Search results for: nursing staff
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1830

Search results for: nursing staff

1350 A Review on the Importance of Nursing Approaches in Nutrition of Children with Cancer

Authors: Ş. Çiftcioğlu, E. Efe

Abstract:

In recent years, cancer has been at the top of diseases that cause death in children. Adequate and balanced nutrition plays an important role in the treatment of cancer. Cancer and cancer treatment is affecting food intake, absorption and metabolism, causing nutritional disorders. Appropriate nutrition is very important for the cancerous child to feel well before, during and after the treatment. There are various difficulties in feeding children with cancer. These are the cancer-related factors. Other factors are environmental and behavioral. As health professionals who spend more time with children in the hospital, nurses should be able to support the children on nutrition and help them to have balanced nutrition. This study aimed to evaluate the importance of nursing approaches in the nutrition of children with cancer. This article is planned as a review article by searching the literature on this field. Anorexia may develop due to psychogenic causes or chemotherapeutic agents or accompanying infections and nutrient uptake may be reduced.  In addition, stomatitis, mucositis, taste and odor changes in the mouth, the feeling of nausea, vomiting and diarrhea can also reduce oral intake and result in significant losses in the energy deficit. In assessing the nutritional status of children with cancer, determining weight loss and good nutrition is essential anamnesis of a child.  Some anthropometric measurements and biochemical tests should be used to evaluate the nutrition of the child. The nutritional status of pediatric cancer patients has been studied for a long time and malnutrition, in particular under nutrition, in this population has long been recognized. Yet, its management remains variable with many malnourished children going unrecognized and consequently untreated. Nutritional support is important to pediatric cancer patients and should be integrated into the overall treatment of these children.

Keywords: cancer treatment, children, complication, nutrition, nursing approaches

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1349 Does The Implementation Of A Mindfulness Based Intervention Effect Stress and Burnout In Nursing

Authors: Jennifer Foss, DNP, RN-BC, NEA-BC

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Stress and burnout in the bedside registered nurse have deleterious consequences for registered nurses, patients, and the hospitals that employ them. The objective of this study was to determine whether a sixty-minute mindfulness workshop was effective in reducing perceived levels of stress and decreasing mindfulness in registered nurses working in the acute care setting. Registered nurses at a community hospital in the Northeast part of the country were recruited through e-mail and flyers in breakrooms. Participants completed the Perceived Stress Scale (PSS) and Mindfulness Attention Awareness Scale (MAAS) two weeks prior to taking part in the intervention and two weeks post intervention. Of the twenty-three registered nurses who completed the baseline questionnaires, 91% were female with an average age between 30-39 years. Sixty-five percent of subjects completed the questionnaires two weeks post intervention. Two weeks post intervention, registered nurses reported a decrease in perception of stress (pre and post PSS was .133) and was not significant (t=1.293, df=14, p=.217). Likewise, an increase in mindful attention .325 was reported two-weeks post intervention and indicated a favorable tendency to enter a mindful state. This finding was also not significant (t=-1.990, df=14, p=.066). In this study, nurses reported decreases in perceived stress and increases in mindfulness after attending a sixty-minute mindfulness workshop. Further research is needed to determine the long-term impact of mindfulness-based training on nurses' stress and mindfulness skills. The results of this study add to the body of literature that supports the benefits of mindfulness-based interventions in the healthcare setting.

Keywords: Stress, burnout, nursing, acute care nursing

Procedia PDF Downloads 53
1348 Exploring Key Elements of Successful Distance Learning Programs: A Case Study in Palau

Authors: Maiya Smith, Tyler Thorne

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Background: The Pacific faces multiple healthcare crises, including high rates of noncommunicable diseases, infectious disease outbreaks, and susceptibility to natural disasters. These issues are expected to worsen in the coming decades, increasing the burden on an already understaffed healthcare system. Telehealth is not new to the Pacific, but improvements in technology and accessibility have increased its utility and have already proven to reduce costs and increase access to care in remote areas. Telehealth includes distance learning; a form of education that can help alleviate many healthcare issues by providing continuing education to healthcare professionals and upskilling staff, while decreasing costs. This study examined distance learning programs at the Ministry of Health in the Pacific nation of Palau and identified key elements to their successful distance learning programs. Methods: Staff at the Belau National Hospital in Koror, Palau as well as private practitioners were interviewed to assess distance learning programs utilized. This included physicians, IT personnel, public health members, and department managers of allied health. In total, 36 people were interviewed. Standardized questions and surveys were conducted in person throughout the month of July 2019. Results: Two examples of successful distance learning programs were identified. Looking at the factors that made these programs successful, as well as consulting with staff who undertook other distance learning programs, four factors for success were determined: having a cohort, having a facilitator, dedicated study time off from work, and motivation. Discussion: In countries as geographically isolated as the Pacific, with poor access to specialists and resources, telehealth has the potential to radically change how healthcare is delivered. Palau shares similar resources and issues as other countries in the Pacific and the lessons learned from their successful programs can be adapted to help other Pacific nations develop their own distance learning programs.

Keywords: distance learning, Pacific, Palau, telehealth

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1347 Evaluation of Occupational Doses in Interventional Radiology

Authors: Fernando Antonio Bacchim Neto, Allan Felipe Fattori Alves, Maria Eugênia Dela Rosa, Regina Moura, Diana Rodrigues De Pina

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Interventional Radiology is the radiology modality that provides the highest dose values to medical staff. Recent researches show that personal dosimeters may underestimate dose values in interventional physicians, especially in extremities (hands and feet) and eye lens. The aim of this work was to study radiation exposure levels of medical staff in different interventional radiology procedures and estimate the annual maximum numbers of procedures (AMN) that each physician could perform without exceed the annual limits of dose established by normative. For this purpose LiF:Mg,Ti (TLD-100) dosimeters were positioned in different body regions of the interventional physician (eye lens, thyroid, chest, gonads, hand and foot) above the radiological protection vests as lead apron and thyroid shield. Attenuation values for lead protection vests were based on international guidelines. Based on these data were chosen as 90% attenuation of the lead vests and 60% attenuation of the protective glasses. 25 procedures were evaluated: 10 diagnostics, 10 angioplasty, and 5-aneurysm treatment. The AMN of diagnostic procedures was 641 for the primary interventional radiologist and 930 for the assisting interventional radiologist. For the angioplasty procedures, the AMN for primary interventional radiologist was 445 and for assisting interventional radiologist was 1202. As for the procedures of aneurism treatment, the AMN for the primary interventional radiologist was 113 and for the assisting interventional radiologist were 215. All AMN were limited by the eye lens doses already considering the use of protective glasses. In all categories evaluated, the higher dose values are found in gonads and in the lower regions of professionals, both for the primary interventionist and for the assisting, but the eyes lens dose limits are smaller than these regions. Additional protections as mobile barriers, which can be positioned between the interventionist and the patient, can decrease the exposures in the eye lens, providing a greater protection for the medical staff. The alternation of professionals to perform each type of procedure can reduce the dose values received by them over a period. The analysis of dose profiles proposed in this work showed that personal dosimeters positioned in chest might underestimate dose values in other body parts of the interventional physician, especially in extremities and eye lens. As each body region of the interventionist is subject to different levels of exposure, dose distribution in each region provides a better approach to what actions are necessary to ensure the radiological protection of medical staff.

Keywords: interventional radiology, radiation protection, occupationally exposed individual, hemodynamic

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1346 Effects of Exhibition Firms' Resource Investment Behavior on Their Booth Staffs' Role Perceptions, Goal Acceptance and Work Effort during the Exhibition Period

Authors: Po-Chien Li

Abstract:

Despite the extant literature has hosted a wide-range of knowledge about trade shows, this knowledge base deserves to be further expanded and extended because there exist many unclear issues and overlooked topics. One area that needs much research attention is regarding the behavior and performance of booth workers at the exhibition site. Booth staffs play many key roles in interacting with booth visitors. Their exhibiting-related attitudes and motivations might have significant consequences on a firm’s exhibition results. However, to date, little research, if any, has studied how booth workers are affected and behave in the context of trade fair. The primary purpose of the current study is to develop and test a research model, derived from role theory and resource-based viewpoint, that depicts the effects of a firm’s pre-exhibition resource investment behavior on booth staff’s role perceptions and work behavior during the exhibition period. The author collects data with two survey questionnaires at two trade shows in 2016. One questionnaire is given to the booth head of an exhibiting company, asking about the firm’s resource commitment behavior prior to the exhibition period. In contrast, another questionnaire is provided for a booth worker of the same firm, requesting the individual staff to report his/her own role perceptions, degree of exhibition goal acceptance, and level of work effort during the exhibition period. The study has utilized the following analytic methods, including descriptive statistics, exploratory factor analysis, reliability analysis, and regression analysis. The results of a set of regression analyses show that a firm’s pre-exhibition resource investment behavior has significant effects on a booth staff’s exhibiting perceptions and attitudes. Specifically, an exhibitor’s resource investment behavior has impacts on the factors of booth staff’s role clarity and role conflict. In addition, a booth worker’s role clarity is related to the degree of exhibition goal acceptance, but his/her role conflict is not. Finally, a booth worker’s exhibiting effort is significantly related to the individual’s role clarity, role conflict and goal acceptance. In general, the major contribution of the current research is that it offers insight into and early evidence on the links between an exhibiting firm’s resource commitment behavior and the work perceptions and attitudes of booth staffs during the exhibition period. The current research’s results can benefit the extant literature of exhibition marketing.

Keywords: exhibition resource investment, role perceptions, goal acceptance, work effort

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1345 Handling Patient's Supply during Inpatient Stay: Using Lean Six Sigma Techniques to Implement a Comprehensive Medication Handling Program

Authors: Erika Duggan

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A Major Hospital had identified that there was no standard process for handling a patient’s medication that they brought with them to the hospital. It was also identified that each floor was handling the patient’s medication differently and storing it in multiple locations. Based on this disconnect many patients were leaving the hospital without their medication. The project team was tasked with creating a cohesive process to send a patient’s unneeded medication home on admission, storing any of the patient’s medication that could not be sent home, storing any of the patient’s medication for inpatient administration, and sending all of the patient’s medication home on discharge. The project team consisted of pharmacists, RNs, LPNs, members from nursing informatics and a project engineer and followed a DMAIC framework. Working together observations were performed to identify what was working and not working on the different floors which resulted in process maps. Using the multidisciplinary team, brainstorming, including affinity diagramming and other lean six sigma techniques, the best process for receiving, storing, and returning the medication was created. It was highlighted that being able to track the medication throughout the patient’s stay would be beneficial and would help make sure the medication left with the patient on discharge. Using an automated medications dispensing system would help store, and track patient’s medications. Also, the use of a specific order that would show up on the discharge instructions would assist the front line staff in retrieving the medication from a set location and sending it home with the patient. This new process will effectively streamline the admission and discharge process for patients who brought their medication with them as well as effectively tracking the medication during the patient’s stay. As well as increasing patient safety as it relates to medication administration.

Keywords: lean six sigma, medication dispensing, process improvement, process mapping

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1344 Extent of I.C.T Application in Record Management and Factors Hindering the Utilization of E-Learning in the Government Owned Universities in Enugu State, Nigeria

Authors: Roseline Unoma Chidobi

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The purpose of this study is to identify the extent of Information Communication Technology (ICT) application in record management and some factors militating against the utilization of e-learning in the universities in Enugu state. The study was a survey research the quantitative data were collected through a 30 – item questionnaire title extent of ICT Application in Record management and militating Factors in the utilization of e-learning (EIARMMFUE). This was administered on a population of 603 respondents made up of university academic staff and senior administrative staff. The data were analyzed using mean, standard deviation and t-test statistics on a modified 4 point rating scale. Findings of the study revealed among others that ICT are not adequately applied in the management of records in the Universities in Nigeria. Factors like wrong notion or superstitious believe hinder the effective utilization of e – learning approach. The study recommended that the use of ICT in record management should be enhanced in order to achieve effective school management. All the factors militating against the effective utilization of e-learning approach should be addressed for the maximum realization of teaching and learning.

Keywords: e-learning, information communication, teaching, technology, tertiary institution

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1343 Knowledge Management as Tool for Environmental Management System Implementation in Higher Education Institutions

Authors: Natalia Marulanda Grisales

Abstract:

The most significant changes in the characteristics of consumers have contributed to the development and adoption of methodologies and tools that enable organizations to be more competitive in the marketplace. One of these methodologies is the integration of Knowledge Management (KM) phases and Environmental Management Systems (EMS). This integration allows companies to manage and share the required knowledge for EMS adoption, from the place where it is generated to the place where it is going to be exploited. The aim of this paper is to identify the relationship between KM phases as a tool for the adoption of EMS in HEI. The methodology has a descriptive scope and a qualitative approach. It is based on a case study and a review of the literature about KM and EMS. We conducted 266 surveys to students, professors and staff at Minuto de Dios University (Colombia). Data derived from the study indicate that if a HEI wants to achieve an adequate knowledge acquisition and knowledge transfer, it must have clear goals for implementing an EMS. Also, HEI should create empowerment and training spaces for students, professors and staff. In the case study, HEI must generate alternatives that enhance spaces of knowledge appropriation. It was found that 85% of respondents have not received any training from HEI about EMS. 88% of respondents believe that the actions taken by the university are not efficient to knowledge transfer in order to develop an EMS.

Keywords: environmental management systems, higher education institutions, knowledge management, training

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1342 Medical/Surgical Skills Day Improves Nurse Competence and Satisfaction

Authors: Betsy Hannam

Abstract:

Background: Staff nurses felt overwhelmed to learn new skills or complete competencies during their shift. Med/Surg units need to provide dedicated, uninterrupted time to complete training and mandatory competencies and practice skills. Purpose: To improve nurse satisfaction and competence by creating a Skills Day with uninterrupted time to complete competencies, brush up on skills, and evaluate skills learned through pre- and post-tests. Methods: The USL and CNL interviewed nurses to obtain input regarding skills needing reinforcement and included mandatory competencies relevant to Med/Surg to create the Skills Day agenda. Content experts from multiple disciplines were invited to educate staff to help address knowledge gaps. To increase attendance, multiple class days were offered. Results: 2018 Skills Day was held for an inpatient unit with 95% participation (n=35 out of 37RNs). The average pretest score, comprised of content questions from topics discussed, was 57%, and post test scoresaveraged 80%. 94% of test scores improved or remained the same. RNs were given an evaluation at the end of the day, where100% of staff noted Skills Day as beneficial, and 97% requested to repeat next year. Another Med/Surg unit asked to join Skills Day in 2019. In 2019, with 89% participation (n=57 out 64 RNs), the average pretest score was 68%, and the average post test score was 85%. 97% of scores improved or remained the same. 98% reported the class as beneficial, and 96% requested to repeat next year. Skills Day 2020-2022 on hold due to COVID. Looking forward to Skills Day 2023. Conclusion: Skills Day allows nurses to maintain competencies and improve knowledge in areas of interest without the stress of a patient assignment. Having unit leaders organize Skills Day, with the involvement of content experts from multiple disciplines, showed to be a successful and innovative team approach to support professional development.

Keywords: education, competency, skills day, medical/surgical

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1341 Attitudes, Experiences and Good Practices of Writing Online Course Material: A Case Study in Makerere University

Authors: Ruth Nsibirano

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Online mode of delivery in higher institutions of learning, popularly known in some circles as e-Learning or distance education is a new phenomenon that is steadily taking root in African universities but specifically at Makerere University. For slightly over a decade, the Department of Open and Distance Learning has been offering the first generation mode of distance education. In this, learning and teaching experiences were based on the use of hard copy materials circulated through postal services in a rather correspondence mode. There were more challenges to this including high dropout rates, limited support to the learners and sustainability issues. Fortunately, the Department was supported by the Norwegian Government through a NORHED grant to “leapfrog” to the fifth generation of distance education that makes more use of educational technologies and tools. The capacity of faculty staff was gradually enhanced through a series of training to handle the upgraded structure of fifth generation distance education. The trained staff was then tasked to develop modules befitting an online delivery mode, for use on the program. This paper will present attitudes, experiences of the course writers with a view of sharing the good practices that enabled them leap from e-faculty trainees to distinct online course writers. This perspective will hopefully serve as building blocks to enhance the capacity of other upcoming distance education programs in low capacity universities and also promote the uptake of e-Education on the continent and beyond. Methodologically the findings were collected through individual interviews with the 30 course writers. In addition, semi structured questionnaires were designed to collect data on the profile, challenges and lessons from the writers. Findings show that the attitudes of course writers on project supported activities are so much tagged to the returns from their committed efforts. In conclusion, therefore, it is strategically useful to assess and selectively choose which individual to nominate for involvement at the initial stages.

Keywords: distance education, online course content, staff attitudes, best practices in online learning

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1340 Difficulties for Implementation of Telenursing: An Experience Report

Authors: Jacqueline A. G. Sachett, Cláudia S. Nogueira, Diana C. P. Lima, Jessica T. S. Oliveira, Guilherme K. M. Salazar, Lílian K. Aguiar

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The Polo Amazon Telehealth offers several tools for professionals working in Primary Health Care as a second formative opinion, teleconsulting and training between the different areas, whether medicine, dentistry, nursing, physiotherapy, among others. These activities have a monthly schedule of free access to the municipalities of Amazonas registered. With this premise, and in partnership with the University of the State of Amazonas (UEA), is promoting the practice of the triad; teaching-research-extension in order to collaborate with the enrichment and acquisition of knowledge through educational practices carried out through teleconferences. Therefore, nursing is to join efforts and inserts as a collaborator of this project running, contributing to the education and training of these professionals who are part of the health system in full Amazon. The aim of this study is to report the experience of academic of Amazonas State University nursing course, about the experience in the extension project underway in Polo Telemedicine Amazon. This was a descriptive study, the experience report type, about the experience of nursing academic UEA, by extension 'Telenursing: teleconsulting and second formative opinion for FHS professionals in the state of Amazonas' project, held in Polo Telemedicine Amazon, through an agreement with the UEA and funded by the Foundation of Amazonas Research from July / 2012 to July / 2016. Initially developed active search of members of the Family Health Strategy professionals, in order to provide training and training teams to use the virtual clinic, as well as the virtual environment is the focus of this tool design. The election period was an aggravating factor for the implementation of teleconsulting proposal, due to change of managers in each municipality, requiring the stoppage until they assume their positions. From this definition, we established the need for new training. The first video conference took place on 03.14.2013 for learning and training in the use of Virtual Learning Environment and Virtual Clinic, with the participation of municipalities of Novo Aripuanã, São Paulo de Olivença and Manacapuru. During the whole project was carried out literature about what is being done and produced at the national level about the subject. By the time the telenursing project has received twenty-five (25) consultancy requests. The consultants sent by nursing professionals, all have been answered to date. Faced with the lived experience, particularly in video conferencing, face to cause difficulties issues, such as the fluctuation in the number of participants in activities, difficulty of participants to reconcile the opening hours of the units with the schedule of video conferencing, transmission difficulties and changes schedule. It was concluded that the establishment of connection between the Telehealth points is one of the main factors for the implementation of Telenursing and that this feature is still new for nursing. However, effective training and updating, may provide to these professional category subsidies to quality health care in the Amazon.

Keywords: Amazon, teleconsulting, telehealth, telenursing

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1339 Exploring the Potential of Chatbots in Higher Education: A Preliminary Study

Authors: S. Studente, S. Ellis, S. F. Garivaldis

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We report upon a study introducing a chatbot to develop learning communities at a London University, with a largely international student base. The focus of the chatbot was twofold; to ease the transition for students into their first year of university study, and to increase study engagement. Four learning communities were created using the chatbot; level 3 foundation, level 4 undergraduate, level 6 undergraduate and level 7 post-graduate. Students and programme leaders were provided with access to the chat bot via mobile app prior to their study induction and throughout the autumn term of 2019. At the end of the term, data were collected via questionnaires and focus groups with students and teaching staff to allow for identification of benefits and challenges. Findings indicated a positive correlation between study engagement and engagement with peers. Students reported that the chatbot enabled them to obtain support and connect to their programme leader. Both staff and students also made recommendation on how engagement could be further enhanced using the bot in terms of; clearly specified purpose, integration with existing university systems, leading by example and connectivity. Extending upon these recommendations, a second pilot study is planned for September 2020, for which the focus will be upon improving attendance rates, student satisfaction and module pass rates.

Keywords: chatbot, e-learning, learning communities, student engagement

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1338 The Quantitative SWOT-Analysis of Service Blood Activity of Kazakhstan

Authors: Alua Massalimova

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Situation analysis of Blood Service revealed that the strengths dominated over the weak 1.4 times. The possibilities dominate over the threats by 1.1 times. It follows that by using timely the possibility the Service, it is possible to strengthen its strengths and avoid threats. Priority directions of the resulting analysis are the use of subjective factors, such as personal management capacity managers of the Blood Center in the field of possibilities of legal activity of administrative decisions and the mobilization of stable staff in general market conditions. We have studied for the period 2011-2015 retrospectively indicators of Blood Service of Kazakhstan. Strengths of Blood Service of RK(Ps4,5): 1) indicators of donations for 1000 people is higher than in some countries of the CIS (in Russia 14, Kazakhstan - 17); 2) the functioning science centre of transfusiology; 3) the legal possibility of additional financing blood centers in the form of paid services; 4) the absence of competitors; 5) training on specialty Transfusiology; 6) the stable management staff of blood centers, a high level of competence; 7) increase in the incidence requiring transfusion therapy (oncohematology); 8) equipment upgrades; 9) the opening of a reference laboratory; 10) growth of the proportion of issued high-quality blood components; 11) governmental organization 'Drop of Life'; 12) the functioning bone marrow register; 13) equipped with modern equipment HLA-laboratory; 14) High categorization of average medical workers; 15) availability of own specialized scientific journal; 16) vivarium. The weaknesses (Ps = 3.5): 1) the incomplete equipping of blood centers and blood transfusion cabinets according to standards; 2) low specific weight of paid services of the CC; 3) low categorization of doctors; 4) high staff turnover; 5) the low scientific potential of industrial and clinical of transfusiology; 6) the low wages paid; 7) slight growth of harvested donor blood; 8) the weak continuity with offices blood transfusion; 9) lack of agitation work; 10) the formally functioning of Transfusion Association; 11) the absence of scientific laboratories; 12) high standard deviation from the average for donations in the republic. The possibilities (Ps = 2,7): 1): international grants; 2) organization of international seminars on clinical of transfusiology; 3) cross-sectoral cooperation; 4) to increase scientific research in the field of clinical of transfusiology; 5) reduce the share of donation unsuitable for transfusion and processing; 6) strengthening marketing management in the development of fee-based services; 7) advertising paid services; 8) strengthening the publishing of teaching aids; 9) team-building staff. The threats (Ps = 2.1): 1) an increase of staff turnover; 2) the risk of litigation; 3) reduction gemoprodukts based on evidence-based medicine; 4) regression of scientific capacity; 5) organization of marketing; 6) transfusiologist marketing; 7) reduction in the quality of the evidence base transfusions.

Keywords: blood service, healthcare, Kazakhstan, quantative swot analysis

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1337 The Relationship between the Competence Perception of Student and Graduate Nurses and Their Autonomy and Critical Thinking Disposition

Authors: Zülfiye Bıkmaz, Aytolan Yıldırım

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This study was planned as a descriptive regressive study in order to determine the relationship between the competency levels of working nurses, the levels of competency expected by nursing students, the critical thinking disposition of nurses, their perceived autonomy levels, and certain socio demographic characteristics. It is also a methodological study with regard to the intercultural adaptation of the Nursing Competence Scale (NCS) in both working and student samples. The sample of the study group of nurses at a university hospital for at least 6 months working properly and consists of 443 people filled out questionnaires. The student group, consisting of 543 individuals from the 4 public university nursing 3rd and 4th grade students. Data collection tools consisted of a questionnaire prepared in order to define the socio demographic, economic, and personal characteristics of the participants, the ‘Nursing Competency Scale’, the ‘Autonomy Subscale of the Sociotropy – Autonomy Scale’, and the ‘California Critical Thinking Disposition Inventory’. In data evaluation, descriptive statistics, nonparametric tests, Rasch analysis and correlation and regression tests were used. The language validity of the ‘NCS’ was performed by translation and back translation, and the context validity of the scale was performed with expert views. The scale, which was formed into its final structure, was applied in a pilot application from a group consisting of graduate and student nurses. The time constancy of the test was obtained by analysis testing retesting method. In order to reduce the time problems with the two half reliability method was used. The Cronbach Alfa coefficient of the scale was found to be 0.980 for the nurse group and 0.986 for the student group. Statistically meaningful relationships between competence and critical thinking and variables such as age, gender, marital status, family structure, having had critical thinking training, education level, class of the students, service worked in, employment style and position, and employment duration were found. Statistically meaningful relationships between autonomy and certain variables of the student group such as year, employment status, decision making style regarding self, total duration of employment, employment style, and education status were found. As a result, it was determined that the NCS which was adapted interculturally was a valid and reliable measurement tool and was found to be associated with autonomy and critical thinking.

Keywords: nurse, nursing student, competence, autonomy, critical thinking, Rasch analysis

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1336 Academic Staff Identity and Emotional Labour: Exploring Pride, Motivation, and Relationships in Universities

Authors: Keith Schofield, Garry R. Prentice

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The perceptions of the work an academic does, and the environment in which they do it, contributes to the professional identity of that academic. In turn, this has implications for the level of involvement they have in their job, their satisfaction, and their work product. This research explores academic identities in British and Irish institutions and considers the complex interplay between identity, practice, and participation. Theoretical assumptions made in this paper assert that meaningful work has positive effects on work pride, organisational commitment, organisational citizenship, and motivation; when employees participate enthusiastically they are likely to be more engaged, more successful, and more satisfied. Further examination is given to the context in which this participation happens; the nature of institutional process, management, and relationships with colleagues, team members, and students is considered. The present study follows a mixed-methods approach to explore work satisfaction constructs in a number of academic contexts in the UK and Ireland. The quantitative component of this research (Convenience Sample: 155 academics, and support/ administrative staff; 36.1% male, 63.9% female; 60.8% academic staff, 39.2% support/ administration staff; across a number of universities in the UK and Ireland) was based on an established emotional labour model and was tested across gender groups, job roles, and years of service. This was complimented by qualitative semi-structured interviews (Purposive Sample: 10 academics, and 5 support/ administrative staff across the same universities in the UK and Ireland) to examine various themes including values within academia, work conditions, professional development, and transmission of knowledge to students. Experiences from both academic and support perspectives were sought in order to gain a holistic view of academia and to provide an opportunity to explore the dynamic of the academic/administrator relationship within the broader institutional context. The quantitative emotional labour model, tested via a path analysis, provided a robust description of the relationships within the data. The significant relationships found within the quantitative emotional labour model included a link between non-expression of true feelings resulting in emotional labourious work and lower levels of intrinsic motivation and higher levels of extrinsic motivation. Higher levels of intrinsic motivation also linked positively to work pride. These findings were further explored in the qualitative elements of the research where themes emerged including the disconnection between faculty management and staff, personal fulfilment and the friction between the identities of teacher, researcher/ practitioner and administrator. The implications of the research findings from this study are combined and discussed in relation to possible identity-related and emotional labour management-related interventions. Further, suggestions are made to institutions concerning the application of these findings including the development of academic practices, with specific reference to the duality of identity required to service the combined teacher/ researcher role. Broader considerations of the paper include how individuals and institutions may engage with the changing nature of students-as-consumers as well as a recommendation to centralise personal fulfillment through the development of professional academic identities.

Keywords: academic work, emotional labour, identity friction, mixed methods

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1335 The Nursing Experience for an Intestinal Perforation Elderly with a Temporary Enterostomy

Authors: Hsiu-Chuan Hsueh, Kuei-Feng Shen Jr., Chia-Ling Chao, Hui-Chuan Pan

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This article described a 75 years old woman who has suffered from intestinal perforation and accepted surgery with temporary enterostomy, the operation makes her depressed, refused relatives and friend's care, facing low willingness to participate in various activities due to fear of changing body appearance caused by surgery and leave enterostomy. The author collected information through observation talks, physical evaluation, and medical records during the period of care from November 14 to November 30, 2016, we used the four aspects of physiology, psychology, society and spirituality as a whole sexual assessment to establish the nursing problems of patient, included of acute pain, disturbance of body image,coping ineffective individual. For patient care issues, to encouraged case to express their inner feelings and take part in self-care programs through providing good therapeutic interpersonal relationships with their families. However, it provided clear information about the disease and follow-up treatment plan, give compliments in a timely manner, enhanced self-confidence of individual cases and their motivation to participate in self-care of stoma, further face the disease in a positive manner. At the same time, cross-section team care model and individual care measures were developed to enhance the care skills after returning home and at the same time assist the individual in facing the psychological impact caused by stoma. Hope to provide this experience, as a reference for the future care of the disease.

Keywords: enterostomy, intestinal perforation, nursing experience, ostomy

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1334 The Development of Potential in Skilled Laborers in Producing Basketry

Authors: Chutikarn Sriwiboon

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The purposes of this paper were to study the production problems of basketry in the central region and to study the development of potential in skilled labourers in producing basketry in three provinces: Suphanburi, Ayuthaya, and Aungthong. A quota sampling was utilized to get 486 respondents from 243 basketry communities that were registered with OTOP project. A focus group was also used with a connoisseurship model to study knowledge and factors that related to the development of potential in skilled labourers in producing basketry. The findings revealed that the process getting service is the major problem for customers to get service. Also, there should be more of a variety of knowledge for customers. In terms of technology, the variety of information was rated as the most important problem. In terms staff's ability, the knowledge of staff was the most important problem. For the development of potential in high skilled labours for basketry, the findings revealed that having proper tools was considered the most important factor. In terms of economy, the findings revealed that the basketry job must provide sufficient income was considered the most important factor. In terms of using natural resources, efficiency is the most important factor. In terms of mentality, integrity is the most important factor. Finally, in terms of society and culture, help in the local activities is the most important factor.

Keywords: basketry, development, potential, skilled labours

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1333 A Multi-Criteria Decision Method for the Recruitment of Academic Personnel Based on the Analytical Hierarchy Process and the Delphi Method in a Neutrosophic Environment

Authors: Antonios Paraskevas, Michael Madas

Abstract:

For a university to maintain its international competitiveness in education, it is essential to recruit qualitative academic staff as it constitutes its most valuable asset. This selection demonstrates a significant role in achieving strategic objectives, particularly by emphasizing a firm commitment to the exceptional student experience and innovative teaching and learning practices of high quality. In this vein, the appropriate selection of academic staff establishes a very important factor of competitiveness, efficiency and reputation of an academic institute. Within this framework, our work demonstrates a comprehensive methodological concept that emphasizes the multi-criteria nature of the problem and how decision-makers could utilize our approach in order to proceed to the appropriate judgment. The conceptual framework introduced in this paper is built upon a hybrid neutrosophic method based on the Neutrosophic Analytical Hierarchy Process (N-AHP), which uses the theory of neutrosophy sets and is considered suitable in terms of a significant degree of ambiguity and indeterminacy observed in the decision-making process. To this end, our framework extends the N-AHP by incorporating the Neutrosophic Delphi Method (N-DM). By applying the N-DM, we can take into consideration the importance of each decision-maker and their preferences per evaluation criterion. To the best of our knowledge, the proposed model is the first which applies the Neutrosophic Delphi Method in the selection of academic staff. As a case study, it was decided to use our method for a real problem of academic personnel selection, having as the main goal to enhance the algorithm proposed in previous scholars’ work, and thus taking care of the inherent ineffectiveness which becomes apparent in traditional multi-criteria decision-making methods when dealing with situations alike. As a further result, we prove that our method demonstrates greater applicability and reliability when compared to other decision models.

Keywords: multi-criteria decision making methods, analytical hierarchy process, delphi method, personnel recruitment, neutrosophic set theory

Procedia PDF Downloads 97
1332 Communication Skills Training in Continuing Nursing Education: Enabling Nurses to Improve Competency and Performance in Communication

Authors: Marzieh Moattari Mitra Abbasi, Masoud Mousavinasab, Poorahmad

Abstract:

Background: Nurses in their daily practice need to communicate with patients and their families as well as health professional team members. Effective communication contributes to patients’ satisfaction which is a fundamental outcome of nursing practice. There are some evidences in support of patients' dissatisfaction with nurses’ performance in communication process. Therefore improving nurses’ communication skills is a necessity for nursing scholars and nursing administrators. Objective: The aim of the present study was to evaluate the effect of a 2-days workshop on nurses’ competencies and performances in communication in a central hospital located in the sought of Iran. Materials and Method: This is a randomized controlled trial which comprised of a convenient sample of 70 eligible nurses, working in a central hospital. They were randomly divided into 2 experimental and control groups. Nurses’ competencies was measured by an Objective Structured Clinical Examination (OSCE) and their performance was measured by asking eligible patients hospitalized in the nurses work setting during a one month period to evaluate nurses' communication skills before and 2 months after intervention. The experimental group participated in a 2 day workshop on communication skills. Content included in this workshop were: the importance of communication (verbal and non verbal), basic communication skills such as initiating the communication, active listening and questioning technique. Other subjects were patient teaching, problem solving, and decision making, cross cultural communication and breaking bad news. Appropriate teaching strategies such as brief didactic sessions, small group discussion and reflection were applied to enhance participants learning. The data was analyzed using SPSS 16. Result: A significant between group differences was found in nurses’ communication skills competencies and performances in the posttest. The mean scores of the experimental group was higher than that of the control group in the total score of OSCE as well as all stations of OSCE (p<0.003). Overall posttest mean scores of patient satisfaction with nurse's communication skills and all of its four dimensions significantly differed between the two groups of the study (p<0.001). Conclusion: This study shows that the education of nurses in communication skills, improves their competencies and performances. Measurement of Nurses’ communication skills as a central component of efficient nurse patient relationship by valid and reliable methods of evaluation is recommended. Also it is necessary to integrate teaching of communication skills in continuing nursing education programs. Trial Registration Number: IRCT201204042621N11

Keywords: communication skills, simulation, performance, competency, objective structure, clinical evaluation

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1331 Maintenance Management Practice for Building

Authors: Harold Jideofor Nnachetam

Abstract:

Maintenance management in Nigeria Polytechnic faced many issues due to poor service delivery, inadequate finance, and poor maintenance plan and maintenance backlogs. The purpose of this study is to improve the conventional method practices which tend to be ineffective in Nigeria Polytechnic. The case study was conducted with eight Polytechnics in Nigeria. The selected Polytechnic is based on conventional method practices and its major problems, attempt to implement computerized technology and the willingness of staff to share their experiences. All feedbacks from respondents through semi-structured interview were recorded using video camera and transcribed verbatim. The overall findings of this research indicated; poor service delivery, inadequate financial, poor maintenance planning and maintenance backlogs. There is also need to overcome less man power competencies of maintenance management practices which existed with all eight Polytechnics. In addition, the study also found that the Polytechnics still use conventional maintenance management processes in managing building facility condition. As a result, the maintenance management staff was not able to improve the maintenance management performance at the Polytechnics. The findings are intended to be used for maintenance management practices at Nigeria Polytechnics in order to provide high-quality of building facility with safe and healthy environments.

Keywords: maintenance management, conventional method, maintenance management system, Nigeria polytechnic

Procedia PDF Downloads 300
1330 Academic Staff Recruitment in Islamic University: A Proposed Holistic Model

Authors: Syahruddin Sumardi, Indra Fajar Alamsyah, Junaidah Hashim

Abstract:

This study attempts to explore and presents a proposed recruitment model in Islamic university which aligned with holistic role. It is a conceptual paper in nature. In turn, this study is designed to utilize exploratory approach. Literature and document review that related to this topic are used as the methods to analyse the content found. Recruitment for any organization is fundamental to achieve its goal effectively. Staffing in universities is vital due to the importance role of lecturers. Currently, Islamic universities still adopt the common process of recruitment for their academic staffs. Whereas, they have own characteristics which are embedded in their institutions. Furthermore, the FCWC (Foundation, Capability, Worldview and Commitment) model of recruitment proposes to suit the holistic character of Islamic university. Further studies are required to empirically validate the concept through systematic investigations. Additionally, measuring this model by a designed means is appreciated. The model provides the map and alternative tool of recruitment for Islamic universities to determine the process of recruitment which can appropriate their institutions. In addition, it also allows stakeholders and policy makers to consider regarding Islamic values that should inculcate in the Islamic higher learning institutions. This study initiates a foundational contribution for an early sequence of research.

Keywords: academic staff, Islamic values, recruitment model, university

Procedia PDF Downloads 147
1329 Leadership Development for Nurses as Educators

Authors: Abeer Alhazmi

Abstract:

Introduction: Clinical education is considered a significant part of the learning process for nurses and nursing students. However, recruiting high- caliber individuals to train them to be tomorrow’s educators/teachers has been a recurrent challenge. One of the troubling challenges in this field is the absent of proper training programmes to train educators to be future education professionals and leaders. Aim: To explore the impact of a stage 1 and stage 2 clinical instructor courses on developing leadership skills for nurses as educators.Theoretical Framework: Informed by a symbolic interactionist framework, this research explored the Impact of stage 1 and stage 2 clinical instructor courses on nurses' knowledge, attitudes, and leadership skills. Method: Using Glaserian grounded theory method the data were derived from 3 focus groups and 15 in-depth interviews with nurse educators/clinical instructors and nurses who attended stage 1 and stage 2 clinical instructor courses at King Abdu-Aziz University Hospital (KAUH). Findings: The findings of the research are represented in the core category exploring new identity as educator and its two constituent categories Accepting change, and constructing educator identity. The core and sub- categories were generated through a theoretical exploration of the development of educator’s identity throughout stage 1 and stage 2 clinical instructor courses. Conclusion: The social identity of the nurse educators was developed and changed during and after attending stage 1 and stage 2 clinical instructor courses. In light of an increased understanding of the development process of educators identity and role, the research presents implications and recommendations that may contribute to the development of nursing educators in general and in Saudi Arabia in specific.

Keywords: clinical instructor course, educators, identity work, clinical nursing

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1328 A Research Using Remote Monitoring Technology for Pump Output Monitoring in Distributed Fuel Stations in Nigeria

Authors: Ofoegbu Ositadinma Edward

Abstract:

This research paper discusses a web based monitoring system that enables effective monitoring of fuel pump output and sales volume from distributed fuel stations under the domain of a single company/organization. The traditional method of operation by these organizations in Nigeria is non-automated and accounting for dispensed product is usually approximated and manual as there is little or no technology implemented to presently provide information relating to the state of affairs in the station both to on-ground staff and to supervisory staff that are not physically present in the station. This results in unaccountable losses in product and revenue as well as slow decision making. Remote monitoring technology as a vast research field with numerous application areas incorporating various data collation techniques and sensor networks can be applied to provide information relating to fuel pump status in distributed fuel stations reliably. Thus, the proposed system relies upon a microcontroller, keypad and pump to demonstrate the traditional fuel dispenser. A web-enabled PC with an accompanying graphic user interface (GUI) was designed using virtual basic which is connected to the microcontroller via the serial port which is to provide the web implementation.

Keywords: fuel pump, microcontroller, GUI, web

Procedia PDF Downloads 417
1327 A Multi-criteria Decision Method For The Recruitment Of Academic Personnel Based On The Analytical Hierarchy Process And The Delphi Method In A Neutrosophic Environment (Full Text)

Authors: Antonios Paraskevas, Michael Madas

Abstract:

For a university to maintain its international competitiveness in education, it is essential to recruit qualitative academic staff as it constitutes its most valuable asset. This selection demonstrates a significant role in achieving strategic objectives, particularly by emphasizing a firm commitment to exceptional student experience and innovative teaching and learning practices of high quality. In this vein, the appropriate selection of academic staff establishes a very important factor of competitiveness, efficiency and reputation of an academic institute. Within this framework, our work demonstrates a comprehensive methodological concept that emphasizes on the multi-criteria nature of the problem and on how decision makers could utilize our approach in order to proceed to the appropriate judgment. The conceptual framework introduced in this paper is built upon a hybrid neutrosophic method based on the Neutrosophic Analytical Hierarchy Process (N-AHP), which uses the theory of neutrosophy sets and is considered suitable in terms of significant degree of ambiguity and indeterminacy observed in decision-making process. To this end, our framework extends the N-AHP by incorporating the Neutrosophic Delphi Method (N-DM). By applying the N-DM, we can take into consideration the importance of each decision-maker and their preferences per evaluation criterion. To the best of our knowledge, the proposed model is the first which applies Neutrosophic Delphi Method in the selection of academic staff. As a case study, it was decided to use our method to a real problem of academic personnel selection, having as main goal to enhance the algorithm proposed in previous scholars’ work, and thus taking care of the inherit ineffectiveness which becomes apparent in traditional multi-criteria decision-making methods when dealing with situations alike. As a further result, we prove that our method demonstrates greater applicability and reliability when compared to other decision models.

Keywords: analytical hierarchy process, delphi method, multi-criteria decision maiking method, neutrosophic set theory, personnel recruitment

Procedia PDF Downloads 172
1326 Analysis of Policy Issues on Computer-Based Testing in Nigeria

Authors: Samuel Oye Bandele

Abstract:

A policy is a system of principles to guide activities and strategic decisions of an organisation in order to achieve stated objectives and meeting expected outcomes. A Computer Based Test (CBT) policy is therefore a statement of intent to drive the CBT programmes, and should be implemented as a procedure or protocol. Policies are hence generally adopted by an organization or a nation. The concern here, in this paper, is the consideration and analysis of issues that are significant to evolving the acceptable policy that will drive the new CBT innovation in Nigeria. Public examinations and internal examinations in higher educational institutions in Nigeria are gradually making a radical shift from Paper Based or Paper-Pencil to Computer-Based Testing. The need to make an objective and empirical analysis of Policy issues relating to CBT became expedient. The following are some of the issues on CBT evolution in Nigeria that were identified as requiring policy backing. Prominent among them are requirements for establishing CBT centres, purpose of CBT, types and acquisition of CBT equipment, qualifications of staff: professional, technical and regular, security plans and curbing of cheating during examinations, among others. The descriptive research design was employed based on a population consisting of Principal Officers (Policymakers), Staff (Teaching and non-Teaching-Policy implementors), and CBT staff ( Technical and Professional- Policy supports) and candidates (internal and external). A fifty-item researcher-constructed questionnaire on policy issues was employed to collect data from 600 subjects drawn from higher institutions in South West Nigeria, using the purposive and stratified random sampling techniques. Data collected were analysed using descriptive (frequency counts, means and standard deviation) and inferential (t-test, ANOVA, regression and Factor analysis) techniques. Findings from this study showed, among others, that the factor loadings had significantly weights on the organizational and National policy issues on CBT innovation in Nigeria.

Keywords: computer-based testing, examination, innovation, paper-based testing, paper pencil based testing, policy issues

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1325 Understanding of Heritage Values within University Education Systems in the Kingdom of Saudi Arabia

Authors: Mahmoud Tarek Mohamed Hammad

Abstract:

Despite the importance of the role and efforts made by the universities of the Kingdom of Saudi Arabia in reviving and preserving heritage architecture as an important cultural heritage in the Kingdom, The idea revolves around restoration and conservation processes and neglects the architectural heritage values, whose content can be used in sustainable contemporary architectural works. Educational values based on heritage architecture and how to integrate with the contemporary requirements were investigated in this research. For this purpose, by understanding the heritage architectural values as well as educational, academic process, the researcher presented an educational model of questionnaire forms for architecture students and the staff at the Architecture Department at Al-Baha University as a case study that serves the aims of the research. The results of the research show that heritage values especially those interview results are considered as a positive indicator of the importance of these values. The students and the staff need both to gain an understanding of heritage values as well as an understanding of theories of incorporating those values into the design process of contemporary local architecture. The research concludes that a correct understanding of the heritage values, its performance, and its reintegration with modern architecture technology should be focused on architectural education.

Keywords: heritage architecture, academic work, heritage values, sustainable contemporary local architectural

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1324 A Mixed-Method Exploration of the Interrelationship between Corporate Governance and Firm Performance

Authors: Chen Xiatong

Abstract:

The study aims to explore the interrelationship between corporate governance factors and firm performance in Mainland China using a mixed-method approach. To clarify the current effectiveness of corporate governance, uncover the complex interrelationships between governance factors and firm performance, and enhance understanding of corporate governance strategies in Mainland China. The research involves quantitative methods like statistical analysis of governance factors and firm performance data, as well as qualitative approaches including policy research, case studies, and interviews with staff members. The study aims to reveal the current effectiveness of corporate governance in Mainland China, identify complex interrelationships between governance factors and firm performance, and provide suggestions for companies to enhance their governance practices. The research contributes to enriching the literature on corporate governance by providing insights into the effectiveness of governance practices in Mainland China and offering suggestions for improvement. Quantitative data will be gathered through surveys and sampling methods, focusing on governance factors and firm performance indicators. Qualitative data will be collected through policy research, case studies, and interviews with staff members. Quantitative data will be analyzed using statistical, mathematical, and computational techniques. Qualitative data will be analyzed through thematic analysis and interpretation of policy documents, case study findings, and interview responses. The study addresses the effectiveness of corporate governance in Mainland China, the interrelationship between governance factors and firm performance, and staff members' perceptions of corporate governance strategies. The research aims to enhance understanding of corporate governance effectiveness, enrich the literature on governance practices, and contribute to the field of business management and human resources management in Mainland China.

Keywords: corporate governance, business management, human resources management, board of directors

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1323 Assessment of Menus in a Selected Social Welfare Home with Regard to Nutritional Recommendations

Authors: E. Grochowska-Niedworok, K. Brukalo, B. Całyniuk, J. Piekorz, M. Kardas

Abstract:

The aim of the study was to assess diets of residents of nursing homes. Provided by social welfare home, 10 day menus were introduced into the computer program Diet 5 and analyzed in respect of protein, fats, carbohydrates, energy, vitamin D and calcium. The resulting mean values of 10-day menus were compared with the existing Nutrition Standards for Polish population. The analysis menus showed that the average amount of energy supplied from food is not sufficient. Carbohydrates in food supply are too high and represent 257% of normal. The average value of fats and proteins supplied with food is adequate 85.2 g/day and 75.2 g/day. The calcium content of the diet is 513.9 mg/day. The amount of vitamin D supplied in the age group 51-65 years is 2.3 µg/day. Dietary errors that have been shown are due to the lack of detailed nutritional guidelines for nursing homes, as well as state-owned care facilities in general.

Keywords: assessment of diet, essential nutrients, social welfare home, nutrition

Procedia PDF Downloads 139
1322 Automatic Music Score Recognition System Using Digital Image Processing

Authors: Yuan-Hsiang Chang, Zhong-Xian Peng, Li-Der Jeng

Abstract:

Music has always been an integral part of human’s daily lives. But, for the most people, reading musical score and turning it into melody is not easy. This study aims to develop an Automatic music score recognition system using digital image processing, which can be used to read and analyze musical score images automatically. The technical approaches included: (1) staff region segmentation; (2) image preprocessing; (3) note recognition; and (4) accidental and rest recognition. Digital image processing techniques (e.g., horizontal /vertical projections, connected component labeling, morphological processing, template matching, etc.) were applied according to musical notes, accidents, and rests in staff notations. Preliminary results showed that our system could achieve detection and recognition rates of 96.3% and 91.7%, respectively. In conclusion, we presented an effective automated musical score recognition system that could be integrated in a system with a media player to play music/songs given input images of musical score. Ultimately, this system could also be incorporated in applications for mobile devices as a learning tool, such that a music player could learn to play music/songs.

Keywords: connected component labeling, image processing, morphological processing, optical musical recognition

Procedia PDF Downloads 397
1321 Surgical Team Perceptions of the Surgical Safety Checklist in a Tertiary Hospital in Jordan: A Descriptive Qualitative Study

Authors: Rania Albsoul, Muhammad Ahmed Alshyyab, Baraa Ayed Al Odat, Nermeen Borhan Al Dwekat, Batool Emad Al-masri, Fatima Abdulsattar Alkubaisi, Salsabil Awni Flefil, Majd Hussein Al-Khawaldeh, Ragad Ayman Sa’ed, Maha Waleed Abu Ajamieh, Gerard Fitzgerald

Abstract:

Purpose: The purpose of this paper is to explore the perceptions of operating room staff towards the use of the World Health Organization Surgical Safety Checklist in a tertiary hospital in Jordan. Design/methodology/approach: This was a qualitative descriptive study. Semi-structured interviews were conducted with a purposeful sample of 21 healthcare staff employed in the operating room (nurses, residents, surgeons, and anaesthesiologists). The interviews were conducted in the period from October to December 2021. Thematic analysis was used to analyse the data. Findings: Three main themes emerged from data analysis, namely compliance with the surgical safety checklist, the impact of the surgical safety checklist, and barriers and facilitators to the use of the surgical safety checklist. The use of the checklist was seen as enabling staff to communicate effectively and thus accomplish patient safety and positive outcomes. The perceived barriers to compliance included excessive workload, congestion, and lack of training and awareness. Enhanced training and education were thought to improve the utilization of the surgical safety checklist and help enhance awareness about its importance. Originality/value: While steps to utilize the surgical safety checklist by the operation room personnel may seem simple, the quality of its administration is not necessarily robust. There are several challenges to consistent, complete, and effective administration of the surgical safety checklist by the surgical team members. Healthcare managers must employ interventions to eliminate barriers to and offer facilitators of adherence to the application of the surgical safety checklist, therefore promoting quality healthcare and patient safety.

Keywords: patient safety, surgical safety checklist, compliance, utility, operating room, quality healthcare, communication, teamwork

Procedia PDF Downloads 92