Search results for: organizational mortality
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2662

Search results for: organizational mortality

2002 How Leader's Language Framing Affects Employees’ Perceptions and Moral Judgment in Organizations

Authors: Cindy Carvalho

Abstract:

Leaders play a crucial role in shaping employee behavior through their communication. Language is a powerful tool used by leaders to influence perceptions, frame actions, and shape organizational culture. While euphemisms and metaphors are widely used, their impact on unethical behaviors in organizational settings remains underexplored. This study investigates how euphemistic and aggressive (military) language in leaders’ speeches can influence employees’ perceptions and encourage unethical behaviors. Two studies were conducted using a between-subjects design where 200 participants for the first study and 280 participants for the second study, recruited through Prolific, were exposed to either a euphemistic or aggressive (military) version of a hypothetical CEO’s speech. They evaluated their perception of the CEO and the company’s attractiveness. In the second part, participants were presented with three vignettes describing each different daily business situation tainted with ethical issues and they were asked how likely they would engage in such behavior. The type of speech impacted the perceptions of the CEO, with the military version leading to participants judging the CEO as less trustworthy, fair, and moral. However, no significant difference in moral judgment or organizational perception was observed. Interestingly, younger participants and female participants rated the CEO more negatively compared to older and male counterparts. The findings suggest that language framing influences perceptions of leadership but may have a limited immediate impact on ethical decision-making. The study's limitations include hypothetical context, isolated focus on language, and lack of incentives. Incentives push participants to consider their responses carefully and align them with perceived norms, reducing biases like social desirability. Future research should examine real-world settings and consider factors such as age, gender, and experience to understand unethical behavior in organizations better.

Keywords: leadership communication, language framing, ethical behavior, euphemism

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2001 Infectivity of Glossina pallidipes Salivary Gland Hypertrophy Virus (GpSGHV) to Various Tsetse Species

Authors: Guler D. Uzel, Andrew G. Parker, Robert L. Mach, Adly Abd-Alla

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Several tsetse fly species (Diptera: Glossinidae) in natural or colonized populations can be infected with the salivary gland hypertrophy virus (SGHV), a circular dsDNA virus (Hytrosaviridae). The virus infection is mainly asymptomatic but, in some species under certain conditions, the infection can produce salivary gland hypertrophy (SGH) symptoms. In the laboratory colonized tsetse, flies with SGH have reduced fertility, which negatively affects colony performance. Therefore, a high prevalence of SGH in insect mass rearing represents a major challenge for tsetse control using the sterile insect technique. The main objective of this study is to analyze the impact of Glossina pallidipes SGHV infection in various tsetse species on mortality and productivity and its impact on the symbiotic bacteria. Hypertropied salivary glands (SG) were collected from G. pallidipes into phosphate buffered saline (PBS) to prepare suspension; 2 µl aliquots were injected into adults of several tsetse species (G. pallidipes (Gp), G. p. gambiensis (Gpg), G. brevipalpis (Gb), G. morsitans morsitans (Gmm), G. morsitans centralis (Gmc) and G. fuscipes (Gf)) and the change in virus and symbiont titers were analyzed using qPCR. The development of SGH in the F1 was detected by dissection 10 days after emergence and virus infection was confirmed by PCR. The impact of virus infection on fly mortality and productivity was recorded. 2 µl aliquots were also injected into 3rd instar larvae of the different species and the adult SGs assayed by PCR for virus. Virus positive SGs from each species were homogenized in PBS and pooled within species for injection into larvae of the same species. Flies injected with PBS were used as control. Injecting teneral flies with SGHV caused increasing virus titer over time in all species but no SGH was detected. Dissection of the F1 also showed no development of SGH except in Gp (the homologous host). Injection of SGHV did not have any impact on the prevalence of the tsetse symbionts, but an increase in Sodalis titer was observed correlated with fly age regardless of virus infection. The virus infection had a negative impact on productivity and mortality. SGHV injection into larvae of the different species produced SGHV infected glands in the adults determined by PCR with a rate of 60%, 27%, 16%, 7% and 7% for Gp, Gf, Gpg, Gmm and Gmc, respectively. Virus positive SGs observed in the heterologous species were smaller than SGH found in Gp. No virus positive SG was detected by PCR in Gb and no SGH was observed in any adults except in Gp. Injecting virus suspension from the virus positive SGs into conspecific larvae did not produce any adults with infected SGs (except in Gp). SGHV can infect all tested tsetse species. Although the virus can infect and increase in titer in other tsetse species and affect fly mortality and productivity, no vertical virus transmission was observed in other tsetse species with might indicate a transmission barrier in these species, and virus collected from flies injected as larvae was not infective by injection.

Keywords: DNA viruses, glossina, hytrosaviridae, symbiotic bacteria, tsetse

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2000 The Emancipatory Methodological Approach to the Organizational Problems Management

Authors: Slavica P. Petrovic

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One of the key dimensions of management problems in organizations refers to the relations between stakeholders. The management problems that are characterized by conflict and coercion, in which participants do not agree on the ends and means, in which different groups, i.e., individuals, strive to – using the power they have – impose on others their favoured strategy and decisions represent the relevant research subject. Creatively managing the coercive problems in organizations, in which the sources of power can be identified, implies the emancipatory paradigm and the use of corresponding systems methodology. The main research aim is to critically reassess the theoretical foundations and methodological and methodical development of Critical Systems Heuristics (CSH) – as a valid representative of the emancipatory paradigm – in order to determine the conditions, ways, and achievements of its application in managing the coercive problems in organizations. The basic hypothesis is that CSH, as the emancipatory methodology, given its own theoretical foundations and methodological-methodical development, can be employed in a scientifically based and practically useful manner in creative addressing the coercive problems. The scientific instrumentarium corresponding to this research aim is critical systems thinking with its three key commitments to: a) Critical awareness of the strengths and weaknesses of each research instrument (theory, methodology, method, technique, model) for structuring the problem situations in organizations, b) Improvement of managing the coercive problems in organizations, and c) Pluralism – respect the different perceptions and interpretations of problem situations, and enable the combined use of research instruments. The relevant research result is that CSH – considering its theoretical foundations, methodological and methodical development – enables to reveal the normative content of the proposed or existing designs of organizational systems. Accordingly, it can be concluded that through the use of critically heuristic categories and dialectical debate between those involved and those affected by the designs, but who are not included in designing organizational systems, CSH endeavours to – in the application – support the process of improving position of all stakeholders.

Keywords: coercion and conflict in organizations, creative management, critical systems heuristics, the emancipatory systems methodology

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1999 Three Foci of Trust as Potential Mediators in the Association Between Job Insecurity and Dynamic Organizational Capability: A Quantitative, Exploratory Study

Authors: Marita Heyns

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Job insecurity is a distressing phenomenon which has far reaching consequences for both employees and their organizations. Previously, much attention has been given to the link between job insecurity and individual level performance outcomes, while less is known about how subjectively perceived job insecurity might transfer beyond the individual level to affect performance of the organization on an aggregated level. Research focusing on how employees’ fear of job loss might affect the organization’s ability to respond proactively to volatility and drastic change through applying its capabilities of sensing, seizing, and reconfiguring, appears to be practically non-existent. Equally little is known about the potential underlying mechanisms through which job insecurity might affect the dynamic capabilities of an organization. This study examines how job insecurity might affect dynamic organizational capability through trust as an underling process. More specifically, it considered the simultaneous roles of trust at an impersonal (organizational) level as well as trust at an interpersonal level (in leaders and co-workers) as potential underlying mechanisms through which job insecurity might affect the organization’s dynamic capability to respond to opportunities and imminent, drastic change. A quantitative research approach and a stratified random sampling technique enabled the collection of data among 314 managers at four different plant sites of a large South African steel manufacturing organization undergoing dramatic changes. To assess the study hypotheses, the following statistical procedures were employed: Structural equation modelling was performed in Mplus to evaluate the measurement and structural models. The Chi-square values test for absolute fit as well as alternative fit indexes such as the Comparative Fit Index and the Tucker-Lewis Index, the Root Mean Square Error of Approximation and the Standardized Root Mean Square Residual were used as indicators of model fit. Composite reliabilities were calculated to evaluate the reliability of the factors. Finally, interaction effects were tested by using PROCESS and the construction of two-sided 95% confidence intervals. The findings indicate that job insecurity had a lower-than-expected detrimental effect on evaluations of the organization’s dynamic capability through the conducive buffering effects of trust in the organization and in its leaders respectively. In contrast, trust in colleagues did not seem to have any noticeable facilitative effect. The study proposes that both job insecurity and dynamic capability can be managed more effectively by also paying attention to factors that could promote trust in the organization and its leaders; some practical recommendations are given in this regard.

Keywords: dynamic organizational capability, impersonal trust, interpersonal trust, job insecurity

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1998 Maintaining Organizational Harmony: The Way Forward in Ghanaian Basic Schools

Authors: Dominic Kwaku Danso Mensah

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The study examined conflict management strategies among head teachers and teachers in selected basic schools in Okai-Koi sub metro in the greater region of Ghana. In all, 270 participants were engaged in the study, comprising 237 teachers, 32 head teachers, and one officer in charge of the Metropolis. The study employed descriptive survey while using purposive and simple random sampling techniques to sample participants. Interview guides and questionnaires were the main instruments used for gathering primary data. The study found that conflict is inevitable in the schools. Conflicts in schools are usually subtle and hardly noticed by outsiders even though they occur on daily basis. The causes of conflict include among other things, high expectation from head teachers, inability to attain goals set, communication from head teachers and power struggle. The study found out that, in managing and resolving conflicts, issues such as identifying and focusing on the problem, building of trust and cooperation, clarifying goals and objectives were seen to be effective means of managing conflict and recommended that management should design and develop conflict management strategies to quickly resolve conflict.

Keywords: basic education, conflict management, organizational harmony, power

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1997 Assessment of Very Low Birth Weight Neonatal Tracking and a High-Risk Approach to Minimize Neonatal Mortality in Bihar, India

Authors: Aritra Das, Tanmay Mahapatra, Prabir Maharana, Sridhar Srikantiah

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In the absence of adequate well-equipped neonatal-care facilities serving rural Bihar, India, the practice of essential home-based newborn-care remains critically important for reduction of neonatal and infant mortality, especially among pre-term and small-for-gestational-age (Low-birth-weight) newborns. To improve the child health parameters in Bihar, ‘Very-Low-Birth-Weight (vLBW) Tracking’ intervention is being conducted by CARE India, since 2015, targeting public facility-delivered newborns weighing ≤2000g at birth, to improve their identification and provision of immediate post-natal care. To assess the effectiveness of the intervention, 200 public health facilities were randomly selected from all functional public-sector delivery points in Bihar and various outcomes were tracked among the neonates born there. Thus far, one pre-intervention (Feb-Apr’2015-born neonates) and three post-intervention (for Sep-Oct’2015, Sep-Oct’2016 and Sep-Oct’2017-born children) follow-up studies were conducted. In each round, interviews were conducted with the mothers/caregivers of successfully-tracked children to understand outcome, service-coverage and care-seeking during the neonatal period. Data from 171 matched facilities common across all rounds were analyzed using SAS-9.4. Identification of neonates with birth-weight ≤ 2000g improved from 2% at baseline to 3.3%-4% during post-intervention. All indicators pertaining to post-natal home-visits by frontline-workers (FLWs) improved. Significant improvements between baseline and post-intervention rounds were also noted regarding mothers being informed about ‘weak’ child – at the facility (R1 = 25 to R4 = 50%) and at home by FLW (R1 = 19%, to R4 = 30%). Practice of ‘Kangaroo-Mother-Care (KMC)’– an important component of essential newborn care – showed significant improvement in postintervention period compared to baseline in both facility (R1 = 15% to R4 = 31%) and home (R1 = 10% to R4=29%). Increasing trend was noted regarding detection and birth weight-recording of the extremely low-birth-weight newborns (< 1500 g) showed an increasing trend. Moreover, there was a downward trend in mortality across rounds, in each birth-weight strata (< 1500g, 1500-1799g and >= 1800g). After adjustment for the differential distribution of birth-weights, mortality was found to decline significantly from R1 (22.11%) to R4 (11.87%). Significantly declining trend was also observed for both early and late neonatal mortality and morbidities. Multiple regression analysis identified - birth during immediate post-intervention phase as well as that during the maintenance phase, birth weight > 1500g, children of low-parity mothers, receiving visit from FLW in the first week and/or receiving advice on extra care from FLW as predictors of survival during neonatal period among vLBW newborns. vLBW tracking was found to be a successful and sustainable intervention and has already been handed over to the Government.

Keywords: weak newborn tracking, very low birth weight babies, newborn care, community response

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1996 IT Workforce Enablement: How Cloud Computing Changes the Competence Mix of the IT Workforce

Authors: Dominik Krimpmann

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Cloud computing has provided the impetus for change in the demand, sourcing, and consumption of IT-enabled services. The technology developed from an emerging trend towards a ‘must-have’. Many organizations harnessed on the quick-wins of cloud computing within the last five years but nowadays reach a plateau when it comes to sustainable savings and performance. This study aims to investigate what is needed from an organizational perspective to make cloud computing a sustainable success. The study was carried out in Germany among senior IT professionals, both in management and delivery positions. Our research shows that IT executives must be prepared to realign their IT workforce to sustain the advantage of cloud computing for today and the near future. While new roles will undoubtedly emerge, roles alone cannot ensure the success of cloud deployments. What is needed is a change in the IT workforce’s business behaviour, or put more simply, the ways in which the IT personnel works. It gives clear guidance on which dimensions of an employees’ working behaviour need to be adapted. The practical implications are drawn from a series of semi-structured interviews, resulting in a high-level workforce enablement plan. Lastly, it elaborates on tools and gives clear guidance on which pitfalls might arise along the proposed workforce enablement process.

Keywords: cloud computing, organization design, organizational change, workforce enablement

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1995 Varying Frequency Application of Vermicast as Supplemented with 19-19-19+Me in the Agronomic Performance of Lettuce (Lactuca sativa)

Authors: Jesryl B. Paulite, Eixer Niel V. Enesco

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Lettuce is not well known in the lowland locality in the tropical countries like Philippines. Farmers thought that this crop is not adaptable to the climate that we have in lowland. But some new varieties can tolerate warmer conditions. The massive use of pesticides in lettuce production might chronically affect human health and environment. The move of the Philippine government is toward organic. One of the organic material is vermicompost. It is an organic fertilizer that serves as soil conditioner and enhances soil fertility and promotes vigorous and healthy crop growth and Supplementation of 19-19-19+M.E. will make it better since it contains N-P-K and selected microelements to meet the nutritive requirements of the crop. The experiment was conducted at Purok 3, Brgy. Tiburcia, Kapalong, Davao del Norte from February 6, 2014 to March 4, 2014. The study was conducted to determine the effect of varying frequency application of vermicast as supplemented with 19-19-19+M.E. in lettuce. Specifically, this aimed to 1.) Identify the agronomic performance of lettuce as affected by varying frequency application of vermicast as supplemented with 19-19-19+M.E.; 2.) Assess the economic profitability of lettuce as applied with vermicast as supplemented with 19-19-19+M.E. The study was laid out in Randomized Complete Block Design (RCBD) with four treatments and three replications. The treatments were as follow: T1 – Untreated, T2 - Weekly Application, T3- Bi-weekly Application, and T4- Monthly Application. The data on percent (%) mortality were transformed using square root of transformation before Analysis of Variance (ANOVA). Results revealed not significant in terms of percent mortality in weekly and monthly application of the treatment having a mean of 1.76 % and 3.09 %. However, Significant differences were observed in agronomic performances such as; plant height with a mean of 10.63 cm in weekly application and 6.40 cm for the untreated, leaf width with a mean of 10.80 cm for the weekly application and 6.03 for the untreated, fresh weight with a mean of 25.67 g for the weekly application and 6.83 g for the untreated, and yield with a mean of 1,208.33 kg/ha for the weekly application and 327.08 kg/ha for the untreated, respectively. Results further exposed that profitability of lettuce in terms of Return of Production Cost (RPC) were; bi-weekly with 91.01 %, monthly with 68.20 %, weekly with 25.34 % and untreated (control) with 16.69 %.

Keywords: agronomic performance, economic profitability, vermicast, percent mortality, 19-19-19+ME

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1994 The Impact of the Covid-19 Crisis on the Information Behavior in the B2B Buying Process

Authors: Stehr Melanie

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The availability of apposite information is essential for the decision-making process of organizational buyers. Due to the constraints of the Covid-19 crisis, information channels that emphasize face-to-face contact (e.g. sales visits, trade shows) have been unavailable, and usage of digitally-driven information channels (e.g. videoconferencing, platforms) has skyrocketed. This paper explores the question in which areas the pandemic induced shift in the use of information channels could be sustainable and in which areas it is a temporary phenomenon. While information and buying behavior in B2C purchases has been regularly studied in the last decade, the last fundamental model of organizational buying behavior in B2B was introduced by Johnston and Lewin (1996) in times before the advent of the internet. Subsequently, research efforts in B2B marketing shifted from organizational buyers and their decision and information behavior to the business relationships between sellers and buyers. This study builds on the extensive literature on situational factors influencing organizational buying and information behavior and uses the economics of information theory as a theoretical framework. The research focuses on the German woodworking industry, which before the Covid-19 crisis was characterized by a rather low level of digitization of information channels. By focusing on an industry with traditional communication structures, a shift in information behavior induced by an exogenous shock is considered a ripe research setting. The study is exploratory in nature. The primary data source is 40 in-depth interviews based on the repertory-grid method. Thus, 120 typical buying situations in the woodworking industry and the information and channels relevant to them are identified. The results are combined into clusters, each of which shows similar information behavior in the procurement process. In the next step, the clusters are analyzed in terms of the post and pre-Covid-19 crisis’ behavior identifying stable and dynamic information behavior aspects. Initial results show that, for example, clusters representing search goods with low risk and complexity suggest a sustainable rise in the use of digitally-driven information channels. However, in clusters containing trust goods with high significance and novelty, an increased return to face-to-face information channels can be expected after the Covid-19 crisis. The results are interesting from both a scientific and a practical point of view. This study is one of the first to apply the economics of information theory to organizational buyers and their decision and information behavior in the digital information age. Especially the focus on the dynamic aspects of information behavior after an exogenous shock might contribute new impulses to theoretical debates related to the economics of information theory. For practitioners - especially suppliers’ marketing managers and intermediaries such as publishers or trade show organizers from the woodworking industry - the study shows wide-ranging starting points for a future-oriented segmentation of their marketing program by highlighting the dynamic and stable preferences of elaborated clusters in the choice of their information channels.

Keywords: B2B buying process, crisis, economics of information theory, information channel

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1993 Gender Mainstreaming in Kazakhstan: A University Audit as the First Stage to Inform Policy

Authors: A. S. CohenMiller, Jenifer Lewis, Gwen McEvoy, Kristy Kelly

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This international, interdisciplinary study presents the first stage of a gender mainstreaming project within one university as a microcosm of society in Kazakhstan to make concrete policy recommendations and set up the potential for new research to monitor change over time. Local, regional, and UN representatives have noted the critical need and interest in gender related issues in Kazakhstan. Gender mainstreaming has been noted as a strategy to understand and address gender equality and equity such as within the academy in exploring and examining organizational/management issues, university decision-making and leadership, assessing the overall academic climate, discrimination issues, hiring and promotion, and student recruitment and retention. This presentation provides preliminary findings from the university gender audit, highlighting key elements for moving forward in gender mainstreaming. The full study analyzes findings from the full gender audit including interview with key stakeholders, time-use surveys, participant-observations and interviews with female students, staff and faculty, and reviews of formal organizational policies and practices.

Keywords: academia, equity, Eurasia, gender audit, gender mainstreaming, Kazakhstan, policy, time-use survey

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1992 Difficulties Faced by the Sports Clubs in the Sultanate of Oman

Authors: Majid Al-Busafi, Almur Al-Hashmi

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The aim of this study was to identify the difficulties of planning and organizational, technical and finance facing sports clubs in the Sultanate of Oman. To answer the research questions, the researchers set up and developed a questionnaire as a major tool for the study. The researchers also conducted field visits to targeted clubs, collecting documents and publications related to the current situation of these clubs. The study sample (totaling 231) was selected of boards members of sports clubs and federations, executive staff of the Ministry of Sports Affairs, sports clubs and federations, and the media. The results indicated that the order of the difficulties faced by sports clubs is as follows: planning difficulties, the financial difficulties, technical difficulties and fourth and finally organizational difficulties. The study recommended the need to develop long-term plans and a timetable for the activities of the federations or the clubs. It is also important not to ignore to plan the qualification activities for the workers in the federations and clubs. Finally, there is a need to develop regulated forms of relations between members in the clubs. This study makes an original contribution to knowledge as it addresses needs in a country with no clear clubs systems and is informed by case studies from other countries, two of which have similar cultural contexts.

Keywords: sports club, sports federation, difficulties, plans

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1991 Segregation Patterns of Trees and Grass Based on a Modified Age-Structured Continuous-Space Forest Model

Authors: Jian Yang, Atsushi Yagi

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Tree-grass coexistence system is of great importance for forest ecology. Mathematical models are being proposed to study the dynamics of tree-grass coexistence and the stability of the systems. However, few of the models concentrates on spatial dynamics of the tree-grass coexistence. In this study, we modified an age-structured continuous-space population model for forests, obtaining an age-structured continuous-space population model for the tree-grass competition model. In the model, for thermal competitions, adult trees can out-compete grass, and grass can out-compete seedlings. We mathematically studied the model to make sure tree-grass coexistence solutions exist. Numerical experiments demonstrated that a fraction of area that trees or grass occupies can affect whether the coexistence is stable or not. We also tried regulating the mortality of adult trees with other parameters and the fraction of area trees and grass occupies were fixed; results show that the mortality of adult trees is also a factor affecting the stability of the tree-grass coexistence in this model.

Keywords: population-structured models, stabilities of ecosystems, thermal competitions, tree-grass coexistence systems

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1990 Traumatic Brain Injury Neurosurgical Care Continuum Delays in Mulago Hospital in Kampala Uganda

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Patients with traumatic brain injury (TBI) can develop rapid neurological deterioration from swelling and intracranial hematomas, which can result in focal tissue ischemia, brain compression, and herniation. Moreover, delays in management increase the risk of secondary brain injury from hypoxemia and hypotension. Therefore, in TBI patients with subdural hematomas (SDHs) and epidural hematomas (EDHs), surgical intervention is both necessary and time sensitive. Significant delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of TBI in Sub Saharan Africa (SSA). While many LMICs have subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold: logistical and financial barriers. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified 'three delays' framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, traumatic brain injury

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1989 Challenging Clinical Scenario of Blood Stream Candida Infections – An Indian Experience

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

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

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

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1988 Spontaneous Pneumothorax in Mixed Poisoning Presented as Daisley Barton Syndrome

Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

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Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

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1987 Fragility Fractures of the Pelvis: Application of an Imaging-Based Classification System and Assessment of Patient Outcome

Authors: Blake Milton, Georgette Goode, Elias Sachawars, Virgil Chan, Jason Dizon, Christopher Oldmeadow, Garbor Major

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Fragility fractures of the pelvis (FFP) are a common and increasing fracture type in our ageing population. A novel grading classification system developed for FFP by Rommens and Hofmann attributes a severity score related to degree of pelvic ring involvement, which is assessed on CT imaging. The purpose of this study is to assess the relationship between radiologist-assigned FFP grading and patient mortality in conservatively managed patients. This retrospective review identified consecutive 100 patients aged ≥ 65 years at time of FFP. The Rommens-Hofmann severity grading was allocated to these injuries by 2 radiology trainees and a consultant radiologist. Five-year survival was determined from review of patient medical records. Patient medical records were also analysed to account for possible confounding factors including age, gender, comorbidities (Charlson score) and relative socio-economic disadvantage (SEIFA decile). Suitable FFP’s (n = 99) were classified by increasing severity by increasing severity grades: Type I (43% (n = 43)), Type II (33% (n = 33)), Type III (13% (n = 13)), Type IV (10% (n = 10)). No significant differences in survival were found between fracture groups, which persisted when also adjusting for age, gender, Charslon score or SEIFA decile. There was a lack of evidence to suggest a relationship between CT-based fracture grading and patient survival, even when accounting for the listed possible confounding factors. This may be due to small sample size or possible study biases, or possible heterogeneity within the population not adequately captured with available metrics. Given that no difference in mortality has been identified between FFP grades in conservatively managed patients, further research is important to assess mortality benefit in an operative patient population.

Keywords: fragility fractures, fracture classification, pelvic CT, pelvic fracture, pelvic ring fracture

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1986 A Qualitative Exploration of the Strategic Management of Employee Resistance to Organisational Change

Authors: Muneeb Banday, Anukriti Dixit

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Change in organizations is viewed as a conversion process of the organizational functioning. One of the crucial elements of this conversion process is the employee resistance to organizational change. The existing literature on change resistance has generally treated resistance as a barrier or an opportunity for successful implementation of change. However, there is little empirical research exploring how resistance to change is managed. This may be partially due to difficulty in getting information on resistance to change. The top management does not divulge such information to avoid negative evaluation whereas employees face huge risk in sharing information related to resistance. The focus of the study is to understand how the organization under study dealt with the employee resistance to change. The conversion process is a story of how the organization went from one stage to another. We used narrative approach to change. Data was collected data through company visits and interviews. The interviews were transcribed, coded, and themes were identified. We focused on the strands that left huge scope for alternative interpretations than the dominant narrative of change prevalent in the organization. The study reveals that the top management strategically uses the legitimacy of leadership, roles of key employees, and rationality of change to manage resistance.

Keywords: employee resistance, legitimacy of leadership, narrative analysis, organisational change

Procedia PDF Downloads 275
1985 [Keynote Talk]: New Generations and Employment: An Exploratory Study about Tensions between the Psycho-Social Characteristics of the Generation Z and Expectations and Actions of Organizational Structures Related with Employment (CABA, 2016)

Authors: Esteban Maioli

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Generational studies have an important research tradition in social and human sciences. On the one hand, the speed of social change in the context of globalization imposes the need to research the transformations are identified both the subjectivity of the agents involved and its inclusion in the institutional matrix, specifically employment. Generation Z, (generally considered as the population group whose birth occurs after 1995) have unique psycho-social characteristics. Gen Z is characterized by a different set of values, beliefs, attitudes and ambitions that impact in their concrete action in organizational structures. On the other hand, managers often have to deal with generational differences in the workplace. Organizations have members who belong to different generations; they had never before faced the challenge of having such a diverse group of members. The members of each historical generation are characterized by a different set of values, beliefs, attitudes and ambitions that are manifest in their concrete action in organizational structures. Gen Z it’s the only one who can fully be considered "global," while its members were born in the consolidated context of globalization. Some salient features of the Generation Z can be summarized as follows. They’re the first fully born into a digital world. Social networks and technology are integrated into their lives. They are concerned about the challenges of the modern world (poverty, inequality, climate change, among others). They are self-expressive, more liberal and open to change. They often bore easily, with short attention spans. They do not like routine tasks. They want to achieve a good life-work balance, and they are interested in a flexible work environment, as opposed to traditional work schedule. They are critical thinkers, who come with innovative and creative ideas to help. Research design considered methodological triangulation. Data was collected with two techniques: a self-administered survey with multiple choice questions and attitudinal scales applied over a non-probabilistic sample by reasoned decision. According to the multi-method strategy, also it was conducted in-depth interviews. Organizations constantly face new challenges. One of the biggest ones is to learn to manage a multi-generational scope of work. While Gen Z has not yet been fully incorporated (expected to do so in five years or so), many organizations have already begun to implement a series of changes in its recruitment and development. The main obstacle to retaining young talent is the gap between the expectations of iGen applicants and what companies offer. Members of the iGen expect not only a good salary and job stability but also a clear career plan. Generation Z needs to have immediate feedback on their tasks. However, many organizations have yet to improve both motivation and monitoring practices. It is essential for companies to take a review of organizational practices anchored in the culture of the organization.

Keywords: employment, expectations, generation Z, organizational culture, organizations, psycho-social characteristics

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1984 Biomarkers in a Post-Stroke Population: Allied to Health Care in Brazil

Authors: Michael Ricardo Lang, AdriéLle Costa, Ivana Iesbik, Karine Haag, Leonardo Trindade Buffara, Oscar Reimann Junior, Chelin Auswaldt Steclan

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Stroke affects not only the individual, but has significant impacts on the social and family context. Therefore, it is necessary to know the peculiarities of each region, in order to contribute to regional public health policies effectively. Thus, the present study discusses biomarkers in a post-stroke population, admitted to a stroke unit (U-stroke) of reference in the southern region of Brazil. Biomarkers were analyzed, such as age, length of stay, mortality rate, survival time, risk factors and family history of stroke in patients after ischemic stroke. In this studied population, comparing men and women, it was identified that men were more affected than women, and the average age of women affected was higher, as they also had the highest mortality rate and the shortest hospital stay. The risk factors identified here were according to the global scenario; with SAH being the most frequent and those associated with sedentary lifestyle in women the most frequent (dyspilipidemia, heart disease and obesity). In view of this, the importance of studies that characterize populations regionally is evident, strengthening the strategic planning of policies in favor of health care.

Keywords: biomarkers, sex, stroke, stroke unit, population

Procedia PDF Downloads 269
1983 Evaluation of Affecting Factors on Effectiveness of Animal Artificial Insemination Training Courses in Zanjan Province

Authors: Ali Ashraf Hamedi Oghul Beyk

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This research is aimed in order to demonstrate the factors affecting on effectiveness of animal artificial insemination training courses in Zanjan province. The research method is descriptive and correlation. Research tools a questionnaire and research sample are 104 persons who participated in animal artificial insemination training courses. The data resulted from this procedure was analysed by using SPSS software under windows system.independent variables include :individual, sociological, technical, and organizational, dependent variable is: affecting factors on effectiveness of animal artificial insemination training courses the finding of this study indicates that there is a significant correlation(99/0) between individual variables such as motivation and interest and experiment and effectiveness of animal artificial insemination training courses. There is significant correlation (95/0) between sociological variables such as job and education and effectiveness of animal artificial insemination training course. There is significant correlation (99/0) between techn ical variables such as training quality media and instructional materials. Moreover, effectiveness of animal artificial insemination training course there is significant correlation(0/95) between organizational variables such as trainers combination,place conditions.

Keywords: animal artificial insemination, effect, effectiveness, training courses, Zanjan

Procedia PDF Downloads 388
1982 Revising Our Ideas on Revisions: Non-Contact Bridging Plate Fixation of Vancouver B1 and B2 Periprosthetic Femoral Fractures

Authors: S. Ayeko, J. Milton, C. Hughes, K. Anderson, R. G. Middleton

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Background: Periprosthetic femoral fractures (PFF) in association with hip hemiarthroplasty or total hip arthroplasty is a common and serious complication. In the Vancouver Classification system algorithm, B1 fractures should be treated with Open Reduction and Internal Fixation (ORIF) and preferentially revised in combination with ORIF if B2 or B3. This study aims to assess patient outcomes after plate osteosynthesis alone for Vancouver B1 and B2 fractures. The main outcome is the 1-year re-revision rate, and secondary outcomes are 30-day and 1-year mortality. Method: This is a retrospective single-centre case-series review from January 2016 to June 2021. Vancouver B1 and B2, non-malignancy fractures in adults over 18 years of age treated with polyaxial Non-Contact Bridging plate osteosynthesis, have been included. Outcomes were gathered from electronic notes and radiographs. Results: There were 50 B1 and 64 B2 fractures. 26 B2 fractures were managed with ORIF and revision, 39 ORIF alone. Of the revision group, one died within 30 days (3.8%), one at one year (3.8%), and two were revised within one year (7.7). Of the B2 ORIF group, three died within 30-day mortality (7.96%), eight at one year (21.1%), and 0 were revised in 1 year. Conclusion: This study has demonstrated that satisfactory outcomes can be achieved with ORIF, excluding revision in the management of B2 fractures.

Keywords: arthroplasty, bridging plate, periprosthetic fracture, revision surgery

Procedia PDF Downloads 101
1981 Enquiry into Psychological and Psychosocial Aspects in Cancer Care: Cancer Diseases Hospital, Zambia

Authors: Mubita Namuyamba

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Despite an increase in the number of cancer programs and partnerships in cancer care provision, the burden of cancer in Zambia is increasingly having a significant impact on morbidity and mortality rates. The increase in cancer morbidity and mortality rates has given rise to psychological and psycho social implications (PPsI) in cancer care. Cancer patients, care givers and health care providers are faced with a multitude of PPsIs in cancer care that mainly impact negatively on the management of cancer patients. The study adopted a case study design and was purposively conducted at the Cancer Diseases Hospital in Lusaka (Zambia) after obtaining ethical clearance from the Ethics committee. The sample for this study included 70 cancer patients, 20 care givers and 5 hospital staff (4 nurses and 1 doctor). Data was collected using interviews guides, focus group discussion guides and questionnaires respectively. The qualitative data was analysed thematically. The various psychological and psychosocial challenges that conspire to deter the provision of effective cancer care nursing and improved methods of minimizing the psychological and psychosocial implications in cancer care are the products of this study.

Keywords: case study, enquiry, psychological and psycho social aspects, Zambia

Procedia PDF Downloads 340
1980 Investing in Minds: A Financial Framework for Mental Health and Well-Being in the Workplace

Authors: Abdelrahman A. Elsehsah, Nada A. El-Kordy

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The "Investing in Minds: A Financial Framework for Mental Health and Well-Being in the Workplace" project aims to address the pressing mental health challenges faced by employees in modern workplaces. Recognizing the significant impact of mental health on productivity, employee engagement, and overall organizational performance, this initiative proposes a structured approach that includes comprehensive needs assessments, evidence-based interventions, and robust evaluation frameworks. Key components, such as employee assistance programs (EAPs) and wellness initiatives, are designed to foster a supportive workplace culture and promote healthy behaviors. By prioritizing mental health, organizations can expect substantial benefits, including reduced healthcare costs, improved employee retention, and enhanced productivity. This project aligns with the goals of the International Labour Organization (ILO) and emphasizes the importance of integrating mental health strategies into organizational policies. Through effective communication and a commitment to continuous improvement, "Investing in Minds" seeks to create a sustainable framework for mental health support, ultimately contributing to a healthier workforce and better business outcomes.

Keywords: mental health, workplace well-being, employee assistance programs, evaluation framework

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1979 Deployment of Electronic Healthcare Records and Development of Big Data Analytics Capabilities in the Healthcare Industry: A Systematic Literature Review

Authors: Tigabu Dagne Akal

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Electronic health records (EHRs) can help to store, maintain, and make the appropriate handling of patient histories for proper treatment and decision. Merging the EHRs with big data analytics (BDA) capabilities enable healthcare stakeholders to provide effective and efficient treatments for chronic diseases. Though there are huge opportunities and efforts that exist in the deployment of EMRs and the development of BDA, there are challenges in addressing resources and organizational capabilities that are required to achieve the competitive advantage and sustainability of EHRs and BDA. The resource-based view (RBV), information system (IS), and non- IS theories should be extended to examine organizational capabilities and resources which are required for successful data analytics in the healthcare industries. The main purpose of this study is to develop a conceptual framework for the development of healthcare BDA capabilities based on past works so that researchers can extend. The research question was formulated for the search strategy as a research methodology. The study selection was made at the end. Based on the study selection, the conceptual framework for the development of BDA capabilities in the healthcare settings was formulated.

Keywords: EHR, EMR, Big data, Big data analytics, resource-based view

Procedia PDF Downloads 132
1978 Health Outcomes from Multidrug-Resistant Salmonella in High-Income Countries: A Systematic Review and Meta-Analysis

Authors: Andrea Parisi, Samantha Vilkins, Luis Furuya-Kanamori, John A. Crump, Benjamin P. Howden, Darren Gray, Kathryn Glass, Martyn Kirk

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Objectives: Salmonella is a leading cause of foodborne enterocolitis worldwide. Nontyphoidal Salmonella (NTS) infections that are Multi-Drug Resistant (MDR) (non-susceptible to ≥1 agent in ≥3 antimicrobial categories) may result in more severe outcomes, although these effects have not been systematically examined. We conducted a systematic review and meta-analysis to examine impacts of MDR NTS on health in high-income settings. Methods: We systematically reviewed the literature from scientific databases, including PubMed, Scopus and grey literature sources, using PRISMA guidelines. We searched for data from case-control studies, cohorts, outbreaks, reports and theses, imposing no language restriction. We included only publications from January 1990 to September 2016 from high income countries as classified by World Bank. We extracted data from papers on duration of illness, hospitalisation rates, morbidity and mortality for MDR and non-MDR NTS strains. Results: After removing duplicates, the initial search revealed 4258 articles. After further screening, we identified 16 eligible studies for the systematic review, and 9 of these were included in meta-analysis. NTS serotypes differed among the reported studies but serotype Typhimurium, Enteritidis, Newport and Heidelberg were among the most often reported as MDR pathogens. Salmonella infections that were MDR were associated with excess bloodstream infections (OR 1.63; 95%CI 1.18-2.26), excess hospitalisations (OR 2.77; 95%CI 1.47-5.21) and higher mortality (OR 3.54; 95%CI 1.10-11.40). Conclusions: MDR NTS infections are a serious public health concern. With the emergence of MDR Salmonella strains in the high-income countries, it is crucial to restrict the use of antimicrobials both in animals and humans, and intervene to prevent foodborne infections.

Keywords: Antimicrobial Resistance, Bloodstream Infection, Health Outcomes, Hospitalisation, Invasive Disease, Multi-Drug Resistance (MDR), Mortality, Nontyphoidal Salmonella

Procedia PDF Downloads 383
1977 Radiation Safety Factor of Education and Research Institution in Republic of Korea

Authors: Yeo Ryeong Jeon, Pyong Kon Cho, Eun Ok Han, Hyon Chul Jang, Yong Min Kim

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This study surveyed on recognition related to radiation safety for radiation safety managers and workers those who have been worked in Republic of Korea education and research institution. At present, South Korea has no guideline and manual of radiation safety for education and research institution. Therefore, we tried to find an educational basis for development of radiation safety guideline and manual. To check the level of knowledge, attitude, and behavior about radiation safety, we used the questionnaire that consisted of 29 questions against knowledge, attitude and behavior, 4 questions against self-efficacy and expectation based on four factors (radiation source, human, organizational and physical environment) of the Haddon's matrix. Responses were collected between May 4 and June 30, 2015. We analyzed questionnaire by means of IBM SPSS/WIN 15 which well known as statistical package for social science. The data were compared with mean, standard deviation, Pearson's correlation, ANOVA (analysis of variance) and regression analysis. 180 copies of the questionnaire were returned from 60 workplaces. The overall mean results for behavior level was relatively lower than knowledge and attitude level. In particular, organizational environment factor on the radiation safety management indicated the lowest behavior level. Most of the factors were correlated in Pearson’s correlation analysis, especially between knowledge of human factors and behavior of human factors (Pearson’s correlation coefficient 0.809, P<.01). When analysis performed in line with the main radiation source type, institutions where have been used only opened RI (radioisotope) behavior level was the lowest among all subjects. Finally, knowledge of radiation source factor (β=0.556, P<.001) and human factor(β=0.376, P<.001) had the greatest impact in terms of behavior practice. Radiation safety managers and workers think positively about radiation safety management, but are poorly informed organizational environment of their institution. Thus, each institution need to efforts to settlement of radiation safety culture. Also, pedagogical interventions for improving knowledge on radiation safety needs in terms of safety accident prevention.

Keywords: radiation safety management, factor analysis, SPSS, republic of Korea

Procedia PDF Downloads 365
1976 Working Conditions and Occupational Health: Analyzing the Stressing Factors in Outsourced Employees

Authors: Cledinaldo A. Dias, Isabela C. Santos, Marcus V. S. Siqueira

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In the contemporary globalization, the competitiveness generated in the search of new markets aiming at the growth of productivity and, consequently, of profits, implies the redefinition of productive processes and new forms of work organization. As a result of this structuring, unemployment, labor force turnover and the increase in outsourcing and informal work occur. Considering the different relationships and working conditions of outsourced employees, this study aims to identify the most present stressors among outsourced service providers from a Federal Institution of Higher Education in Brazil. To reach this objective, a descriptive exploratory study with a quantitative approach was carried out. The qualitative approach was chosen to provide an in-depth analysis of the occupational conditions of outsourced workers since this method seeks to focus on the social as a world of investigated meanings and the language or speech of each subject as the object of this approach. The survey was conducted in the city of Montes Claros - Minas Gerais (Brazil) and involved eighty workers from companies hired by the institution, including armed security guards, porters, cleaners, drivers, gardeners, and administrative assistants. The choice of professionals obeyed non-probabilistic criteria for convenience or accessibility. Data collection was performed by means of a structured questionnaire composed of sixty questions, in a Likert-type frequency interval scale format, in order to identify potential organizational stressors. The results obtained evidence that the stress factors pointed out by the workers are, in most cases, a determining factor due to the low productive performance at work. Amongst the factors associated with stress, the ones that stood out most were those related to organizational communication failures, the incentive to competition, lack of expectations of professional growth, insecurity and job instability. Based on the results, the need for greater concern and organizational responsibility with the well-being and mental health of the outsourced worker and the recognition of their physical and psychological limitations, and care that goes beyond the functional capacity for the work. Specifically for the preservation of mental health, physical and quality of life, it is concluded that it is necessary for the professional to be inserted in the external world that favors it internally since this set is complemented so that the individual remains in balance and obtain satisfaction in your work.

Keywords: occupational health, outsourced, organizational studies, stressors

Procedia PDF Downloads 106
1975 A Realist Review of Interventions Targeting Maternal Health in Low- and Middle-income Countries

Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

Procedia PDF Downloads 79
1974 Effect of Planting Techniques on Mangrove Seedling Establishment in Kuwait Bay

Authors: L. Al-Mulla, B. M. Thomas, N. R. Bhat, M. K. Suleiman, P. George

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Mangroves are halophytic shrubs habituated in the intertidal zones in the tropics and subtropics, forming a complex and highly dynamic coastal ecosystem. Historical evidence indicating the existence followed by the extinction of mangrove in Kuwait; hence, continuous projects have been established to reintroduce this plant to the marine ecosystem. One of the major challenges in establishing large-scale mangrove plantations in Kuwait is the very high rate of seedling mortality, which should ideally be less than 20%. This study was conducted at three selected locations in the Kuwait bay during 2016-2017, to evaluate the effect of four planting techniques on mangrove seedling establishment. Coir-pillow planting technique, comp-mat planting technique, and anchored container planting technique were compared with the conventional planting method. The study revealed that the planting techniques significantly affected the establishment of mangrove seedlings in the initial stages of growth. Location-specific difference in seedling establishment was also observed during the course of the study. However, irrespective of the planting techniques employed, high seedling mortality was observed in all the planting locations towards the end of the study; which may be attributed to the physicochemical characteristics of the mudflats selected.

Keywords: Avicennia marina (Forsk.) Vierh, coastal pollution, heavy metal accumulation, marine ecosystem, sedimentation, tidal inundation

Procedia PDF Downloads 152
1973 Spectrum of Acute Kidney Injury in Obstetrics

Authors: Seema Chopra, Amandeep Kaur, Vanita Suri, Shalini Gainder, Minakshi Rohilla

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Background: Acute kidney injury (AKI) associated with pregnancy is a serious medical complication which can lead to significant maternal as well as perinatal morbidity and mortality. Material and methods: This prospective observational study was carried out in the Obstetrics and Gynaecology department and dialysis unit of Nephrology department of PGIMER, Chandigarh from July 2013 to June 2014. Forty antenatal/postnatal/postabortal patients who fulfilled the AKIN criteria were enrolled in the study. All patients were followed up till 3 months postpartum. Results: Majority of the patients 23/40 (57.5%) with AKI presented in postpartum period, 14/40 (35%) developed AKI in antenatal period, and 3/40 (7.5%) were postabortal. AKI was attributable mostly to sepsis in 11/40 (27.5%) and PPH in 5/40 (12.5%). Hypertension and its complications causing AKI included eclampsia in 5/40 (12.5%) followed by 3/40 (7.5%) as HELLP syndrome and abruption placentae in 2/40(5%) patients. Three patients each (7.5%) had AFLP, TMA, and HEV as the cause of AKI. Renal replacement therapy in the form of hemodialysis was the treatment in majority of them (28 (70%)). After the acute event, 25 (62.5%) had complete recovery of their renal functions at 3 months follow up. Maternal mortality was seen in 25% (n=10) of the study patients. Conclusion: Timely initiation of RRT in patients with AKI associated with pregnancy has a good maternal outcome in the form of complete recovery of renal functions in 62.5% (25/40) of patients.

Keywords: AKI, dialysis, hypertension, sepsis, renal parameters

Procedia PDF Downloads 163