Search results for: team leadership

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

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A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team

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Authors: Tahira Iram, Ahmad Raza Bilal

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In 2016, the Kingdom of Saudi Arabia (KSA) initiated Saudi Vision 2030, an ambitious plan to lessen the country's dependency on fossil fuels and increase economic diversification. The Vision 2030 framework strives to establish a thriving economy, a vibrant society, and an ambitious nation. This study aims to investigate the role of green service innovation (SI) and green work engagement (WE) in mediating the nexus between green HRM and green creativity (GC) under the conditional role of spiritual leadership (SL). A survey was done of 300 female intrepreneurs working in the organization within Saudi Arabia. This study has collected data via a stratified random sampling technique. The framework was tested using PLS-SEM software. The findings reveal that WE fully intervenes in the nexus between green HRM and GC. Moreover, SL positively moderates the nexus between green HRM and SI. Thus based on findings, it is recommended that female intrapreneurs prioritize environmentally responsible operations to gain and sustain a competitive edge over rivals in the Saudi competitive market.

Keywords: green HRM, spiritual leadership, Vision 2030, women intrapreneurs, green service innovation behavior, green creativity

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Authors: Shailendra Natraj, Kristin Paetzold, B. R. Katzy

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The significant role of technology in strategic business decisions has created the need for executives who understand technology and recognize profitable applications to products, services and processes. The role of CTO’s is very complex within technology-based firms, which stretches from the technology aspects to the strategic goal and vision of the firm. Often the roles of CTOs scales from as functional leaders, strategic leaders or supera- functional leaders. In most of the companies the roles are unclear and fuzzy. We in our research are trying to explore each of the orientation and link between leadership types (functional, strategic and super functional) of CTOs, responsibilities, credibility and strategic and conceptual responsibilities. Approach: We conducted a comprehensive literature review with the available databank sources. Results: From the conducted literature review we could identify that most of the research work conducted so far were mainly distributed between roles and responsibilities of CTOs. The available sources pointed were limited to roles of CTOs as functional leaders. Contribution: In our findings based on the literature review, we could identify that apart from the conducted research what so far has not been focused yet are (a) The leadership types (mainly) strategic and super-functional leaders) of CTOs, (b) the responsibilities and credibility of CTOs and (c) the strategic and conceptual responsibilities of CTOs.

Keywords: CTO, chief technology officer, strategy, technology leaders

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Authors: Tahsien Okasha

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Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page." .The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: postoperative care, organ transplant, clinical pathway, patient

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Authors: Drishti Sharma, Mona Duggal

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Background: WhatsApp can serve as a cost-effective, scalable, convenient, and popular medium for public health management related communication in the developing world where the existing system of communication is top-down and slow. The product supports sending and receiving a variety of media: text, photos, videos, documents, and location, as well as voice/video calls. With growing number of users of smartphones and improving access and penetration of internet, the scope of information technology remains immense in resolving the hurdles faced by traditional public health system. Poor infrastructure, gap in digital literacy, faulty documentation, strict organizational hierarchy and slow movement of information across desks and offices- all these, make WhatsApp an efficient prospect to complement the existing system for communication, feedback and leadership for public health system in India. Objective: This study investigates the benefits, challenges and limitations associated with WhatsApp usage as a public health management tool. Methods: The study was conducted within the Chandigarh Union Territory. We used a qualitative approach and conducted individual semi-structured interviews and group interviews (n = 10). Participants included medical officers (n 20), Program managers (n = 4), academicians (n=2) and administrators (n=2). Thematic and content qualitative analyses were conducted. Message log of the WhatsApp group of one of the health program was assessed. Results: Medical Officers said that WhatsApp helped them remain in touch with the program officer. They could easily give feedback and highlight those challenges which needed immediate intervention from the program managers, hence they felt supported. Also, the application helped them share pictures of their activities (meetings and field activities) with the group which they thought inspired others and gave themselves immense satisfaction. Also, it helped build stronger relationships and better coordination among themselves, the same being important in team events. For program managers, it had become a portal for coordinating large scale campaigns. Its reach and the fact that the feedback is real-time make WhatsApp ideal for district level events. Though the easy informal connectivity made them answerable to their staff but it also provided them with flexibility in operations. It turned out to be an important portal for sharing outcome and goals related feedback (both positive and negative) to the team. To be sure, using WhatsApp for the purpose of public health program presents considerable challenges, including technological barriers, organizational challenges, gender issues, confidentiality concerns and unplanned aftereffects. Nevertheless, its advantages in a low-cost setting make it an efficient alternative. Conclusion: WhatsApp has become an integral part of our lives. Use of this app for public health program management within closed groups looks promising and useful. At the same time, addressing the challenges involved would make its usage safer.

Keywords: communication, mobile technology, public health management, WhatsApp

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Authors: Yananda Siraphatthada

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The objectives of this research were to study the level of influencing factors, leadership, supply chain management, innovation, competitive advantages, business success, and affecting factors to the business success of the mobile phone system service providers in Bangkok Metropolitan. This research was done by the quantitative approach and the qualitative approach. The quantitative approach was used for questionnaires to collect data from the 331 mobile service shop managers franchised by AIS, Dtac and TrueMove. The mobile phone system service providers/shop managers were randomly stratified and proportionally allocated into subgroups exclusive to the number of the providers in each network. In terms of qualitative method, there were in-depth interviews of 6 mobile service providers/managers of Telewiz and Dtac and TrueMove shop to find the agreement or disagreement with the content analysis method. Descriptive Statistics, including Frequency, Percentage, Means and Standard Deviation were employed; also, the Structural Equation Model (SEM) was used as a tool for data analysis. The content analysis method was applied to identify key patterns emerging from the interview responses. The two data sets were brought together for comparing and contrasting to make the findings, providing triangulation to enrich result interpretation. It revealed that the level of the influencing factors – leadership, innovation management, supply chain management, and business competitiveness had an impact at a great level, but that the level of factors, innovation and the business, financial success and nonbusiness financial success of the mobile phone system service providers in Bangkok Metropolitan, is at the highest level. Moreover, the business influencing factors, competitive advantages in the business of mobile system service providers which were leadership, supply chain management, innovation management, business advantages, and business success, had statistical significance at .01 which corresponded to the data from the interviews.

Keywords: mobile service providers, facilitating factors, Bangkok Metropolitan, business success

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Authors: Prakash Singh

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Employees who are satisfied at their place of work rate their leaders’ intrapersonal competencies as being high. They also believe that a leader’s intrapersonal competencies influence their sense of job satisfaction. Employees who indicate that they are unhappy at their place of work rate their leaders’ intrapersonal competencies as being low. They also believe that a leader’s intrapersonal intelligence influence their feeling of job satisfaction. The leader’s appropriate intrapersonal competencies are crucial to the creation of a motivated and satisfied employee team. In this study, the quantitative research method was used to determine the employees’ perceptions of their leaders’ intrapersonal competencies and their influence on their job satisfaction; the six competencies being self-awareness, self-confidence, self-expression, self-control, adaptability, and optimism. All the competencies of leaders identified in this quantitative study can therefore be described as intervening variables that influence an employee’s sense of job satisfaction. The number of responses that indicate that each of the intrapersonal competencies of a leader that will have an influence on an employee’s sense of job satisfaction, ranges from 93% (a leader’s sense of self-awareness) to 99% (a leader’s ability to be adaptable). As the responses are significantly similar, it can be stated that the respondents indicate that all the intrapersonal competencies of a leader can influence an employee’s sense of job satisfaction. The findings of this study strongly suggest that in order to be satisfied at work, employees prefer to be led by leaders who are confident in their leadership roles; who send out clear, unambiguous messages; who maintain self-control; who are adaptable and flexible;, who face the future with optimism and who support the establishment of a collegial working environment. Evidently, the findings corroborate the hypothesis that employees believe that the intrapersonal competencies of leaders have a positive influence on the employees’ sense of job satisfaction. This study’s findings, therefore, confirm that the key to the leaders’ self-knowledge is access to their own feelings and the ability to discriminate among them and draw upon them to guide behaviour in their organisations. This exploratory study makes a contribution to the emerging research being accomplished on leaders’ intrapersonal intelligence with more research still needing to be attempted to determine to what extent these competencies of leaders can reshape the organizational climate and culture.

Keywords: emotional intelligence, employees’ job satisfaction, leaders’ intrapersonal competencies, leaders’ self-knowledge

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Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Nirmalasanti Pramesi

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In 2004 the CLD KHI Team offered several new ideas in the field of Islamic family law, such as marriage, inheritance (waris), and waqf. The new idea is based on six main principles; pluralism, nationality, human rights, democracy, maslahah, and gender equality. However, the existence of this has actually caused various criticisms, appreciations, and controversies. For this reason, CLD-KHI, as the idea of reforming family law, especially in the field of marriage, really needs to be studied academically with a comprehensive method as an unfinished problem. The main issues examined in this study are what are the ideas for reforming the law of marriage that have been formulated by the CLD KHI team, as well as how to implement Maqasid Sharia in legal reform. The methodology used in this research is a qualitative method with a normative-empirical-sociological approach. The results of this research show every substance of the idea considers aspects of locality, nationality, and global ethics. The Maqasid approach used in most of the legal provisions is moderate (wasati). Meanwhile, in matters of wali niqah and inheritance, it is adjusted to the context of Indonesian society.

Keywords: Maqasid syari'ah, CLD KHI, marriage law reform, moderate

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Authors: Zakir H. Shaik, Punam L. Vartak

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Management By Objectives (MBO) is a management technique in which objectives of an organisation are conveyed to the employees to establish the individual goals. These objectives and goals are then monitored and assessed jointly by management and the employee time to time. This tool can be used for planning, monitoring as well as for performance appraisal. The success of an organisation is largely dependent on its’s Vision. Thus, it is of paramount importance to achieve the realm of vision through a mission which is well crafted within the organisation to address the objectives. The success of the mission depends upon how realistic and action oriented philosophical approach, an organisation caters to; and how the individual goals are set to track and meet the objectives. Thus, focused and passionate efforts of the team, assigned for the mission, are an absolute obligation for achieving the vision of any organisation. Any construction site is generally a controlled disorder having huge investments, resources and logistics involved. The Construction progression is time-consuming with many isolated as well as interconnected activities. Traditional MBO approach can be unsuccessful if planning and control is non-realistic and inflexible. Moreover, the Construction Industry is far behind understanding these concepts. It is important to address the employee engagement in defining and creating awareness to achieve the targets. Besides, current economic environment and competitive world demands refined management tools to achieve profit, growth and survival of the business. Therefore, the necessity of rational MBO becomes vital part towards the success of an organisation. This paper details about the philosophical assumptions to develop the grounded theory in lieu of achieving objectives through RATIONAL MBO approach in Construction Contracting Organisations. The goals and objectives of the Construction Contracting Organisations can be achieved efficiently by adopting this RATIONAL MBO approach, as those are based on realistic, logical and balanced assumptions.

Keywords: growth, leadership, management by objectives, Management By Objectives (MBO), profit, rational

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Authors: Naza Djafarova, Tony Bates, Margaret Verkuyl, Leonora Zefi, Ozgur Turetken, Alex Ferworn, Mastrilli Paula, Daria Romaniuk, Kosha Bramesfeld, Anastasia Dimitriadou, Cheryl To

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Designing serious games for education is a challenging and resource-intensive effort. If a well-designed process that balances pedagogical principles with game mechanics is in place, it can help to simplify the design process of serious games and increase efficiency. Multidisciplinary teams involved in designing serious games can benefit tremendously from such a process in their endeavours to develop and implement these games at undergraduate and graduate levels. This paper presentation will outline research results on identified gaps within existing processes and frameworks and present an adapted process that emerged from the research. The research methodology was based on a survey, semi-structured interviews and workshops for testing the adapted process for game design. Based on the findings, the authors propose a simple process for the pre-production stage of serious game design that may help guide multidisciplinary teams in their work. This process was used to facilitate team brainstorming, and is currently being tested to assess if multidisciplinary teams find value in using it in their process of designing serious games.

Keywords: serious game-design, multidisciplinary team, game design framework, learning games, multidisciplinary game design process

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Authors: Josie Gardner

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The overall intention of this research is to reimagine peacebuilding in both in theory and practical application in light of the shortcomings and unsustainability of the current peacebuilding paradigm. These limitations are identified here as an overly rational-material approach to peacebuilding that neglects the inner dimension of peace for a fragmented rather than holistic model, and that espouses a conflict and violence-centric approach to peacebuilding. In counter, this presentation is purposed to investigate the dynamics of inner and outer peace as a holistic, complex system towards ‘inner-outer’ peacebuilding. This paper draws from primary research in the protracted conflict context of north-western India (Jammu, Kashmir & Ladakh) as a case study. This presentation has two central aims. First, to introduce the process of inner (psycho-spiritual) peacebuilding, which has thus far been neglected by mainstream and orthodox literature. Second, to examine why inner peacebuilding is essential for realising sustainable peace on a broader scale as outer (socio-political) peace and to better understand how the inner and outer dynamics of peace relate and affect one another. To these ends, Josephine (the researcher/author/presenter) partnered with Yakjah Reconciliation and Development Network to implement a series of action-oriented workshops and retreats centred around healing, reconciliation, leadership, and personal development for the dual purpose of collaboratively generating data, theory, and insights, as well as providing the youth leaders with an experiential, transformative experience. The research team created and used a novel methodological approach called Mapping Ritual Ecologies, which draws from Participatory Action Research and Digital Ethnography to form a collaborative research model with a group of 20 youth co-researchers who are emerging youth peace leaders in Kashmir, Jammu, and Ladakh. This research found significant intra- and inter-personal shifts towards an experience of inner peace through inner peacebuilding activities. Moreover, this process of inner peacebuilding affected their families and communities through interpersonal healing and peace leadership in an inside-out process of change. These insights have generated rich insights and have supported emerging theories about the dynamics between inner and outer peace, power, justice, and collective healing. This presentation argues that the largely neglected dimension of inner (psycho-spiritual) peacebuilding is imperative for broader socio-political (outer) change. Changing structures of oppression, injustice, and violence—i.e. structures of separation—requires individual, interpersonal, and collective healing. While this presentation primarily examines and advocates for inside-out peacebuilding and social justice, it will also touch upon the effect of systems of separation on the inner condition and human experience. This research reimagines peacebuilding as a holistic inner-outer approach. This offers an alternative path forward those weaves together self-actualisation and social justice. While contextualised within north-western India with a small case study population, the findings speak also to other conflict contexts as well as our global peacebuilding and social justice milieu.

Keywords: holistic, inner peacebuilding, psycho-spiritual, systems youth

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Authors: Muncharee Phaobthip

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In this research, the researcher re-examine the mediating effect of employee engagement between its antecedents and consequences for investigates the relation of leadership practices, employment branding and employee engagement based on social exchange theory. As such the researcher has four objectives as follows: First, to study the effects of leadership practices on employment branding, employee engagement and work intention; second, to examine the effects of employer brand perception on employee engagement and work intention; third, to examine the effects of employee engagement on work intention; and last, forth, the researcher inquires into the respondence of work intention. The researcher constituted a sample population of 535 employees of a Thai hotel chain located in four regions of the Kingdom of Thailand (Thailand). The researcher utilized a mixed-methods approach divided into quantitative and qualitative research investigatory phases, respectively. In the quantitative phase of research investigation, the researcher collected germane data from the 535 members of the sample population through the use of a questionnaire as a research instrument. In the qualitative phase of research investigation, relevant data were obtained through carrying out in-depth interviews with three subgroups of members of the sample population. These three subgroups consisted of twelve hotelier experts, six employees at the administrator level, and operational level employees. Focus group discussions were held with discussants from these three subgroups. Findings are as follows: Leadership practices showed positive effects on employment branding, employee engagement, and work intention. Employment branding displayed positive effects on employee engagement and work intention. Employee engagement had positive effects on work intention. However, in the analysis of the equation, the researcher confirmed that the important role of employee engagement is mediator factor between its antecedent and consequence factors. This provides benefits, in that it augments the body of knowledge devoted to the fostering of employee engagement in respect to psychological conditions. In conclusion, the researcher found that the value co-creation between leaders, employers and employees had positive effects on employee outcomes for lead to business outcomes according to reciprocal rule.

Keywords: antecedents, employee engagement, psychological conditions, work intention

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Authors: Ajay Das, Sandip Basu

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Introduction: There is increasing recognition that diverse streams of knowledge can often be recombined in novel ways to generate new knowledge. However, knowledge recombination theory has not been applied to examine the effects of collaborator diversity on the quality of knowledge such collaborators produce. This is surprising because one would expect that a collaborative team with certain aspects of diversity should be able to recombine process elements related to knowledge development, which are relatively tacit, but also complementary because of the collaborator’s varying backgrounds. Theory and Hypotheses: We propose to examine two aspects of diversity in the environments of collaborative teams to try and capture such potential recombinations of relatively tacit, process knowledge. The first aspect of diversity in team members’ environments is geographical. Collaborators with more geographical distance between them (perhaps working in different countries) often have more autonomy in the processes they adopt for knowledge development. In the absence of overt monitoring, such collaborators are likely to adopt differing approaches to knowledge development. The sharing of such varying approaches among collaborators is likely to result in greater quality of the common collaborative pursuit. The second aspect is diversity in the work backgrounds of team members. Such diversity can also increase the potential for knowledge recombination. For example, if one or more members are from a manufacturing center (versus all of them being from a purely R&D center), such members will provide unique perspectives on the implementation of innovative ideas. Again, knowledge that has been evaluated from these diverse perspectives is likely to be of a higher quality. In addition to the above aspects of environmental diversity among team members, we also plan to examine the extent to which individual collaborators are in different environments from the primary innovation center of their employing firms. Proposed Methods: We will test our model on a sample of firms in the semiconductor industry. Our level of analysis will be individual patents generated by these firms and the teams involved in the generation of these. Information on manufacturing activities of our sample firms will be obtained from SEMI, a proprietary database of the semiconductor industry, as well as company 10-K reports. Conclusion: We believe that our results will represent a preliminary attempt to understand how various forms of diversity in collaborative teams impact the knowledge development process. Our dependent variable of knowledge quality is important to study since higher values of this variable can not only drive firm performance but the broader development of regions and societies through spillover impacts on future innovation. The results of this study will, therefore, inform future research and practice in innovation, geographical location, and vertical integration.

Keywords: innovation, manufacturing strategy, knowledge, diversity

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Authors: Fatemeh Yazdani

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This paper explores the student intake policies in high-performing private schools in Iran by studying both sides involved in the school choice processes, parents and the school leaders. It is based on in-depth interviews with 27 parents and private schools’ staff and principals supplemented by ethnographic observation in two private schools in Tehran. From the Bourdieusian point of view, this paper argues that the school leadership engineers the composition of private schools’ students via different gatekeeping strategies, and these strategies represent and reconstruct the school’s institutional habitus. It further explores the ways that parents who look for quality education among non-state education providers deal with the school's institutional habitus based on their familial habitus and possessed economic, social, and cultural capital. The conclusion highlights that investigating school choice as a reciprocal process between family and school leadership can shed more light on the ways that an exclusive environment has been created in some high-performing private schools for certain class strata maintaining a distance that needs to be kept from ‘others.’ In a broader sense, this paper engages into an exploration of social inequality reproduction through private education.

Keywords: institutional habitus, private education, school choice, social inequality, student intake

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Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie

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Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.

Keywords: abortion, contraception, quality improvement, service provision

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Authors: Ricardo Schnug

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This paper puts the transnational crime of human trafficking in the context of Sub-Saharan Africa and its quickly growing youth bulge. By mapping recent and concurrent trends and emerging issues, it explores the implications that it has not only for the region itself but also for the greater global dynamics of the issue. Through the application of Causal Layered Analysis to various alternative future scenarios as well as the identification of the core narrative surrounding the international discourse, it is possible to understand more deeply the forces that underlie future trafficking and what change becomes possible. With the provision of a reconstructed narrative that avoids the current blind spots, this research points out the need for a new and organic leadership paradigm that allows for a more holistic and future-oriented inquiry about socio-economic and political change and what it entails for a transnational crime such as human trafficking. 'Ubuntu' as a social and leadership philosophy then, provides the principles needed for creating this path towards a truly preferred future. Furthermore, this paper inspires follow-up research and the continuous monitoring and transdisciplinary research of this region’s demographic emergence as well as its possible consequences that have been explored in this inquiry.

Keywords: causal layered analysis, emerging issues, human trafficking, scenarios, sub-Saharan Africa

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Authors: Alaaeddeen M. Seufi

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Many have been published on therapeutic derivatives from living organisms including insects. In addition to traditional maggot therapy, more than 900 therapeutic products were isolated from insects. Most people look at insects as enemies and others believe that insects are friends. Many beneficial insects rather than Honey Bees, Silk Worms and Shellac insect could insure human-insect friendship. In addition, insects could be MicroFactories, Biosensors or Bioreactors. InsectFarm is an amazing example of the applied research that transfers insects from laboratory to market by Prof Mircea Ciuhrii and co-workers. They worked for 18 years to derive therapeutics from insects. Their research resulted in production of more than 30 commercial medications derived from insects (e.g. Imunomax, Noblesse, etc.). Two general approaches were followed to discover drugs from living organisms. Some laboratories preferred biochemical approach to purify components of the innate immune system of insects and insect metabolites as well. Then the purified components could be tested for many therapeutic trials. Other researchers preferred molecular approach based on proteomic studies. Components of the innate immune system of insects were then tested for their medical activities. Our Laboratory team preferred to induce insect immune system (using oral, topical and injection routes of administration), then a transcriptomic study was done to discover the induced genes and to identify specific biomarkers that can help in drug discovery. Biomarkers play an important role in medicine and in drug discovery and development as well. Optimum biomarker development and application will require a team approach because of the multifaceted nature of biomarker selection, validation, and application. This team uses several techniques such as pharmacoepidemiology, pharmacogenomics, and functional proteomics; bioanalytical development and validation; modeling and simulation to improve and refine drug development. Our Achievements included the discovery of four components of the innate immune system of Spodoptera littoralis and Musca domestica. These components were designated as SpliDef (defesin), SpliLec (lectin), SpliCec (cecropin) and MdAtt (attacin). SpliDef, SpliLec and MdAtt were confirmed as antimicrobial peptides, while SpliCec was additionally confirmed as anticancer peptide. Our current research is going on to achieve something in antioxidants and anticoagulants from insects. Our perspective is to achieve something in the mass production of prototypes of our products and to reach it to the commercial level. These achievements are the integrated contributions of everybody in our team staff.

Keywords: AMPs, insect, innate immunitty, therappeutics

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Authors: Steven J. Singer, Julianna F. Kamenakis, Allison R. Shapiro, Kimberly M. Cacciato

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Communication and language are topics frequently studied among deaf children. However, there is limited research that focuses specifically on the communication and language experiences of Deaf-Disabled children. In this ethnography, researchers investigated the language experiences of six sets of parents with Deaf-Disabled children who chose American Sign Language (ASL) as the preferred mode of communication for their child. Specifically, the researchers were interested in the factors that influenced the parents’ decisions regarding their child’s communication options, educational placements, and social experiences. Data collection in this research included 18 hours of semi-structured interviews, 20 hours of participant observations, over 150 pages of reflexive journals and field notes, and a 2-hour focus group. The team conducted constant comparison qualitative analysis using NVivo software and an inductive coding procedure. The four researchers each read the data several times until they were able to chunk it into broad categories about communication and social influences. The team compared the various categories they developed, selecting ones that were consistent among researchers and redefining categories that differed. Continuing to use open inductive coding, the research team refined the categories until they were able to develop distinct themes. Two team members developed each theme through a process of independent coding, comparison, discussion, and resolution. The research team developed three themes: 1) early medical needs provided time for the parents to explore various communication options for their Deaf-Disabled child, 2) without intervention from medical professionals or educators, ASL emerged as a prioritized mode of communication for the family, 3) atypical gender roles affected familial communication dynamics. While managing the significant health issues of their Deaf-Disabled child at birth, families and medical professionals were so fixated on tending to the medical needs of the child that the typical pressures of determining a mode of communication were deprioritized. This allowed the families to meticulously research various methods of communication, resulting in an informed, rational, and well-considered decision to use ASL as the primary mode of communication with their Deaf-Disabled child. It was evident that having a Deaf-Disabled child meant an increased amount of labor and responsibilities for parents. This led to a shift in the roles of the family members. During the child’s development, the mother transformed from fulfilling the stereotypical roles of nurturer and administrator to that of administrator and champion. The mother facilitated medical proceedings and educational arrangements while the father became the caretaker and nurturer of their Deaf-Disabled child in addition to the traditional role of earning the family’s primary income. Ultimately, this research led to a deeper understanding of the critical role that time plays in parents’ decision-making process regarding communication methods with their Deaf-Disabled child.

Keywords: American Sign Language, deaf-disabled, ethnography, sociolinguistics

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Authors: Swati Vohra

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A genuine economic and social transformation requires equal contribution and participation from both men and women; however, achieving this gender parity is a global concern. In the patriarchal societies around the world, women have been silenced, oppressed, and subjugated. Girls and women comprise half of the world’s population. This, however, must not be the lone reason for recognizing and providing equal opportunities to them. Every individual has a right to develop through opportunities without the biases of gender, caste, race, or ethnicity. The world today is confronted by pressing issues of climate change, economic crisis, violence against women and children, escalating conflicts, to name a few. Achieving gender parity is thus an essential component in meeting this wide array of challenges in order to create just, robust and inclusive societies. In 2015, The United Nation enunciated achieving 17 Sustainable Development Goals by 2030, one of which is SGD#5- Gender Equality, that is not merely a stand-alone goal. It is central to the achievement of all 17 SDG’s. Without progress on gender equality, the global community will not only fail to achieve the SDG5, but it will also lose the impetus towards achieving the broad 2030 agenda. This research is based on a hypothesis that aims to connect the targets laid by the UN under SDG#5 - 5.4 (Recognize and value unpaid care and domestic work) and 5.5 (Ensure women participation for leadership at all levels of decision-making). The study evaluates the impact of unpaid household responsibilities on women’s leadership in India. In Indian society, women have experienced a low social status for centuries, which is reflected throughout the Indian history with preference of a male child and common occurrences of female infanticides that are still prevalent in many parts of the country. Insistence on the traditional gender roles builds patriarchal inequalities into the structure of Indian society. It is argued that a burden of unpaid labor on women is placed, which narrows the opportunities and life chances women are given and the choices they are able to make, thereby shutting them from shared participation in public and economic leadership. The study investigates theoretical framework of social construction of gender, unpaid labor, challenges to women leaders and peace theorist perspective as the core components. The methodology used is qualitative research of comprehensive literature, accompanied by the data collected through interviews of representatives of women leaders from various fields within Delhi-National Capital Region (NCR). The women leaders interviewed had the privilege of receiving good education and a conducive family support; however, post marriage and children it was not the case and the social obligations weighed heavy on them. The research concludes by recommending the importance of gender-neutral parenting and education along with government ratified paternal leaves for at least six months and childcare facilities available for both the parents at workplace.

Keywords: gender equality, gender roles, peace studies, sustainable development goals, social construction, unpaid labor, women’s leadership

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Authors: Yasmin Nanabhay

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The paper scrutinizes the literature on accountability and non-accountability, and then presents an analysis of a South African case which demonstrated consequences of a lack of accountability. Ethical conduct displayed by members of the public sector is integral to creating a sustainable democratic government, which upholds the constitutional tenets of accountability, transparency and professional ethicality. Furthermore, a true constitutional democracy emphasises and advocates the notion of service leadership that nurtures public participation and engages with citizens in a positive manner. Ethical conduct and accountability in the public sector earns public trust; hence these are key principles in good governance. Yet, in the years since the advent of democracy in South Africa, the government has been plagued by rampant corruption and mal-administration by public officials and politicians in leadership positions. The control measures passed by government in an attempt to ensure ethicality and accountability within the public sector include codes of ethics, rules of conduct and the enactment of legislation. These are intended to shape the mindset of members of the public sector, with the ultimate aim of an efficient, effective, ethical, responsive and accountable public service. The purpose of the paper is to analyse control systems and accountability within the public sector and to present reasons for non-accountability by means of a selected case study. The selected case study is the corruption trial of Jackie Selebi, who served as National Commissioner of the South African Police Service but was dismissed from the post. The reasons for non-accountability in the public sector as well as recommendations based on the findings to enhance accountability will be undertaken. The case study demonstrates the experience and impact of corruption and/or mal-administration, as a result of a lack of accountability, which has contributed to the increasing loss of confidence in political leadership in the country as elsewhere in the world. The literature is applied to the erstwhile National Commissioner of the South African Police Service and President of Interpol, as a case study of non-accountability.

Keywords: corruption, internal control, maladministration, non-compliance, oversight mechanisms, public accountability, public sector

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Authors: Peter Boyes, Sarah Sharples, Paul Tennent, Gary Priestnall, Jeremy Morley

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Significant long-term investment projects can involve complex decisions. These are often described as capital projects, and the factors that contribute to their complexity include budgets, motivating reasons for investment, stakeholder involvement, interdependent projects, and the delivery phases required. The complexity of these projects often requires management groups to be established involving stakeholder representatives; these teams are inherently multidisciplinary. This study uses two university campus capital projects as case studies for this type of management group. Due to the interaction of projects with wider campus infrastructure and users, decisions are made at varying spatial granularity throughout the project lifespan. This spatial-related context brings complexity to the group decisions. Sensemaking is the process used to achieve group situational awareness of a complex situation, enabling the team to arrive at a consensus and make a decision. The purpose of this study is to understand the role of people and data in the complex spatial related long-term decision and sensemaking processes. The paper aims to identify and present issues experienced in practical settings of these types of decision. A series of exploratory semi-structured interviews with members of the two projects elicit an understanding of their operation. From two stages of thematic analysis, inductive and deductive, emergent themes are identified around the group structure, the data usage, and the decision making within these groups. When data were made available to the group, there were commonly issues with the perception of veracity and validity of the data presented; this impacted the ability of group to reach consensus and, therefore, for decisions to be made. Similarly, there were different responses to forecasted or modelled data, shaped by the experience and occupation of the individuals within the multidisciplinary management group. This paper provides an understanding of further support required for team sensemaking and decision making in complex capital projects. The paper also discusses the barriers found to effective decision making in this setting and suggests opportunities to develop decision support systems in this team strategic decision-making process. Recommendations are made for further research into the sensemaking and decision-making process of this complex spatial-related setting.

Keywords: decision making, decisions under uncertainty, real decisions, sensemaking, spatial, team decision making

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Authors: Ummi Sholihah Pertiwi Abidin, Khusnul Hajar Nuansari

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Human resource is one of the most important components that can not be separated from communication fields, either in a large community like a mass or narrow ones such as an institution, office, group and even family. Human resource is an asset which is often used as a tool to achieve certain goals. Therefore, development of human resources is essential for improving skills and character of a person especially at the time that has entered globalization era. People are required to be able to compete both in the local and international arena, no matter what. This paper raised topic related to human resource development solution by a unique educational leadership and communication skill improvement through a linguistic approach. Here the authors want to go by form of public speaking method applied in Modern Islamic Boarding School Darussalam Gontor as the extracurricular activity that is using three languages, they are: Indonesian as the mother language or the nation language of the students, Arabic and English as the second language and Gontor’s mean to supply its students to be able to conquer the globalization needs. This implementation produced the establishment of great leaders through confidence growing to speak in public by adjusting the listener context. In linguistic term, it will help enhancing verbal and nonverbal communication skills and so forth in owning a lot of vocabulary.

Keywords: public speaking, Gontor, language, leadership

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Authors: Reem Al-Garni

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Malnutrition is a global epidemic, but the under-weight or Failure-To-Thrive risk is increasing in rehabilitation setting and considered one of the contribution factor for developmental delay. Beside the consequences of malnutrition on children growth and development, there are other side-effects that might delay or hold the progress of rehabilitation. The awareness for malnutrition must be raised and discussed by the rehabilitation team, to promote the treatment and to optimize the client care. The solution can start from food supplements intake and / or Enteral Nutrition plan, depending on the malnutrition level and to reach the goal, the medical team should to work together in order to provide comprehensive treatment and to help the family to be able to manage their child condition. We have explore the outcomes of rehabilitation between the children with CP whose diagnosed with malnutrition and children with normal body Wight Over a period of 4 months who received 4-6 weeks of rehabilitation two hours daily by using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings reported that children with normal body Wight has better outcomes and improvement comparing with children with malnutrition for the entire study sample.

Keywords: Cerebral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, malnutrition

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Authors: Ting-I Lin

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Objective: This article explores the nursing care experience of a 51-year-old terminal lung cancer patient admitted to the intensive care unit (ICU) following an upper right lobectomy. The patient initially sought emergency treatment due to worsening cough and dyspnea. A sudden deterioration led to the placement of an endotracheal tube. Follow-up CT scans and chest X-rays revealed a mass in the upper right lung with metastases to the lungs, liver, bones, and adrenal glands. The patient underwent a right upper lobectomy and a wedge resection of the right middle lobe. Biopsy staging: T4N3M1c s/p. Methods: During the care period, the nurse continuously monitored physiological data, conducted observations, direct care, interviews, and physical assessments, and reviewed the patient’s medical records. The nurse collaborated with the critical care team and the palliative care team to conduct a comprehensive evaluation using Gordon’s Eleven Functional Health Patterns. Key health problems identified included pain related to postoperative cancer resection and invasive devices, fear of death due to rapid disease progression, and altered tissue perfusion associated with hemodynamic instability. Results: Postoperatively, the patient experienced pain from the surgical wound and increased dyspnea due to widespread metastases, often presenting with confusion. Adjusting the dosage of pain medication reduced the patient’s discomfort, with Morphine 8mg in 0.9% N/S 60ml IV drip q6h prn and Ultracet 37.5 mg/325 mg 1# PO q6h. The FLACC pain score decreased from 7 to below 3. After respiratory training, the endotracheal tube was removed, and the patient's breathing stabilized at 16-18 breaths per minute. Body temperature remained between 35.8°C and 36.1°C, with a mean arterial pressure of 60-80 mmHg. Conclusion: The critical care team, together with the palliative care team, held a family meeting to address not only the patient’s care but also the emotional well-being of the family. By facilitating open visiting hours and fostering expressions of love and gratitude, the patient and family were able to strengthen their emotional connection and reduce anxiety from severe to mild. The family expressed no regrets. After the patient was transferred to the general ward, ongoing care continued with genuine empathy, compassion, and religious support, offering end-of-life care that helped the patient and family through the final stage of life.

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

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Authors: Lisa M. Coleman

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The focus on disability, LGBTQ+, and internationalization has certainly been the subject of much research and programmatic across higher education. Many universities have entered into global partnerships with varying success and challenges across the various areas, including laws and policies. Attentiveness to the specific nuances of global inclusion, diversity, equity, belonging, and access (GIDBEA) and the leadership to support these efforts is crucial to the development of longstanding success across the programs. There have been a number of shifts related to diversification across student and alumni bodies. These shifts include but are not limited to how people identify gender, race, and sexuality (and the intersections across such identities), as well as trends across emerging and diverse disability communities. NYU is the most international campus in the United States, with the most campuses and sites outside of its county of origin and the most international students and exchange programs than any other university. As a result, the ongoing work related to GIDEBA is at the center of much of the leadership, administrative, and research efforts. Climate assessment work across NYU’s diverse global campus landscape will serve as the foundation to exemplify best practices related to data collection and dissemination, community and stakeholder engagement, and effective implementation of innovative strategies to close gap areas as identified. The data (quantitative and qualitative) and related research findings represent data collected from close to 22,000 stakeholders across the NYU campuses. The case study centers on specific methodological considerations, data integrity, stakeholder engagement from across student-faculty, staff, and alumni constituencies, and tactics to advance specific GIDBEA initiatives related to navigating shifting landscapes. Design thinking, incubation, and co-creation strategies have been employed to expand, leverage, actualize, and implement GIDBEA strategies that are – concrete, measurable, differentiated, and specific to global sites and regions and emerging trends.

Keywords: disability, LGBTQ+, DEI, research, case studies

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Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

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Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

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Authors: Ahmed Mohamed Elnady Mohamed Elsafty

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This paper explains a developed applied objective model to measure the culture qualitatively and quantitatively, whether in individuals or in teams, in order to be able to use culture correctly or modify it efficiently. This model provides precise measurements and consistent interpretations by being comprehensive, updateable, and protected from being misled by imitations. Methodically, the provided model divides the culture into seven dimensions (total 43 cultural factors): First dimension is outcome-orientation which consists of five factors and should be highest in leaders. Second dimension is details-orientation which consists of eight factors and should be in highest intelligence members. Third dimension is team-orientation which consists of five factors and should be highest in instructors or coaches. Fourth dimension is change-orientation which consists of five factors and should be highest in soldiers. Fifth dimension is people-orientation which consists of eight factors and should be highest in media members. Sixth dimension is masculinity which consists of seven factors and should be highest in hard workers. Last dimension is stability which consists of seven factors and should be highest in soft workers. In this paper, the details of all cultural factors are explained. Practically, information collection about each cultural factor in the targeted person or team is essential in order to calculate the degrees of all cultural factors using the suggested equation of multiplying 'the score of factor presence' by 'the score of factor strength'. In this paper, the details of how to build each score are explained. Based on the highest degrees - to identify which cultural dimension is the prominent - choosing the tested individual or team in the supposedly right position at the right time will provide a chance to use minimal efforts to make everyone aligned to the organization’s objectives. In other words, making everyone self-motivated by setting him/her at the right source of motivation is the most effective and efficient method to achieve high levels of competency, commitment, and sustainability. Modifying a team culture can be achieved by excluding or including new members with relatively high or low degrees in specific cultural factors. For conclusion, culture is considered as the software of the human beings and it is one of the major compression factors on the managerial discretion. It represents the behaviors, attitudes, and motivations of the human resources which are vital to enhance quality and safety, expanding the market share, and defending against attacks from external environments. Thus, it is tremendously essential and useful to use such a comprehensive model to measure, use, and modify culture.

Keywords: culture dimensions, culture factors, culture measurement, cultural analysis, cultural modification, self-motivation, alignment to objectives, competency, sustainability

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Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

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In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

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