructure is already outdated and will need to be replaced in the coming decades. The replacement of these systems will entail massive costs as well as important traffic disruption and environmental disturbance. However, this challenge may also open a unique opportunity to introduce new, more sustainable technologies and management practices. The transformation of WBIS management for long-term sustainability and meeting maintenance and renewal needs does not have a comprehensive approach. However, a systemic approach may inform WBIS management. This approach considers both technical and non-technical aspects, as well as time-related factors. Nevertheless, there is limited systemic knowledge of how different factors influence current management practices. The aim of this study is to address this knowledge gap and contribute to the understanding of what factors influence the current practice of WBIS management. A case study approach is used to identify current management practices, the underlying factors that influence them, and their implications for sustainability outcomes. The case study is based on both quantitative data on the local system and data from interviews and workshops with local practitioners and other stakeholders. Linköping was selected as a case since it provided good accessibility to the water administration and relevant data for analyzing water infrastructure management strategies. It is a sufficiently important city in Sweden to be able to identify challenges, which, to some extent, are common to all Swedish cities. By uncovering current practices and what is influencing Linköping, knowledge gaps and uncertainties related to sustainability consequences were highlighted. The findings show that goals, priorities, and policies controlling management are short-termed, and decisions on maintenance and renewal are often restricted to finding solutions to the most urgent issues. Sustainability transformation in the infrastructure area will not be possible through individual efforts without coordinated technical, organizational, business, and regulatory changes.

Keywords: case study, infrastructure, management, practice, Sweden

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Authors: Nolitha L. Skenjana, Bongani P. Kubheka, Maxwell A. Poswal

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The Eastern Cape Province of South Africa is characterized by subsistence farming, which is mostly distributed in the rural areas of the province. It is estimated that cereal crops such as maize and sorghum, and vegetables such as cabbage are grown in more than 400.000 rural households, with maize being the most dominant crop. However, compared to commercial agriculture, small-scale farmers receive minimal support from research and development, limited technology transfer on the latest production practices and systems and have poor production infrastructure and equipment. Similarly, there is limited farmers' appreciation on best practices in insect pest management and control. The paper presents findings from the primary literature and personal observations on insect pest management practices of small-scale farmers in the province. Inferences from literature and personal experiences in the production areas have led to a number of deductions regarding the level of exposure and extent of vulnerability. Farmers' pest management practices, which included not controlling at all though there is a pest problem, resulted in their crop stands to be more vulnerable to pest attacks. This became more evident with the recent brown locust, African armyworm, and Fall armyworm outbreaks, and with the incidences of opportunistic phytophagous insects previously collected on wild hosts only, found causing serious damages on crops. In most of these occurrences, damage to crops resulted in low or no yield. Improvements on farmers' reaction and response to pest problems were only observed in areas where focused awareness campaigns and trainings on specific pests and their management techniques were done. This then calls for a concerted effort from all role players in the sphere of small-scale crop production, to train and equip farmers with relevant skills, and provide them with information on affordable and climate-smart strategies and technologies in order to create a state of preparedness. This is necessary for the prevention of substantial crop losses that may exacerbate food insecurity in the province.

Keywords: Eastern Cape Province, small-scale farmers, insect pest management, vulnerability

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Authors: Jill Round

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In the economic system, the financial sector plays a crucial role as an intermediary between market participants, other financial institutions, and customers. Financial institutions such as banks have to make decisions to satisfy the demands of all the participants by keeping abreast of regulatory change. In recent years, progress has been made regarding frameworks, development of rules, standards, and processes to manage risks in the banking sector. The increasing focus of regulators and policymakers placed on risk management, corporate governance, and the organization’s culture is of special interest as it requires a well-resourced risk controlling function, compliance function, and internal audit function. In the past years, the relevance of these functions that make up the so-called Three Lines of Defense has moved from the backroom to the boardroom. The approach of the model can vary based on the various organizational characteristics. Due to the intense regulatory requirements, organizations operating in the financial sector have more mature models. In less regulated industries there is more cloudiness about what tasks are allocated where. All parties strive to achieve their objectives through the effective management of risks and serve the identical stakeholders. Today, the Three Lines of Defense model is used throughout the world. The research looks at trends and emerging issues in the professions of the Three Lines of Defense within the banking sector. The answers are believed to helping to explain the increasing regulatory requirements for the banking sector. While the number of supervisory practices increases the risk management requirements intensify and demand more regulatory compliance at the same time. The Structural Equation Modeling (SEM) is applied by making use of conducted surveys in the research field. It aims to describe (i) the theoretical model regarding the applicable linearity relationships, (ii) the causal relationship between multiple predictors (exogenous) and multiple dependent variables (endogenous), (iii) taking into consideration the unobservable variables and (iv) the measurement errors. The surveys conducted on the research field suggest that the observable variables are caused by various latent variables. The SEM consists of the 1) measurement model and the 2) structural model. There is a detectable correlation regarding the cause-effect relationship among the performed supervisory practices and the increasing scope of regulation. Supervisory practices reinforce the regulatory density. In the past, controls were placed after supervisory practices were conducted or incidents occurred. In further research, it is of interest to examine, whether risk management is proactive, reactive to incidents and supervisory practices or can be both at the same time.

Keywords: risk management, structural equation model, supervisory practice, three lines of defense

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Authors: Nicolas Koslover, Tamara Levene

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Aims: Tonsilitis is one of the most common presentations to the A+E department. We aimed to assess whether patients presenting with tonsilitis are being managed in-line with current guidance. We then set out to educate A+E staff about tonsilitis management and then assessed for improvement in management. Methods: All patients presenting to A+E in one fortnight with a documented diagnosis of tonsilitis were included. We reviewed the notes to assess the choice of treatment in each case and whether a clinical score (CENTOR or FEVERPain score) was used to guide choice of treatment (in accordance with NICE guideline [NG84]). We designed and delivered an educational intervention for A+E staff covering tonsilitis guidelines. The audit was repeated two weeks later. Results: Over the study period, 49 patients were included; only 35% (n=17) had either a clinical score documented or had all components of a score recorded. In total, 39% (n=19) were treated with antibiotics. Of these, 63% (n=12) should not have been prescribed an antibiotic and 37% (n=7) were prescribed an inappropriate antibiotic. At re-audit, (n=50 cases), 58% (n=29) had a clinical score documented and 28% (n=14) were treated with antibiotics. Of these, 29% (n=4) should not have been prescribed antibiotics and 21% (n=3) were prescribed an inappropriate antibiotic. Thus, after this teaching session, there was a significant improvement in antibiotic prescribing practices (63% vs. 29%, p=0.026). Conclusions: A+E assessment and management of tonsilitis frequently deviated from guidelines, but a single teaching session vastly improved clinical scoring and antibiotic prescribing practices.

Keywords: tonsilitis, education, emergency medicine, ENT

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Authors: Ghazanfar Bozai, Kanwal Gul

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In Pakistan, SMEs are the major source of contribution to the economy, but due to lack of proper HR practices (lack of employee engagement), these fast growing business shut down with in few years of startup. The purpose of this study is to conduct a comprehensive literature survy of the major best practices used for employee engagement globally. This paper could be used as employee engagement best practices guide for SME’s in developing countries. This article is focused on identifying the attributes of employee engagement in different countries/ cultures and organizations. It will provide a summary of employee engagement models used globally and how SMEs could pick suitable attributes of employee engagement as per their structural culture. This article will add valuable literature on employee engagement in developing countries for new startups and small, medium business.

Keywords: attributes, employee engagement, human resources practices, small medium enterprises

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Authors: Pascale Brasseur, Binu Gurung, Nicholas Halfpenny, James Eaton

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Development of minimally invasive treatments in recent years provides a potential alternative to invasive surgical interventions which are of limited value to patients with spinal metastases due to short life expectancy. A systematic review was conducted to explore the efficacy and safety of radiofrequency ablation (RFA), a minimally invasive treatment in patients with spinal metastases. EMBASE, Medline and CENTRAL were searched from database inception to March 2017 for randomised controlled trials (RCTs) and non-randomised studies. Conference proceedings for ASCO and ESMO published in 2015 and 2016 were also searched. Fourteen studies were included: three prospective interventional studies, four prospective case series and seven retrospective case series. No RCTs or studies comparing RFA with another treatment were identified. RFA was followed by cement augmentation in all patients in seven studies and some patients (40-96%) in the remaining seven studies. Efficacy was assessed as pain relief in 13/14 studies with the use of a numerical rating scale (NRS) or a visual analogue scale (VAS) at various time points. Ten of the 13 studies reported a significant decrease in pain outcome, post-RFA compared to baseline. NRS scores improved significantly at 1 week (5.9 to 3.5, p < 0.0001; 8 to 4.3, p < 0.02 and 8 to 3.9, p < 0.0001) and this improvement was maintained at 1 month post-RFA compared to baseline (5.9 to 2.6, p < 0.0001; 8 to 2.9, p < 0.0003; 8 to 2.9, p < 0.0001). Similarly, VAS scores decreased significantly at 1 week (7.5 to 2.7, p=0.00005; 7.51 to 1.73, p < 0.0001; 7.82 to 2.82, p < 0.001) and this pattern was maintained at 1 month post-RFA compared to baseline (7.51 to 2.25, p < 0.0001; 7.82 to 3.3; p < 0.001). A significant pain relief was achieved regardless of whether patients had cement augmentation in two studies assessing the impact of RFA with or without cement augmentation on VAS pain scores. In these two studies, a significant decrease in pain scores was reported for patients receiving RFA alone and RFA+cement at 1 week (4.3 to 1.7. p=0.0004 and 6.6 to 1.7, p=0.003 respectively) and 15-36 months (7.9 to 4, p=0.008 and 7.6 to 3.5, p=0.005 respectively) after therapy. Few minor complications were reported and these included neural damage, radicular pain, vertebroplasty leakage and lower limb pain/numbness. In conclusion, the efficacy and safety of RFA were consistently positive between prospective and retrospective studies with reductions in pain and few procedural complications. However, the lack of control groups in the identified studies indicates the possibility of selection bias inherent in single arm studies. Controlled trials exploring efficacy and safety of RFA in patients with spinal metastases are warranted to provide robust evidence. The identified studies provide an initial foundation for such future trials.

Keywords: pain relief, radiofrequency ablation, spinal metastases, systematic review

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Authors: Fazle Rabbi, Mashuda Khanom Tithi, Tasnim Mirza, Sanjida Rowshan Anannya, Ahmed Hossain

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Background: Low Back Pain (LBP) is one of the common health problems among the garment workers that causes workers absenteeism from the work. The purpose of the study is to identify the association between occupational factors and LBP among the female garment workers in Bangladesh. Materials and Methods: A cross-sectional study was conducted with 487 female garment workers from three compliant garment factories of Bangladesh. Face-to-face interview on four different LBP measures along with questions on socio-demographic, occupational, and physical factors were used to collect the data. Result: The prevalence rates for LBP lasts for at least one day during the last six months, chronic pain, intense pain, and seeking medical care for LBP were found 63.04%, 38.60%, 13.76%, and 18.89%, respectively among the female garments workers. The multivariate logistic regression analysis indicates that duration of employment (>5 years), regular weight bearing and extended weekly working hours (>48 hours) are positively associated with LBP. Besides, age, BMI, family income, marital status and number of children are also found positively associated with the LBP measures. Conclusion: The prevalence of LBP among female garment workers in Bangladesh is found high. The duration of employment (>5 years), regular weight bearing and extended weekly working hours (>48 hours) play a significant role in developing LBP among the female workers. Factories need to consider training programs on the appropriate technique of weight bearing. It is also important to conduct regular screening programs to identify LBP, especially with married, overweight/obese and older age group to reduce the occurrence of LBP.

Keywords: Bangladesh, garment workers, low back pain, occupational health

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Authors: Shaheeb Abdul Azeez, Siong-Choy Chong

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Background: Talent retention is increasingly becoming a major challenge for many industries due to the high turnover rate. Public higher learning institutions in the Maldives have a similar situation with the turnover of their employees'. This paper is to identify whether Human Resource Management (HRM) practices have any impact on employee retention in public higher learning institutions in the Maldives. Purpose: This paper aims to identify the influence of HRM practices on employee retention in public higher learning institutions in the Maldives. A total of 15 variables used in this study; 11 HRM practices as independent variables (leadership, rewards, salary, employee participation, compensation, training and development, career development, recognition, appraisal system and supervisor support); job satisfaction and motivation as mediating variables; demographic profile as moderating variable and employee retention as dependent variable. Design/Methodology/Approach: A structured self-administered questionnaire was used for data collection. A total of 300 respondents were selected as the study sample, representing the academic and administrative from public higher learning institutions using a stratified random sampling method. AMOS was used to test the hypotheses constructed. Findings: The results suggest that there is no direct effect between the independent variable and dependent variable. Also, the study concludes that no moderate effects of demographic profile between independent and dependent variables. However, the mediating effects of job satisfaction and motivation in the relationship between HRM practices and employee retention were significant. Salary had a significant influence on job satisfaction, whilst both compensation and recognition have significant influence on motivation. Job satisfaction and motivation were also found to significantly influence employee retention. Research Limitations: The study consists of many variables more time consuming for the respondents to answer the questionnaire. The study is focussed only on public higher learning institutions in the Maldives due to no participation from the private sector higher learning institutions. Therefore, the researcher is unable to identify the actual situation of the higher learning industry in the Maldives. Originality/Value: To our best knowledge, no study has been conducted using the same framework throughout the world. This study is the initial study conducted in the Maldives in this study area and can be used as a baseline for future researches. But there are few types of research conducted on the same subject throughout the world. Some of them concluded with positive findings while others with negative findings. Also, they have used 4 to 7 HRM practices as their study framework.

Keywords: human resource management practices, employee retention, motivation, job satisfaction

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Authors: Clement Yeboah

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Prior research concludes that environmental commitment positively drives organisational performance. Nonetheless, the nexus and conditions under which environmental commitment capabilities contribute to a firm’s performance are less understood. The purpose of this quantitative relational study was to examine the relationship between environmental commitment and 500 firms’ performances in Ghana. The researchers further seek to draw insights from the resource-based view to conceptualize environmental commitment and green procurement practices as resource capabilities to enhance firm performance. The researchers used insights from the contingent resource-based view to examine green leadership orientation conditions under which environmental commitment capability contributes to firm performance through green procurement practices. The study’s conceptual framework was tested on primary data from some firms in the Ghanaian market. PROCESS Macro was used to test the study’s hypotheses. Beyond that, green procurement practices mediated the association between environmental commitment capabilities and the firm’s performance. The study further seeks to find out whether green leadership orientation positively moderates the indirect relationship between environmental commitment capabilities and firm performance through green procurement practices. While conventional wisdom suggests that improved environmental commitment capabilities help improve a firm’s performance, this study tested this presumed relationship between environmental commitment capabilities and firm performance and provides theoretical arguments and empirical evidence to justify how green procurement practices uniquely and in synergy with green leadership orientation transform this relationship. The study results indicated a positive correlation between environmental commitment and firm performance. This result suggests that firms that prioritize environmental sustainability and demonstrate a strong commitment to environmentally responsible practices tend to experience better overall performance. This includes financial gains, operational efficiency, enhanced reputation, and improved relationships with stakeholders. The study's findings inform policy formulation in Ghana related to environmental regulations, incentives, and support mechanisms. Policymakers can use the insights to design policies that encourage and reward firms for their environmental commitments, thereby fostering a more sustainable and environmentally responsible business environment. The findings from such research can influence the design and development of educational programs in Ghana, specifically in fields related to sustainability, environmental management, and corporate social responsibility (CSR). Institutions may consider integrating environmental and sustainability topics into their business and management courses to create awareness and promote responsible practices among future business professionals. Also the study results can also promote the adoption of environmental accounting practices in Ghana. By recognizing and measuring the environmental impacts and costs associated with business activities, firms can better understand the financial implications of their environmental commitments and develop strategies for improved performance.

Keywords: firm’s performance, green procurement practice, environmental commitment, environmental management, sustainability

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Authors: Ngong Eugene Ekia

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Education is the foundation for the success of any society as its impact transcends across all sectors, including economics, politics, and social welfare. It is through education that individuals acquire the necessary knowledge and skills to succeed in life and contribute meaningfully to society. However, the world is changing rapidly, and it is vital for education systems to adapt to these changes to remain relevant. In this paper, we will discuss the current trends and challenges in education and management and propose solutions that can enable individuals to thrive in an ever-evolving world.

Keywords: access to education, effective teaching and learning, strong management practices, and empowering and personal development

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Authors: Sapana Purandare

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The landscape of school leadership is evolving with the changing world of the 21st century. In this era, it is crucial to adapt our approaches to school leadership, with the school leader playing an important role in shaping the educational system. During the implementation of the LEAD project, the volume of 67 practices was impractical for any school leader to effectively incorporate. Consequently, this study aims to address this issue by administering a questionnaire to school leaders, including those from Kotak Education Foundation partner schools and others operating within similar contexts. The goal is to pinpoint the practices that can enhance school leadership and Student Learning Outcomes (SLO) both presently and in the near future. Utilizing the Qualtrics tool, a survey was conducted to identify the top 15 practices that respondents believe will be crucial for improving SLO over the next 10-15 years. Additionally, focus group discussions (FGDs) and interviews were conducted to elucidate the challenges hindering the implementation of these practices within schools. The recommendations derived from the identified top 15 practices will be instrumental in devising scalable models for LEAD and advocating for their adoption at the state level. Practices with higher standard deviations and average scores hold particular significance for future development. Furthermore, demographic factors such as age, gender, and years of service influence individuals' perceptions of these practices and thus warrant consideration in our analysis.

Keywords: exploring top sustainable practices, practice implementation, school leadership, student learning outcomes

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Authors: Neerja Bharti, Drishya P.

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Introduction: Thyroidectomies are extensive surgeries involving a significant degree of tissue handling and dissection and are associated with considerable postoperative pain. Regional anaesthesia techniques have immerged as possible inexpensive and safe alternatives to opioids in the management of pain after thyroidectomy. The front of the neck is innervated by branches from the cervical plexus, and hence, several approaches for superficial and deep cervical plexus block (CPB) have been described to provide postoperative analgesia after neck surgery. However, very few studies have explored the analgesic efficacy of intermediate CPB for thyroid surgery. In this study, we have evaluated the effects of ultrasound-guided bilateral intermediate CPB on perioperative opioid consumption in patients undergoing thyroidectomy under general anesthesia. Methods: In this prospective randomized controlled study, fifty ASA grade I-II adult patients undergoing thyroidectomy were randomly divided into two groups: the study group received ultrasound-guided bilateral intermediate CPB with 10 ml 0.5% ropivacaine on each side, while the control group received the same block with 10 ml normal saline on each side just after induction of anesthesia. Anesthesia was induced with propofol, fentanyl, and vecuronium and maintained with propofol infusion titrated to maintain the BIS between 40 and 60. During the postoperative period, rescue analgesia was provided with PCA fentanyl, and the pain scores, total fentanyl consumption, and incidence of nausea and vomiting during 24 hours were recorded, and overall patient satisfaction was assessed. Results: The groups were well-matched with respect to age, gender, BMI, and duration of surgery. The difference in intraoperative propofol and fentanyl consumption was not statistically significant between groups. However, the intraoperative haemodynamic parameters were better maintained in the study group than in the control group. The postoperative pain scores, as measured by VAS at rest and during movement, were lower, and the total fentanyl consumption during 24 hours was significantly less in the study group as compared to the control group. Patients in the study group reported better satisfaction scores than those in the control group. No adverse effects of ultrasound-guided intermediate CPB block were reported. Conclusion: We concluded that ultrasound-guided intermediate cervical plexus block is a safe and effective method for providing perioperative analgesia during thyroid surgery.

Keywords: thyroidectomy, cervical plexus block, pain relief, opioid consumption

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Authors: Hosen Tilat Mahal, Monir Hossain

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Despite being a food-sufficient country after revolutionary changes in agricultural inputs, Bangladesh still has food insecurity and undernutrition. This study examines the association between agricultural practices (as social practices) and food security concentrating on the potential impact of sociodemographic factors and climate change. Using data from the 2012 Bangladesh Integrated Household Survey (BIHS), this study shows how modifiedagricultural practices are strongly associated with climate change and different sociodemographic factors (land ownership, religion, gender, education, and occupation) subsequently affect the status of food security in Bangladesh. We used linear and logistic regression models to analyze the association between modified agricultural practices and food security. The findings indicate that socioeconomic statuses are significant predictors of determining agricultural practices in a society like Bangladesh and control food security at the household level. Moreover, climate change is adversely impactingeven the modified agricultural and food security association version. We conclude that agricultural practices must consider climate change while boosting food security. Therefore, future research should integrate climate change into the agriculture and food-related mitigation and resiliency models.

Keywords: food security, agricultural productivity, climate change, bangladesh

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Authors: Syue-Wen Lin

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Objective:This article reviews the care experience of a 40-year-old male patient who underwent a thoracoscopic right lower lobectomy following a COVID-19 infection. His complex medical history included multiple metastases (lungs, liver, spleen, and left kidney) and lung damage from COVID-19, which complicated the weaning process from mechanical ventilation. The care involved managing cancer treatment, postoperative pain, wound care, and palliative care. Methods:Nursing care was provided from August 16 to August 17, 2024. Challenges included difficulty with sputum clearance, which exacerbated the patient's anxiety and fear of reintubation. Pain management strategies combined analgesic drugs, non-drug methods, essential oil massages with family members, and playing the patient’s favorite music to reduce pain and anxiety. Progressive rehabilitation began with stabilizing vital signs, followed by assistance with sitting on the edge of the bed and walking within the ward. Strict sterile procedures and advanced wound care technology were used for daily dressing changes, with meticulous documentation of wound conditions and appropriate dressing selection. Holistic cancer care and palliative measures were integrated to address the patient’s physical and psychological needs. Results:The interdisciplinary care team developed a comprehensive plan addressing both physical and psychological aspects. Respiratory therapy, lung expansion exercises, and a high-frequency chest wall oscillation vest facilitated sputum expulsion and assisted in weaning from mechanical ventilation. The integration of cancer care, pain management, wound care, and palliative care led to improved quality of life and recovery. The collaborative approach between nursing staff and family ensured that the patient received compassionate and effective care. Conclusion: The complex interplay of emergency surgery, COVID-19, and advanced cancer required a multifaceted care strategy. The care team’s approach, combining critical care with tailored cancer and palliative care, effectively improved the patient’s quality of life and facilitated recovery. The comprehensive care plan, developed with family collaboration, provided both high-quality medical care and compassionate support for the terminally ill patient.

Keywords: multiple metastases, testicular cancer, palliative care, nursing experience

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Authors: Soyhan Egitim

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This case study aims to investigate leadership practices in diversity management in the liberal arts department of a Japanese university. In 2013, the Japanese Ministry of Education, Sports, Science, and Technology (MEXT) revealed their English education reform plan in response to rapid globalization. Based on the new reform plan, Japanese universities would expand their international faculty in order to promote globalization through an increased number of intercultural communication and content-based language classes in English. The study employed a two-phased qualitative approach to gain a deeper understanding of the management strategies employed in diversity management, and the leadership practices influenced those management strategies. In the first phase, a closed-ended qualitative survey was conducted with ten adjunct faculty members from the liberal arts department. The results indicate that syllabus design, grading scheme, textbook choices, and class management policies are strictly regulated by the tenured Japanese faculty. In the second phase, semi-structured interviews were held with international faculty members to understand their personal experiences. Their responses revealed that top-down management approaches are counter-effective in the department’s efforts to promote diversity and thus, a new organizational culture needs to be nurtured to emphasize inclusion alongside diversity. In this regard, the study proposes collaborative leadership as an inclusive leadership practice to minimize power differences in the hierarchy and increase opportunities for inclusion in the rapidly diversifying workforce.

Keywords: collaborative leadership, diversity, inclusion, international faculty, top-down

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