Search results for: some guidelines for implementation

Authors: Xiwu Feng

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The paper is to analyze research ethics in social and behavioral sciences from a cross-cultural perspective. A multi-phase study investigated implementations of ethical standards and guidelines in higher institutions in China. Institutional policies and procedures on human subject research and perceptions of human subject protection were assessed in the Chinese research universities from different regions. The findings of the study indicate that the implementations of ethical standards and guidelines vary from institution to institution and from region to region. Education and cultural backgrounds of the participants influence their perceptions of the welfare and privacy of human subjects. The results of the study reveal great differences and complexities in ethical standards for the protection of human subjects of research in contrast to the Western world. The Chinese collectivistic values and the cooperative-harmonious democracy play a significant role in perceiving and implementing ethical guidelines. Chinese researchers find themselves a long way to go before seeing implementations of regulations and guidelines on human subject research in social and behavioral sciences.

Keywords: ethical standards, human subjects, research ethics, social and behavioral research

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Authors: Maryam Risla Shahul Hameed, Tharsiga Yogarajah, Fritzy Mathew, Tayyaba Syed, Shalin Shaunak

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Aim: Auditing the adherence of Trauma and Orthopaedics Operative notes to the RCS Good Surgical Practice Guidelines. Method: Clinical audit conducted on 150 operative notes over a period of 2 months April- May 2023, including emergency and elective surgeries performed in Ashford and St. Peter’s Hospital. The RCS Good Practice Surgical Guidelines for an ideal operative note were used to compare.Results: Date of the procedure and signature of the surgeon were mentioned in all the notes by default in the electronic template being used. Title of the operation performed and whether elective or emergency were mentioned by 92% and 45%, respectively. Name of theatre anaesthetist and operating surgeons were mentioned by 73% and 93% respectively. Time of surgery mentioned by 26%. Operative findings and operative diagnosis mentioned by 83% and 53% respectively. Incision and complications of surgery mentioned in 80% and 53%, respectively. Details of tissue added/ altered/ removed mentioned by 46%. Information on prosthesis or implant used is mentioned by 54%. Details of closure and anticipated blood loss mentioned in 91% and 45% respectively. Antibiotic prophylaxis was mentioned by 63%, out of which only 23% mentioned the name and duration of the antibiotic. VTE prophylaxis was mentioned by 84%, out of which only 23% and 29% mentioned the name and duration of the prophylaxis, respectively. Conclusion: There is more for improvement in the operative notes for better continuity of care between the operating surgeons and other doctors in the wards taking care of the patients post operatively. We recommend to follow a standardized guidelines by all the nationwide and a standard template to be followed by all.

Keywords: surgery, notes, RCS, guidelines

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Authors: Laura Mion

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The implementation of quality management systems in higher education in different countries is determined by national regulatory choices and supranational indications (such as the European Standard Guidelines for Quality Assurance). The effective functioning and transformative capacity of these quality management systems largely depend on the organizational context in which they are applied and, more specifically, on the culture of quality developed in single universities or in single countries. The University's concept of quality culture integrates the structural dimension of QA (quality management manuals, process definitions, tools) with the value dimension of an organization (principles, skills, and attitudes). Within the EHEA (European Higher Education Area), countries such as Portugal, the Netherlands, the UK, and Norway demonstrate a greater integration of QA principles in the various organizational levels and areas of competence of university institutions or have greater experience in implementation or scientific and political debate on the matter. Therefore, the study, through an integrative literature review, of the quality management systems of these countries is aimed at determining a framework of the culture of quality, helpful in defining the elements which, both in structural-organizational terms and in terms of values and skills and attitudes, have proved to be factors of success in the effective implementation of quality assurance systems in universities and in the countries considered in the research. In order for a QA system to effectively aim for continuous improvement in a complex and dynamic context such as the university one, it must embrace a holistic vision of quality from an integrative perspective, focusing on the objective of transforming the reality being evaluated.

Keywords: higher education, quality assurance, quality culture, Portugal, Norway, Netherlands, United Kingdom

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Authors: Bader Al-Mannai, Saad Sulieman, Yaser Al-Alawi

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Research studies worldwide undoubtedly demonstrated that the implementation of Total Quality Management (TQM) program can improve organizations competitive abilities and provide strategic quality advances. However, limited empirical studies and research are directed to measure the effectiveness of TQM implementation on the industrial and manufacturing organizations performance. Accordingly, this paper is aimed at discussing “the degree of TQM implementation in Bahrain industries and its effect on their performance”. The paper will present the measurement indicators and success factors that were used to assess the degree of TQM implementation in Bahrain industry, and the main performance indicators that were affected by TQM implementation. The adopted research methodology in this study was a survey that was based on self-completion questionnaire. The sample population represented the industrial and manufacturing organizations in Bahrain. The study led to the identification of the operational and strategic measurement indicators and success factors that assist organizations in realizing successful TQM implementation and performance improvement. Furthermore, the research analysis confirmed a positive and significant relationship between the examined performance indicators in Bahrain industry and TQM implementation. In conclusion the investigation of the relationship revealed that the implementation of TQM program has resulted into remarkable improvements on workforce, sales performance, and quality performance indicators in Bahrain industry.

Keywords: performance indicators, success factors, TQM implementation, Bahrain

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Authors: Fatemeh Khalili Varnamkhasti

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In recent times, there has been a notable shift in the application of Total Quality Management (TQM) from manufacturing to service organizations, prompting numerous studies on the subject. TQM has firmly established itself across various sectors, emerging as an approach to process improvement, waste reduction, business optimization, and quality performance. Many researchers and academics have recognized the relevance of TQM for sustainable competitive advantage, particularly in service organizations. In light of this, the purpose of this research study is to explore the applicability of TQM within the service framework. The study delves into existing literature on TQM in service organizations and examines the reasons for its occasional shortcomings. Ultimately, the paper provides systematic guidelines for the effective implementation of TQM in service organizations. The findings of this study offer a much-improved understanding of TQM and its practices, shedding light on the evolution of service organizations. Additionally, the study highlights key insights from recent research on TQM in service organizations and proposes a ten-step approach for the successful implementation of TQM in the service sector. This framework aims to provide service managers and professionals with a comprehensive understanding of TQM fundamentals and encourages a deeper exploration of TQM theory.

Keywords: quality, control, service, management, teamwork

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Authors: Widjojo Suprapto, Zeplin Jiwa Husada Tarigan, Sautma Ronni Basana

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Business process reengineering can be conducted by some procedure rationalization for all related departments in a company so that all data and business processes are connected. The changing of any business process is used to set up the working standard so that it gives an impact to the implementation of ERP and the company performance. After collecting and processing the data from 77 manufacturing companies, it is obtained that BPR (Business Process Reengineering) has no direct impact on the implementation of ERP (Enterprise Resource Planning) in the companies and manufacturing performance; however, it influences the implementation of TQM. The implementation of TQM influences directly the implementation of ERP, but it does not influence directly the company performance. The implementation of ERP gives a significant increase in the work performance of the manufacturing companies in East Java.

Keywords: enterprise resources planning, business process reengineering, TQM, company performance

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Authors: Jamal Ahmed Hama Kareem, Noraini Abu Talib

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The purpose of this paper is to explore the literature on 5S and Total Productive Maintenance (TPM) and the benefits that are to be derived from their implementation. It also seeks to highlight the main phases for implementing both the 5S and the TPM successfully, along with highlighting aspects that are needed for successful implementation of these two techniques simultaneously in the contemporary manufacturing scenario. The literature on classification of 5S and TPM has so far been very limited. The paper reviews a large number of papers in this field and presents the overview of several of implementation practices of 5S and TPM, and the benefits that can be achieved by the implementation of 5S and TPM as a one system by industrial organizations globally. The paper systematically categorizes the published literature and reveals important issues that influence the successful implementation of 5S and TPM in organizations to improve production effectiveness for competitiveness. Further, the paper also highlights various phases suggested by researchers and practitioners, which ensure smooth and effective implementation of the 5S and TPM in industrial organizations. In the end, study puts forth propositions based on the model of the study after extensive review of literature. The paper will be useful to researchers, maintenance professionals and other concerned officials with improving the performance of production processes effectiveness in industrial organizations.

Keywords: 5S, Total Productive Maintenance (TPM), phases of implementation of 5S and TPM, industrial organizations

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Authors: P. Pötters, A. Marquet, B. Leyendecker

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The objective of this paper is to investigate different implementation approaches for the implementation of Lean production in companies. Furthermore, a structured overview of those different approaches is to be made. Therefore, the present work is intended to answer the following research question: What differences and similarities exist between the various systematic approaches and phase models for the implementation of Lean Production? To present various approaches for the implementation of Lean Production discussed in the literature, a qualitative content analysis was conducted. Within the framework of a qualitative survey, a selection of texts dealing with lean production and its introduction was examined. The analysis presents different implementation approaches from the literature, covering the descriptive aspect of the study. The study also provides insights into similarities and differences among the implementation approaches, which are drawn from the analysis of latent text contents and author interpretations. In this study, the focus is on identifying differences and similarities among systemic approaches for implementing Lean Production. The research question takes into account the main object of consideration, objectives pursued, starting point, procedure, and endpoint of the implementation approach. The study defines the concept of Lean Production and presents various approaches described in literature that companies can use to implement Lean Production successfully. The study distinguishes between five systemic implementation approaches and seven phase models to help companies choose the most suitable approach for their implementation project. The findings of this study can contribute to enhancing transparency regarding the existing approaches for implementing Lean Production. This can enable companies to compare and contrast the available implementation approaches and choose the most suitable one for their specific project.

Keywords: implementation, lean production, phase models, systematic approaches

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Authors: Asfa Hussain, Chee Tang, Mien Nguyen

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Introduction: The safe usage of medications is dependent on clear, well-documented prescribing. Medical drug charts should be regularly checked to ensure that they are fit for purpose. Aims: The purpose of this study was to evaluate whether the Isabel Hospice drug charts were effective or prone to medical errors. The aim was to create a comprehensive palliative care drug chart in line with medico-legal guidelines and to minimise drug administration and prescription errors. Methodology: 50 medical drug charts were audited from March to April 2020, to assess whether they complied with medico-legal guidelines, in a hospice within East of England. Meetings were held with the larger multi-disciplinary team (MDT), including the pharmacists, nursing staff and doctors, to raise awareness of the issue. A preliminary drug chart was created, using the input from the wider MDT. The chart was revised and trialled over 15 times, and each time feedback from the MDT was incorporated into the subsequent template. In the midst of the COVID-19 pandemic in September 2020, the finalised drug chart was trialled. 50 new palliative drug charts were re-audited, to evaluate the changes made. Results: Prescribing and administration errors were high prior to the implementation of the new chart. This improved significantly after introducing the new drug charts, therefore improving patient safety and care. The percentage of inadequately documented allergies went down from 66% to 20% and incorrect oxygen prescription from 40% to 16%. The prescription drug-drug interactions decreased by 30%. Conclusion: It is vital to have clear standardised drug charts, in line with medico-legal standards, to allow ease of prescription and administration of medications and ensure optimum patient-centred care. This closed loop audit demonstrated significant improvement in documentation and prevention of possible fatal drug errors and interactions.

Keywords: palliative care, drug chart, medication errors, drug-drug interactions, COVID-19, patient safety

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Authors: Ciaran Smiddy, Fergus Nugent, Karen Fitzmaurice

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A measure of prescribing and administration of Antimicrobial Prophylaxis before and during Covid-19(2019 vs. 2021) was desired to assess how these were affected by Covid-19. Antimicrobial Prophylaxis was assessed for 60 patients, under 3 Orthopaedic Consultants, against local guidelines. The study found that compliance with guidelines improved significantly, from 60% to 83%, but Appropriate use of Vancomycin reduced from 37% to 29%.

Keywords: antimicrobial stewardship, prescribing, spinal surgery, vancomycin

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Authors: Giuliana Murfet, Heidi Behrens

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Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

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Authors: Katarzyna Olejko

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The need to redefine the goals and adapt the operational activities carried out in accordance with the concept of sustainable management to these goals results in the increasing importance of information on the company's activities perceived from the perspective of the effectiveness and efficiency of environmental goals implementation. The narrow scope of reporting data on a company's impact on the environment is not adequate to meet the information needs of modern investors. Reporting obligations are therefore imposed on companies in order to increase the effectiveness of corporate governance and to improve the process of assessing the achievement of environmental goals. The non-financial reporting obligations introduced in Polish legislation increased the scope of reported information. However, the lack of detailed guidelines on the method of reporting resulted in a large diversification of the scope of non-financial information, making it impossible to compare the data presented by companies. The source of information regarding the level of the implementation of standards in Environmental, social and corporate governance (ESG) is the report on compliance with best practices published by the Warsaw Stock Exchange. The document Best Practices of Warsaw Stock Exchange (WSE) Listed Companies (2021), amended by the WSE in 2021, includes the rules applicable to this area (ESG). The aim of this article is to present the level of compliance with good practices in the area of ESG by selected companies listed on the Warsaw Stock Exchange The research carried out as part of this study, which was based on information from reports on the compliance with good practices of companies listed on the Warsaw Stock Exchange that was made available in the good practice scanner, have revealed that good practices in the ESG area are implemented by companies to a limited extent. The level of their application in comparison with other rules is definitely lower. The lack of experience and clear guidelines on ESG reporting may cause some confusion, which is why conscious investors and reporting companies themselves are pinning their hopes on the Corporate Sustainability Reporting Directive (CSRD) adopted by European Parliament.

Keywords: reporting, ESG, corporate governance, best practices

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Authors: Tatsanawalai Utarasakul, Ch. Hirannukhrao

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The purpose of this research was to investigate the appropriate guidelines for promoting manuscript publication of the academic staff in Faculty of Science and Technology, Suan Sunandha Rajabhat University (SciSSRU). Data were collected from 88 academic staff of SciSSRU. The qualitative approach and knowledge management were used to determine the guidelines for promoting manuscript publication. In addition, TUNA Model was applied in order to follow the process of knowledge management. Simplified techniques were presented and shared with academic staff in the Knowledge Management exhibition, brochure, and websites. The result of this study revealed that, the comparison of number of manuscript publication of academic staff between academic year 2012 and 2013 is rapidly increasing for 60 percentages.

Keywords: knowledge management, articles, publication, academic staff

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Authors: Mohamad Khairi Ishak

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Conventional public key crypto systems such as RSA (Ron Rivest, Adi Shamir and Leonard Adleman), DSA (Digital Signature Algorithm), and Elgamal are no longer efficient to be implemented in the small, memory constrained devices. Elliptic Curve Cryptography (ECC), which allows smaller key length as compared to conventional public key crypto systems, has thus become a very attractive choice for many applications. This paper describes implementation of an elliptic curve cryptography (ECC) encryption engine on a FPGA. The system has been implemented in 2 different key sizes, which are 131 bits and 163 bits. Area and timing analysis are provided for both key sizes for comparison. The crypto system, which has been implemented on Altera’s EPF10K200SBC600-1, has a hardware size of 5945/9984 and 6913/9984 of logic cells for 131 bits implementation and 163 bits implementation respectively. The crypto system operates up to 43 MHz, and performs point multiplication operation in 11.3 ms for 131 bits implementation and 14.9 ms for 163 bits implementation. In terms of speed, our crypto system is about 8 times faster than the software implementation of the same system.

Keywords: elliptic curve cryptography, FPGA, key sizes, memory

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Authors: Reem AlKabbi, Hayat Ali, Mariam Yasser

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Nowadays, eGovernment websites are becoming indispensable for public, business, personal efficiency or even improvement of livelihoods. Using these websites, citizens undertake number of tasks that would otherwise be difficult or impossible. However, many of these websites are not accessible to all people' types including People with Disabilities (PWDs). Through Web Accessibility Guidelines, Web developers can develop Web applications that are accessible to PWDs. This research is to investigate the Accessibility of eGovernment websites in Kingdom of Bahrain. The accessibility was measured using Web Content Accessibility Guidelines (WCAG) and section 508. For the evaluation purpose, some automatic tools were used. Samples of 43 eGovernment websites were selected. The accessibility of the websites was analyzed by using several automatic evaluation tools such as Total Validator and Functional Accessibility Evaluator (FAE). The evaluation process revealed several errors according to the accessibility guidelines. This research provides few recommendations for further improvement of accessibility features of eGovernment websites based on the highlighted issues and key findings reported in this research.

Keywords: website accessibility, W3C, PWD, e-government

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Authors: Redha Elhuni, M. Munir Ahmad

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The main purpose of this research is to construct a generic model for successful implementation of Total Quality Management (TQM) in oil sector, and to find out the effects of this model on the organizational sustainability development (OSD) performance of Libyan oil and gas companies using the structured equation modeling (SEM) approach. The research approach covers both quantitative and qualitative methods. A questionnaire was developed in order to identify the quality factors that are seen by Libyan oil and gas companies to be critical to the success of TQM implementation. Hypotheses were developed to evaluate the impact of TQM implementation on O SD. Data analysis reveals that there is a significant positive effect of the TQM implementation on OSD. 24 quality factors are found to be critical and absolutely essential for successful TQM implementation. The results generated a structure of the TQMSD implementation framework based on the four major road map constructs (Top management commitment, employee involvement and participation, customer-driven processes, and continuous improvement culture).

Keywords: total quality management, critical success factors, oil and gas, organizational sustainability development (SD), Libya

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Authors: Alexandra Von Guionneau, William Sloper, Charlotte Burford

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The benefits of exercise for the prevention and management of chronic disease are well established and the importance of primary care practitioners in promoting exercise is becoming increasingly recognized. However, those with severe manifestations of the chronic disease are managed in a secondary care setting. Secondary care practitioners, therefore, have a role to play in promoting physical activity. Methods: In order to assess secondary care doctors’ knowledge of the Chief Medical Officer’s guidelines for physical activity, a 12-question survey was administered to staff working in a district general hospital in South England during team and unit meetings. Questions related to knowledge of the current guidelines for both 19 - 64 year olds and older adults (65 years and above), barriers to exercise discussion or prescription and doctors’ own exercise habits. Responses were collected anonymously and analyzed using SPSS Version 24.0. Results: 96 responses were collected. Doctors taking part in the survey ranged from foundation years (26%) to consultants (40%). 17.7% of participants knew the guidelines for moderate intensity activity for 19 - 64 year olds. Only one participant knew all of the guidance for both 19 - 64 year olds and older adults. While 71.6% of doctors felt they were adequately informed about how to exercise, only 45.6% met the minimum recommended guidance for moderate intensity activity. Conclusion: More work is needed to promote the physical activity guidelines and exercise prescription to doctors working within a secondary care setting. In addition, doctors require more support to personally meet the recommended minimum level of physical activity.

Keywords: exercise is medicine, exercise prescription, physical activity guidelines, exercise habits

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Authors: Zakaria Elkhwesky, Islam E. Salem, Mona Barakat

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The purpose of this study is to analyze the importance of disability management practices (DMPs) and the level of implementation from viewpoints of food and beverage (F & B) managers, F and B entry-level employees, working in F & B departments, and human resources (HRs) managers in five-star hotels in Egypt. It also examined the moderating effect of team orientation (TO) between the importance and the implementation. Data were collected from 400 participants. The correlation proved to be significant, moderate, and positive between the importance and the implementation of DMPs. More, the findings revealed that the relationship between the importance and the implementation is significantly more positive under the condition of a high encouragement of TO.

Keywords: disability management practices, diversity management, team orientation, HR management, hospitality, and tourism operations

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Authors: Naim Ismajli, Ilir Rexhepi

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The article presents the results of the study about the motives and efficiency of quality management system (Quality System, QS) implementation in Kosovo companies. The main purpose of the study was to find out why Kosovo companies seek the implementation and certification of QS in accordance with the requirements of the ISO 9001 series of the standards and what has changed after the QS implementation. Furthermore, the results of the research were compared with similar performed in the other European countries. The performed research revealed that the implementation of QS mostly results in the benefits of an intangible nature that are internal to the company. In addition, although the main reasons to start implementing QS are the expectations of the external advantages, the implementation results mostly in the increase of the internal benefits such as an improvement in the definition of the responsibilities and obligations of the employees, a decrease in the nonconformities, better communication among the employees, and increased efficiency.

Keywords: quality management systems, ISO 9001, total quality management, environmental management system, ISO 14000, competitiveness, efciency

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Authors: Babak Darvish Rouhani, Mohd Nazri Mahrin, Fatemeh Nikpay, Pourya Nikfard, Maryam Khanian Najafabadi

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Enterprise Architecture (EA) is a strategy that is employed by enterprises in order to align their business and Information Technology (IT). EA is managed, developed, and maintained through Enterprise Architecture Implementation Methodology (EAIM). The effectiveness of EA implementation is the degree in which EA helps to achieve the collective goals of the organization. This paper analyzes the results of a survey that aims to explore the factors that affect the effectiveness of EAIM and specifically the relationship between factors and effectiveness of the output and functionality of EA project. The exploratory factor analysis highlights a specific set of five factors: alignment, adaptiveness, support, binding, and innovation. The regression analysis shows that there is a statistically significant and positive relationship between each of the five factors and the effectiveness of EAIM. Consistent with theory and practice, the most prominent factor for developing an effective EAIM is innovation. The findings contribute to the measuring the effectiveness of EA implementation project by providing an indication of the measurement implementation approaches which is used by the Enterprise Architects, and developing an effective EAIM.

Keywords: enterprise architecture, enterprise architecture implementation methodology, implementation methodology, factors, EA, effectiveness

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Authors: Donald Zullick, Cihan Varol

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This research paper begins with a look at current work in business continuity as it relates to the cloud and small to medium business (SMB). While cloud services are an emerging paradigm that is quickly making an impact on business, there has been no substantive research applied to SMB. Seeing this lapse, we have taken a fusion of continuity and cloud research with application to the SMB market. It is an initial reflection with base framework guidelines as a starting point for implementation. In this approach, our research ties together existing work and fill the gap with an SMB outlook.

Keywords: business continuity, cloud services, medium size business, risk assessment, small business

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Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

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The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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Authors: W. Hajuthman, R. Warner, S. Rahman, M. Abraham, H. Helliwell, D. Bodiwala

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Context: Prostate cancer is a prevalent cancer in males in Europe and the US, with diagnosis primarily relying on PSA testing, mpMRI, and subsequent biopsies. However, this diagnostic strategy may lead to complications for patients. Research Aim: The aim of this study is to assess compliance with trust guidelines for antibiotic prophylaxis in patients undergoing transperineal template biopsies of the prostate and evaluate the rate of post-procedure complications. Methodology: This study is conducted retrospectively over an 8-month period. Data collection includes patient demographics, compliance with trust guidelines, associated risk factors, and post-procedure complications such as infection, haematuria, and urinary retention. Findings: The audit includes 100 patients with a median age of 66.11. The compliance with pre-procedure antibiotics was 98%, while compliance with antibiotic prophylaxis recommended by trust guidelines was 68%. Among the patients, 3% developed post-procedure sepsis, with 2 requiring admission for intravenous antibiotics. No evident risk factors were identified in these cases. Additionally, post-procedure urinary retention occurred in 3% of patients and post-procedure haematuria in 2%. Theoretical Importance: This study highlights the increasing use of transperineal template biopsies across UK centres and suggests that having a standardized protocol and compliance with guidelines can reduce confusion, ensure appropriate administration of antibiotics, and mitigate post-procedure complications. Data Collection and Analysis Procedures: Data for this study is collected retrospectively, involving the extraction and analysis of relevant information from patient records over the specified 8-month period. Question Addressed: This study addresses the following research questions: (1) What is the compliance rate with trust guidelines for antibiotic prophylaxis in transperineal template biopsies of the prostate? (2) What is the rate of post-procedure complications, such as infection, haematuria, and urinary retention? Conclusion: Transperineal template biopsies are becoming increasingly prevalent in the UK. Implementing a standardized protocol and ensuring compliance with guidelines can reduce confusion, ensure proper administration of antibiotics, and potentially minimize post-procedure complications. Additionally, considering that studies show no difference in outcomes when prophylactic antibiotics are not used, the reminder to follow trust guidelines may prompt a re-evaluation of antibiotic prescribing practices.

Keywords: prostate, transperineal template biopsies of prostate, antibiotics, complications, microbiology, guidelines

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Authors: G. Surendra Babu

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We all know the importance of mineral wealth, which has been buried inside the layers of the earth for decades. These are the natural energy sources that are used in our day to day life like fuel, electricity, construction, etc. but the process of extraction causes damage to the nature that can’t be returned back and which are left over after completion of mining we can see these are barren from decades these remain unused degraded land. Most of them are covered with vegetation before the start during mining which damages the native vegetation of the region and disturbs the watershed boundary of the regions and it also disturbs the biodiversity of the reign. The major motto of the study is to understand the various issues that are found and to understand various methods of reclamations process that are suitable for revegetating and also variously practiced which are carried out in the different case studies and government guidelines procedure of lease licenses which includes the environmental clearances and also to study the vegetation pattern according to the major issues identified. And finally suggesting the new guidelines with respect to the old guidelines which helps in the revegetation of the mine-sites which helps in establishing of its own sustainable ecosystem in future.

Keywords: reclamation, open-pit mining, revegetation, reclamation methods

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Authors: Suraj Kumar Mukti

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Enterprise Resource Planning (ERP) system is a management tool to integrate all departments in an organization. It integrates business processes, manages resources efficiently and provides an appropriate decision support system to management. ERP system implementation is a typical and time taking process as well as money consuming process. Articles related to key success factors of ERP system implementation are available in the literature, but rare authors have focused on roadmap of successful ERP system implementation. Postponement is better if the organization is not ready to implement ERP system in better way; hence checking of organization’s preparation to adopt new system is an important prerequisite to ensure the success of ERP system implementation in an organization. Then comes what will be called as success of ERP system implementation. Benefits achieved by ERP system may be categorized into two categories; viz. tangible and intangible benefits. This research article presents a roadmap to ensure the success of ERP system implementation and benefits achieved through the new system as in success indicator. A case study is presented to evaluate the success and benefit achieved through the new system. The article gives a comprehensive approach to academicians and a roadmap to the organizations seeking to implement the ERP system.

Keywords: ERP system, decision support system, tangible, intangible

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Authors: Dhafer Alqahtani

Abstract:

Total quality management (TQM) has become a widely accepted approach in the modern industry over recent years. There is a general consensus that by adopting TQM, the overall effectiveness and performance of an industry can be improved. It is also proved that as long as TQM is adopted fully and practiced effectively in the industry, potential benefits of TQM will be delivered. But despite the benefits of TQM as articulated by many quality gurus and academicians, these benefits are not achieved in practice. Many service industries have found it difficult to implement TQM successfully. This paper, therefore, explores the barriers to TQM’s successful implementation in construction firms. The aim is to identify and rank the barriers to successful TQM implementation in order to make them know and get a better understanding by the managers and practitioners of the Construction Industries. The research methodology adopted in this study was an extensive literature review on barriers to TQM implementation followed by a survey of selected construction firms using the self-administered instrument. The results also showed that only lack of effective communication and lack of top management support were not significantly associated with the level of implementation of TQM.

Keywords: total quality management, construction firms, barriers, successful implementation

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Authors: Sara Ramezanzadeh, Nashid Nabian

Abstract:

Historically, pandemics in different periods have caused compulsory changes in human life. In the case of Covid-19, according to the limitations and established care instructions, spatial alignment with the conditions is important. Following the outbreak of Covid-19, the question raised in this study is how to do spatial design in five scales, namely object, space, architecture, city, and infrastructure, in response to the consequences created in the realms under study. From the beginning of the pandemic until now, some changes in the spatial realm have been created spontaneously or by space users. These transformations have been mostly applied in modifiable parts such as furniture arrangement, especially in work-related spaces. To implement other comprehensive requirements, flexibility and adaptation of space design to the conditions resulting from the pandemics are needed during and after the outbreak. Studying the effects of pandemics from the past to the present, this research covers eight major realms, including three categories of ramifications, solutions, and paradigm shifts, and analytical conclusions about the solutions that have been created in response to them. Finally, by the consideration of epidemiology as a modern discipline influencing the design, spatial solutions in the five scales mentioned (in response to the effects of the eight realms for spatial adaptation in the face of pandemics and their following conditions) are presented as a series of guidelines. Due to the unpredictability of possible pandemics in the future, the possibility of changing and updating the provided guidelines is considered.

Keywords: pandemics, Covid 19, spatial design, ramifications, solutions, paradigm shifts, guidelines

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Authors: Changiz Valmohammadi

Abstract:

The main purpose of this study is to explore the perception of Iranian experts and executive managers of sample organizations on the benefits and barriers of Internet of Things (IoT) solutions implementation. Based on the review of the related literature and web sites, benefits and barriers of successful implementation to IoT solutions were identified. Through a self-administered questionnaire which was collected from 67 Iranian organizations the ranking and importance of benefits and barriers of IoT solutions implementation were determined based on the perception of the experts of the surveyed organizations. Analysis of data and the obtained results revealed that “improved customer experience” and “Supply chain optimization and responsiveness” are the most important benefits that the survey organizations expect to reap as a result of IoT solutions implementation. Also,” Integration challenges" and “cannot find right suppliers” were ranked as the most challenging barriers to IoT solutions implementation.

Keywords: internet of things (IoT), exploratory study, benefits, barriers, Iran

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Authors: Pornthip Seangsanga

Abstract:

Sepsis or septic shock needs urgent care because it is a cause of the high mortality rate if patients do not receive timely treatment. Songkhla Hospital does not have a clear system or clinical practice guidelines for treatment of patients with severe sepsis or septic shock, which contributes to the said problem.To compare clinical outcomes based on the protocol after using the clinical guidelines between the Emergency Room, Intensive Care Unit, and the Ward. This quasi-experimental study was conducted on the population and 50 subjects who were diagnosed with severe sepsis or septic shock from December 2013 to May 2014. The data were collected using a nursing care and referring record form for patients with severe sepsis or septic shock at Songkhla Hospital. The record form had been tested for its validity by three experts, and the IOC was 1.The mortality rate in patients with severe sepsis or septic shock who were moved from the ER to the ICU was significantly lower than that of those patients moved from the Ward to the ICU within 48 hours. This was because patients with severe sepsis or septic shock who were moved from the ER to the ICU received more fluid within the first six hours according to the protocol which helped patients to have adequate tissue perfusion within the first six hours, and that helped improve blood flow to the kidneys, and the patients’ urine was found to be with a higher quantity of 0.5 cc/kg/hr, than those patients who were moved from the Ward to the ICU. This study shows that patients with severe sepsis or septic shock need to be treated immediately. Using the clinical practice guidelines along with timely diagnosis and treatment based on the sepsis bundle in giving sufficient and suitable amount of fluid to help improve blood circulation and blood pressure can clearly prevent or reduce severity of complications.

Keywords: clinical practice guidelines, caring, septic shock, sepsis bundle protocol

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Authors: Alexis Polanco Jr, Tsai Lu Liu

Abstract:

Research on digital assessment for deaf and hard of hearing (DHH) students is negligible. Part of this stems from the DHH assessment design existing at the intersection of the emergent disciplines of usability, accessibility, and child-computer interaction (CCI). While these disciplines have some prevailing guidelines —e.g. in user experience design (UXD), there is Jacob Nielsen’s 10 Usability Heuristics (Nielsen-10); for accessibility, there are the Web Content Accessibility Guidelines (WCAG) & the Principles of Universal Design (PUD)— this research was unable to uncover a unified set of guidelines. Given that digital assessments have lasting implications for the funding and shaping of U.S. school districts, it is vital that cross-disciplinary guidelines emerge. As a result, this research seeks to provide a framework by which these disciplines can share knowledge. The framework entails a process of asking subject-matter experts (SMEs) and design & development professionals to self-describe their fields of expertise, how their work might serve DHH students, and to expose any incongruence between their ideal process and what is permissible at their workplace. This research used two rounds of mixed methods. The first round consisted of structured interviews with SMEs in usability, accessibility, CCI, and DHH education. These practitioners were not designers by trade but were revealed to use designerly work processes. In addition to asking these SMEs about their field of expertise, work process, etc., these SMEs were asked to comment about whether they believed Nielsen-10 and/or PUD were sufficient for designing products for middle-school DHH students. This first round of interviews revealed that Nielsen-10 and PUD were, at best, a starting point for creating middle-school DHH design guidelines or, at worst insufficient. The second round of interviews followed a semi-structured interview methodology. The SMEs who were interviewed in the first round were asked open-ended follow-up questions about their semantic understanding of guidelines— going from the most general sense down to the level of design guidelines for DHH middle school students. Designers and developers who were never interviewed previously were asked the same questions that the SMEs had been asked across both rounds of interviews. In terms of the research goals: it was confirmed that the design of digital assessments for DHH students is inherently cross-disciplinary. Unexpectedly, 1) guidelines did not emerge from the interviews conducted in this study, and 2) the principles of Nielsen-10 and PUD were deemed to be less relevant than expected. Given the prevalence of Nielsen-10 in UXD curricula across academia and certificate programs, this poses a risk to the efficacy of DHH assessments designed by UX designers. Furthermore, the following findings emerged: A) deep collaboration between the disciplines of usability, accessibility, and CCI is low to non-existent; B) there are no universally agreed-upon guidelines for designing digital assessments for DHH middle school students; C) these disciplines are structured academically and professionally in such a way that practitioners may not know to reach out to other disciplines. For example, accessibility teams at large organizations do not have designers and accessibility specialists on the same team.

Keywords: deaf, hard of hearing, design, guidelines, education, assessment

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