Search results for: orthopedic nurse practitioners
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1341

Search results for: orthopedic nurse practitioners

441 A Systematic Review on Communication and Relations between Health Care Professionals and Patients with Cancer in Outpatient Settings Matter

Authors: Anne Prip, Kirsten Alling Møller, Dorte Lisbet Nielsen, Mary Jarden, Marie-Helene Olsen, Anne Kjaergaard Danielsen

Abstract:

Background: The development in cancer care has shifted towards shorter hospital stays and more outpatient treatment. Today, cancer care and treatment predominantly takes place in outpatient settings where encounters between patients and health care professionals are often brief. This development will probably continue internationally as the global cancer burden seems to be growing significantly. Furthermore, the number of patients who require ambulatory treatments such as chemotherapy is increasing. Focusing on the encounters between health care professionals and patients during oncology treatment has thus become increasingly important due to a growing trend in outpatient cancer management. Objective: The aim of the systematic review was to summarize the literature from the perspective of the patient, on experiences of and the need for communication and relationships with the health care professional during chemotherapy treatment in an outpatient setting. Method: The review was designed and carried out according to the PRISMA guidelines and PICO framework. The systematic search was conducted in Medline, CINAHL, The Cochrane Library and Joanna Briggs Institute Evidence Based Practice Database. Results: In all, 1174 studies were identified by literature search. After duplicates were removed, the remaining studies (n = 1053) were screened for inclusion. Nine studies were included; qualitative (n = 5) and quantitative (n = 4) as they met the inclusions criteria. The review identified that communication and relationships between health care professionals and patients were important for the patients’ ability to cope with cancer and also had an impact on patients’ satisfaction with care in the outpatient clinic. Furthermore, the review showed that hope and positivity was a need and strategy for patients with cancer and was facilitated by health care professionals. Finally, it revealed that outpatient clinic visits framed and influenced communication and relationships. Conclusions: This review identified the significance of communication and the relationships between patients and health care professionals in the outpatient setting as it supports patients’ ability to cope with cancer. The review showed the need for health care professionals to pay attention to the relational aspects of communication in an outpatient clinic as encounters are often brief. Furthermore, the review helps to specify which elements of the communication are central in the patient-health care professional interaction from the patients' perspective. Finally, it shows a need for more research to investigate which type of interaction and intervention would be the most effective in supporting patients’ coping during chemotherapy in an outpatient clinic.

Keywords: ambulatory chemotherapy, communication, health care professional-patient relation, nurse-patient relation, outpatient care, systematic review

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440 Commercial Management vs. Quantity Surveying: Hoax or Harmonization

Authors: Zelda Jansen Van Rensburg

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Purpose: This study investigates the perceived disparities between Quantity Surveying and Commercial Management in the construction industry, questioning if these differences are substantive or merely semantic. It aims to challenge the conventional notion of Commercial Managers’ superiority by critically evaluating QS and CM roles, exploring CM integration possibilities, examining qualifications for aspiring Commercial Managers, assessing regulatory frameworks, and considering terminology redefinition for global QS professional enhancement. Design: Utilizing mixed methods like literature reviews, surveys, interviews, and document analyses, this research examines the QS-CM relationship. Insights from industry professionals, academics, and regulatory bodies inform the investigation into changing QS roles. Findings: Empirical data highlight evolving roles, showcasing areas of convergence and divergence between QSs and CM. Potential CM integration into QS practice and qualifications for aspiring Commercial Managers are identified. Limitations/Implications: Limitations include potential bias in self-reported data and findings. Nevertheless, the research informs future practices and educational approaches in QS and CM, reflecting the changing roles and responsibilities of Quantity Surveyors. Practical Implications: Findings inform industry practitioners, educators, and regulators, stressing the need to adapt to changing QS roles and integrate CM principles where applicable. Value to the Conference Theme: Aligned with ‘Evolving roles and responsibilities of Quantity Surveyors,’ this research offers insights crucial for understanding the changing dynamics within the QS profession and informs strategies to navigate these shifts effectively.

Keywords: quantity surveying, commercial management, cost engineering, quantity survey

Procedia PDF Downloads 26
439 Ethnobotany and Antimicrobial Effects of Medicinal Plants Used for the Treatment of Sexually Transmitted Infections in Lesotho

Authors: Sandy Van Vuuren, Lerato Kose, Annah Moteetee

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Lesotho, a country surrounded by South Africa has one of the highest rates of sexually transmitted infections (STI’s) in the world. In fact, the country ranks third highest with respect to infections related to the human immunodeficiency virus (HIV). Despite the high prevalence of STI’s, treatment has been a challenge due to limited accessibility to health facilities. An estimated 77% of the population lives in rural areas and more than 60% of the country is mountainous. Therefore, many villages remain accessible only by foot or horse-back. Thus, the Basotho (indigenous people from Lesotho) have a rich cultural heritage of plant use. The aim of this study was to determine what plant species are used for the treatment of STI’s and which of these have in vitro efficacy against pathogens such as Candida albicans, Gardnerella vaginalis, Oligella ureolytica, and Neisseria gonorrhoeae. A total of 34 medicinal plants were reported by traditional practitioners for the treatment of STI’s. Sixty extracts, both aqueous and organic (mixture of methanol and dichloromethane), from 24 of the recorded plant species were assessed for antimicrobial activity using the minimum inhibition concentration (MIC) micro-titre plate dilution assay. Neisseria gonorrhoeae (ATCC 19424) was found to be the most susceptible among the test pathogens, with the majority of the extracts (21) displaying noteworthy activity (MIC values ≤ 1 mg/ml). Helichrysum caespititium was found to be the most antimicrobially active species (MIC value of 0.01 mg/ml). The results of this study support, to some extent, the traditional medicinal uses of the evaluated plants for the treatment of STI’s, particularly infections related to gonorrhoea.

Keywords: Africa, Candida albicans, Gardnerella vaginalis, Neisseria gonorrhoeae, Oligella urealytica

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438 The Emergence of Smart Growth in Developed and Developing Countries and Its Possible Application in Kabul City, Afghanistan

Authors: Bashir Ahmad Amiri, Nsenda Lukumwena

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The global trend indicates that more and more people live and will continue to live in urban areas. Today cities are expanding both in physical size and number due to the rapid population growth along with sprawl development, which caused the cities to expand beyond the growth boundary and exerting intense pressure on environmental resources specially farmlands to accommodate new housing and urban facilities. Also noticeable is the increase in urban decay along with the increase of slum dwellers present another challenge that most cities in developed and developing countries have to deal with. Today urban practitioners, researchers, planners, and decision-makers are seeking for alternative development and growth management policies to house the rising urban population and also cure the urban decay and slum issues turn to Smart Growth to achieve their goals. Many cities across the globe have adopted smart growth as an alternative growth management tool to deal with patterns and forms of development and to cure the rising urban and environmental problems. The method used in this study is a literature analysis method through reviewing various resources to highlight the potential benefits of Smart Growth in both developed and developing countries and analyze, to what extent it can be a strategic alternative for Afghanistan’s cities, especially the capital city. Hence a comparative analysis is carried on three countries, namely the USA, China, and India to identify the potential benefits of smart growth likely to serve as an achievable broad base for recommendations in different urban contexts.

Keywords: growth management, housing, Kabul city, smart growth, urban-expansion

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437 Polycystic Ovary Syndrome: Cervical Cytology Features and Its Association with Endometrial Cancer

Authors: Faezah Shekh Abdullah, Mohd. Azizuddin Mohd. Yussof, Komathy Thiagarajan, Hasnoorina Husin, Noor Azreena Abd Aziz

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Polycystic ovary syndrome has been associated with multiple disorders such as endocrine disorder, metabolic syndrome, infertility, and endometrial cancer. Women with polycystic ovary syndrome (PCOS) are anticipated to develop three times more chances for endometrial cancer than women without PCOS. This study, therefore, was conducted to determine the association between polycystic ovary syndrome and endometrial cancer and to determine the cervical cytology features of PCOS. Patients attending the Subfertility Clinic of the National Population and Family Development Board were recruited and examined physically by medical practitioners. They were categorized into two groups; i) the PCOS group if they met Rotterdam Criteria 2004 and ii) the control group if they did not meet Rotterdam Criteria 2004. Cervical sampling was done on all patients via the Liquid-Based Cytology (LBC) method in the pre-and post-subfertility treatment. A total of 167 patients participated in the study, of which 79 belonged to the PCOS group and 88 to the control group. The findings showed no cervical and endometrial cancer cases in both groups. The Liquid-Based Cytology results in the PCOS group displayed more cases with cellular changes, i.e., benign inflammation, atrophic smear and Candida sp. infection. To conclude, no association was found between polycystic ovary syndrome and endometrial cancer. A more holistic study with a higher number of participants can further determine the association between endometrial cancer and PCOS. Furthermore, a longer duration between LBC pre- and post-subfertility treatment should be implied to observe changes in the cervical cells.

Keywords: endometrial cancer, liquid-based cytology, PCOS, polycystic ovary syndrome

Procedia PDF Downloads 132
436 A Theoretical Framework of Patient Autonomy in a High-Tech Care Context

Authors: Catharina Lindberg, Cecilia Fagerstrom, Ania Willman

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Patients in high-tech care environments are usually dependent on both formal/informal caregivers and technology, highlighting their vulnerability and challenging their autonomy. Autonomy presumes that a person has education, experience, self-discipline and decision-making capacity. Reference to autonomy in relation to patients in high-tech care environments could, therefore, be considered paradoxical, as in most cases these persons have impaired physical and/or metacognitive capacity. Therefore, to understand the prerequisites for patients to experience autonomy in high-tech care environments and to support them, there is a need to enhance knowledge and understanding of the concept of patient autonomy in this care context. The development of concepts and theories in a practice discipline such as nursing helps to improve both nursing care and nursing education. Theoretical development is important when clarifying a discipline, hence, a theoretical framework could be of use to nurses in high-tech care environments to support and defend the patient’s autonomy. A meta-synthesis was performed with the intention to be interpretative and not aggregative in nature. An amalgamation was made of the results from three previous studies, carried out by members of the same research group, focusing on the phenomenon of patient autonomy from a patient perspective within a caring context. Three basic approaches to theory development: derivation, synthesis, and analysis provided an operational structure that permitted the researchers to move back and forth between these approaches during their work in developing a theoretical framework. The results from the synthesis delineated that patient autonomy in a high-tech care context is: To be in control though trust, co-determination, and transition in everyday life. The theoretical framework contains several components creating the prerequisites for patient autonomy. Assumptions and propositional statements that guide theory development was also outlined, as were guiding principles for use in day-to-day nursing care. Four strategies used by patients to remain or obtain patient autonomy in high-tech care environments were revealed: the strategy of control, the strategy of partnership, the strategy of trust, and the strategy of transition. This study suggests an extended knowledge base founded on theoretical reasoning about patient autonomy, providing an understanding of the strategies used by patients to achieve autonomy in the role of patient, in high-tech care environments. When possessing knowledge about the patient perspective of autonomy, the nurse/carer can avoid adopting a paternalistic or maternalistic approach. Instead, the patient can be considered to be a partner in care, allowing care to be provided that supports him/her in remaining/becoming an autonomous person in the role of patient.

Keywords: autonomy, caring, concept development, high-tech care, theory development

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435 Methodology of the Turkey’s National Geographic Information System Integration Project

Authors: Buse A. Ataç, Doğan K. Cenan, Arda Çetinkaya, Naz D. Şahin, Köksal Sanlı, Zeynep Koç, Akın Kısa

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With its spatial data reliability, interpretation and questioning capabilities, Geographical Information Systems make significant contributions to scientists, planners and practitioners. Geographic information systems have received great attention in today's digital world, growing rapidly, and increasing the efficiency of use. Access to and use of current and accurate geographical data, which are the most important components of the Geographical Information System, has become a necessity rather than a need for sustainable and economic development. This project aims to enable sharing of data collected by public institutions and organizations on a web-based platform. Within the scope of the project, INSPIRE (Infrastructure for Spatial Information in the European Community) data specifications are considered as a road-map. In this context, Turkey's National Geographic Information System (TUCBS) Integration Project supports sharing spatial data within 61 pilot public institutions as complied with defined national standards. In this paper, which is prepared by the project team members in the TUCBS Integration Project, the technical process with a detailed methodology is explained. In this context, the main technical processes of the Project consist of Geographic Data Analysis, Geographic Data Harmonization (Standardization), Web Service Creation (WMS, WFS) and Metadata Creation-Publication. In this paper, the integration process carried out to provide the data produced by 61 institutions to be shared from the National Geographic Data Portal (GEOPORTAL), have been trying to be conveyed with a detailed methodology.

Keywords: data specification, geoportal, GIS, INSPIRE, Turkish National Geographic Information System, TUCBS, Turkey's national geographic information system

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434 Sustainability as a Platform in Microfinance Industry for Developing Countries

Authors: Nor Azlina Ab.Rahman, Salwana Hassan, Zuraeda Ibrahim, Normah Omar, Jamaliah Said

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Revolution in the business environment has crucial growing changes on most globalized markets. Numerous of organizations are necessitating towards producing more proactive entrepreneurs with a dynamic teams, who can run and steer their business to victory. Revolutionizing on business strategy and entrepreneurial skills, also implementing innovation and practices to enhance its performance is necessary for these organizations to be more cost-efficient and increase their efficiency. The study aims to clarify issues of whether measurement has a positive effect on different aspects of innovation and best practices. The study contributes to the current understanding in three ways; first by presenting the important aspects of organizational innovation and best practices. Second by showing the importance of measurement in promoting different aspects of innovation and best practices. Third is to examine the link between innovation, best practices and sustainability in microfinance. The study has been executed by conducting a qualitative study toward the microfinance industry. A representative of management and employees in each company was selected through an invitation to participate in getting information for data collection purpose in the study. The study contains a comprehensive description of the impacts of measurement on different aspects of innovation and best practices towards sustainability in both microfinance industries and SMEs. Findings from this study shows that performance measurement has positive effects on issues related to innovation and best practices. The measurement for several aspects of innovation and best practices is good potential in microfinance industries. Additionally, measurement on innovation and best practices shows a positively related with each other to enhance organization performance. The study suggests that both academics and practitioners should focus on the development of new methods and practices to describe and scrutinize further understanding for measuring issues which is related to innovation and best practices, in order to better develop innovation and best practices towards sustainability. This effort would not only contribute to firm’s success, but also toward the development of the nation in the developing countries.

Keywords: best practices, innovation, microfinance, sustainability

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433 A National Survey of Clinical Psychology Graduate Student Attitudes toward Psychotherapy Treatment Manuals: A Replication Study

Authors: B. Bergström, A. Ladd, A. Jones, L. Rosso, P. Michael

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Attitudes toward treatment manuals serve as a meaningful predictor of general attitudes toward evidence-based practice. Despite demonstrating high effectiveness in treating many mental disorders, manualized treatments have been underutilized by practitioners. Thus, one can assess the state of the field regarding the adoption of evidence-based practices by surveying practitioner attitudes towards manualized treatments. This study is an adapted replication that assesses psychology graduate student attitudes towards manualized treatments, as a general marker for attitudes towards evidence-based practice. Training programs provide future clinicians with the foundation for critical skills in clinical practice. Research demonstrates that post-graduate continuing education has little to no effect on clinical practice; thus, graduate programs serve as the primary, and often final platform for all future practice. However, there are little empirical data identifying the attitudes and training of graduate students in utilizing manualized treatments. The empirical analysis of this study indicates an increase in positive attitudes among graduate student attitudes towards manualized treatments (within the United States), when compared to past surveys of professional psychologists. Findings from this study may inform graduate programs of barriers for students in developing positive attitudes toward manualized treatments and evidence-based practice. This study also serves as a preliminary predictor of the state-of-the field, in regards to professional psychologists attitudes towards evidence-based practice, if attitudes remain stable. This study indicates that the attitudes toward utilizing evidence-based practices, such as treatment manuals, has become more positive since year 2000.

Keywords: exposure therapy, evidence based practice, manualized treatments, student attitudes

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432 Nimart-trained Nurses' Perspectives Regarding Virally Unsuppressed Children HIV-positive on Antiretroviral Therapy and Missing Scheduled Clinic Visits: Mopani District, Limpopo Province

Authors: Linneth Nkateko Mabila, Patrick Hulisani Demana, Tebogo Maria Mothiba

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Background: Sustaining adherence to antiretroviral therapy (ART) over the long term by people, especially children living with Human-Immunodeficiency Virus (HIV), requires accurate and consistent monitoring, and this is a particular challenge for countries in sub-Saharan Africa. However, the regularity and punctuality in monthly antiretroviral treatment collections indicate medication adherence to a certain extent since it has been revealed to be a significant determinant of the outcome of ART. Aim: This study assessed and described the pattern of monthly antiretroviral treatment collections among a cohort of virally unsuppressed HIV-positive children initiated and managed on ART in the rural public clinics of Mopani District, Limpopo, and explored the nurses' perceptions and views of the findings. Methods: A facility-based mixed-methods study was conducted to assess the honoring of scheduled monthly treatment collection practices by a cohort of HIV-positive children under 15 years initiated and managed on ART by Nurse Initiated Management of Antiretroviral Treatment (NIMART)-trained professional nurses (PNs) from 01 January 2015 to 31 December 2015 in public PHC clinics of Mopani District Municipality. This was followed by the exploration of the nurses' perceptions and views regarding this issue to share their experiences and knowledge acquired through managing these children on ART. Results: From a total of 7105 analysable visits, only 44% (3134) were honored as scheduled, with 40% (2828) of children presenting to the clinics after the scheduled appointment date – they missed their appointments, and 11% (768) of treatment collections that took place before the scheduled appointment date. This finding was further confirmed by 90% (97) of the nurses, who reported that they have children who miss scheduled appointments in their public clinics. The primary reasons for children missing appointments were related to caregivers' forgetfulness and conflict between the school schedule and the dates of clinic visits. Conclusion: We confirmed a high prevalence of non-adherence to scheduled monthly ART collections and the existence of health system, social, and caregiver-related factors that threaten treatment adherence and proper clinical outcomes. These findings suggest an urgent need for intervention since non-adherence to ARV therapy can be life-threatening to the child and poses the danger of reduced life expectancy.

Keywords: antiretroviral therapy (art), nimart, virally unsuppressed children, missed appointments

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431 Analyzing Environmental Emotive Triggers in Terrorist Propaganda

Authors: Travis Morris

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The purpose of this study is to measure the intersection of environmental security entities in terrorist propaganda. To the best of author’s knowledge, this is the first study of its kind to examine this intersection within terrorist propaganda. Rosoka, natural language processing software and frame analysis are used to advance our understanding of how environmental frames function as emotive triggers. Violent jihadi demagogues use frames to suggest violent and non-violent solutions to their grievances. Emotive triggers are framed in a way to leverage individual and collective attitudes in psychological warfare. A comparative research design is used because of the differences and similarities that exist between two variants of violent jihadi propaganda that target western audiences. Analysis is based on salience and network text analysis, which generates violent jihadi semantic networks. Findings indicate that environmental frames are used as emotive triggers across both data sets, but also as tactical and information data points. A significant finding is that certain core environmental emotive triggers like “water,” “soil,” and “trees” are significantly salient at the aggregate level across both data sets. All environmental entities can be classified into two categories, symbolic and literal. Importantly, this research illustrates how demagogues use environmental emotive triggers in cyber space from a subcultural perspective to mobilize target audiences to their ideology and praxis. Understanding the anatomy of propaganda construction is necessary in order to generate effective counter narratives in information operations. This research advances an additional method to inform practitioners and policy makers of how environmental security and propaganda intersect.

Keywords: propaganda analysis, emotive triggers environmental security, frames

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430 Destructive Groups: The Impact on Adolescent Mental Health and Social Integration

Authors: Dušica Kovačević

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This study explores the influence of destructive groups on the mental health and social integration of high school students in Loznica, Serbia. Despite increasing concerns, there is a significant lack of research on the impact of these groups on adolescents in this region. This qualitative study aims to fill this gap by examining the prevalence of destructive groups, their psychological effects on students, and their broader social implications. Data were collected through surveys and in-depth interviews with high school students, educators, and mental health professionals. The study focuses on key mental health indicators, such as anxiety, depression, and identity formation, alongside social factors, including peer relationships and community engagement. Additionally, it defines coping mechanisms and supporting strategies employed by students affected by these groups. The findings reveal substantial psychological and social challenges faced by students exposed to destructive groups, including increased levels of anxiety and depression, disrupted identity development, and impaired social integration. Insights into the personal experiences of these students provide a detailed understanding of the groups’ impact, underscoring the need for targeted interventions. This research offers evidence-based recommendations for educators, mental health practitioners, and policymakers. It emphasizes the importance of developing effective educational programs and support services to enhance the well-being of high school advocates for proactive measures to protect adolescent mental health and promote healthy social values within educational and community settings.

Keywords: adolescents, mental health, destructive groups, social integration, qualitative study, high school students, Serbia

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429 The Use of STIMULAN Resorbable Antibiotic Beads in Conjunction with Autologous Tissue Transfer to Treat Recalcitrant Infections and Osteomyelitis in Diabetic Foot Wounds

Authors: Hayden R Schott, John M Felder III

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Introduction: Chronic lower extremity wounds in the diabetic and vasculopathic populations are associated with a high degree of morbidity.When wounds require more extensive treatment than can be offered by wound care centers, more aggressive solutions involve local tissue transfer and microsurgical free tissue transfer for achieving definitive soft tissue coverage. These procedures of autologous tissue transfer (ATT) offer resilient, soft tissue coverage of limb-threatening wounds and confer promising limb salvage rates. However, chronic osteomyelitis and recalcitrant soft tissue infections are common in severe diabetic foot wounds and serve to significantly complicate ATT procedures. Stimulan is a resorbable calcium sulfate antibiotic carrier. The use of stimulan antibiotic beads to treat chronic osteomyelitis is well established in the orthopedic and plastic surgery literature. In these procedures, the beads are placed beneath the skin flap to directly deliver antibiotics to the infection site. The purpose of this study was to quantify the success of Stimulan antibiotic beads in treating recalcitrant infections in patients with diabetic foot wounds receiving ATT. Methods: A retrospective review of clinical and demographic information was performed on patients who underwent ATT with the placement of Stimulan antibiotic beads for attempted limb salvage from 2018-21. Patients were analyzed for preoperative wound characteristics, demographics, infection recurrence, and adverse outcomes as a result of product use. The primary endpoint was 90 day infection recurrence, with secondary endpoints including 90 day complications. Outcomes were compared using basic statistics and Fisher’s exact tests. Results: In this time span, 14 patients were identified. At the time of surgery, all patients exhibited clinical signs of active infection, including positive cultures and erythema. 57% of patients (n=8) exhibited chronic osteomyelitis prior to surgery, and 71% (n=10) had exposed bone at the wound base. In 57% of patients (n=8), Stimulan beads were placed beneath a free tissue flap and beneath a pedicle tissue flap in 42% of patients (n=6). In all patients, Stimulan beads were only applied once. Recurrent infections were observed in 28% of patients (n=4) at 90 days post-op, and flap nonadherence was observed in 7% (n=1). These were the only Stimulan related complications observed. Ultimately, lower limb salvage was successful in 85% of patients (n=12). Notably, there was no significant association between the preoperative presence of osteomyelitis and recurrent infections. Conclusions: The use of Stimulanantiobiotic beads to treat recalcitrant infections in patients receiving definitive skin coverage of diabetic foot wounds does not appear to demonstrate unnecessary risk. Furthermore, the lack of significance between the preoperative presence of osteomyelitis and recurrent infections indicates the successful use of Stimulan to dampen infection in patients with osteomyelitis, as is consistent with the literature. Further research is needed to identify Stimulan as the significant contributor to infection treatment using future cohort and case control studies with more patients. Nonetheless, the use of Stimulan antibiotic beads in patients with diabetic foot wounds demonstrates successful infection suppression and maintenance of definitive soft tissue coverage.

Keywords: wound care, stimulan antibiotic beads, free tissue transfer, plastic surgery, wound, infection

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428 Comparing Business Excellence Models Using Quantitative Methods: A First Step

Authors: Mohammed Alanazi, Dimitrios Tsagdis

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Established Business Excellence Models (BEMs), like the Malcolm Baldrige National Quality Award (MBNQA) model and the European Foundation for Quality Management (EFQM) model, have been adopted by firms all over the world. They exist alongside more recent country-specific BEMs; e.g. the Australian, Canadian, China, New Zealand, Singapore, and Taiwan quality awards that although not as widespread as MBNQA and EFQM have nonetheless strong national followings. Regardless of any differences in their following or prestige, the emergence and development of all BEMs have been shaped both by their local context (e.g. underlying socio-economic dynamics) as well as by global best practices. Besides such similarities, that render them into objects (i.e. models) of the same class (i.e. BEMs), BEMs exhibit non-trivial differences in their criteria, relations, and emphasis. Given the evolution of BEMs (e.g. the MBNQA underwent seven evolutions since its inception in 1987 while the EFQM five since 1993), it is unsurprising that comparative studies of their validity are few and far in between. This poses challenges for practitioners and policy makers alike; as it is not always clear which BEM is to be preferred or better fitting to a particular context. Especially, in contexts that differ substantially from the original context of BEM development. This paper aims to fill this gap by presenting a research design and measurement model for comparing BEMs using quantitative methods (e.g. structural equations). Three BEMs will be focused upon in particular for illustration purposes; the MBNQA, the EFQM, and the King Abdul Aziz Quality Award (KAQA) model. They have been selected so to reflect the two established and widely spread traditions as well as a more recent context-specific arrival promising a better fit.

Keywords: Baldrige, business excellence, European Foundation for Quality Management, Structural Equation Model, total quality management

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427 A Case Study of Business Analytic Use in European Football: Analysis and Implications

Authors: M. C. Schloesser

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The purpose of this paper is to explore the use and impact of business analytics in European football. Despite good evidence from other major sports leagues, research on this topic in Europe is currently very scarce. This research relies on expert interviews on the use and objective of business analytics. Along with revenue data over 16 seasons spanning from 2004/05 to 2019/20 from Manchester City FC, we conducted a time series analysis to detect a structural breakpoint on the different revenue streams, i.e., sponsorship and ticketing, after analytical tools have been implemented. We not only find that business analytics have indeed been applied at Manchester City FC and revenue increase is the main objective of their utilization but also that business analytics is indeed a good means to increase revenues if applied sufficiently. We can thereby support findings from other sports leagues. Consequently, professional sports organizations are advised to apply business analytics if they aim to increase revenues. This research has shown that analytical practices do, in fact, support revenue growth and help to work more efficiently. As the knowledge of analytical practices is very confidential and not publicly available, we had to select one club as a case study which can be considered a research limitation. Other practitioners should explore other clubs or leagues. Further, there are other factors that can lead to increased revenues that need to be considered. Additionally, sports organizations need resources to be able to apply and utilize business analytics. Consequently, findings might only apply to the top teams of the European football leagues. Nonetheless, this paper combines insights and results on usage, objectives, and impact of business analytics in European professional football and thereby fills a current research gap.

Keywords: business analytics, expert interviews, revenue management, time series analysis

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426 Relationships between Emotion Regulation Strategies and Well-Being Outcomes among the Elderly and Their Caregivers: A Dyadic Modeling Approach

Authors: Sakkaphat T. Ngamake, Arunya Tuicomepee, Panrapee Suttiwan, Rewadee Watakakosol, Sompoch Iamsupasit

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Generally, 'positive' emotion regulation strategies such as cognitive reappraisal have linked to desirable outcomes while 'negative' strategies such as behavioral suppression have linked to undesirable outcomes. These trends have been found in both the elderly and professional practitioners. Hence, this study sought to investigate these trends further by examining the relationship between two dominant emotion regulation strategies in the literature (i.e., cognitive reappraisal and behavioral suppression) and well-being outcomes among the elderly (i.e., successful aging) and their caregivers (i.e., satisfaction with life), using the actor-partner interdependence model. A total of 150 elderly-caregiver dyads participated in the study. The elderly responded to two measures assessing the two emotion regulation strategies and successful aging while their caregivers responded to the same emotion regulation measure and a measure of satisfaction with life. Two criterion variables (i.e., successful aging and satisfaction with life) were specified as latent variables whereas four predictors (i.e., two strategies for the elderly and two strategies for their caregivers) were specified as observed variables in the model. Results have shown that, for the actor effect, the cognitive reappraisal strategy yielded positive relationships with the well-being outcomes for both the elderly and their caregivers. For the partner effect, a positive relationship between caregivers’ cognitive reappraisal strategy and the elderly’s successful aging was observed. The behavioral suppression strategy has not related to any well-being outcomes, within and across individual agents. This study has contributed to the literature by empirically showing that the mental activity of the elderly’s immediate environment such as their family members or close friends could affect their quality of life.

Keywords: emotion regulation, caregiver, older adult, well-being

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425 Influence of Well-Being and Quality of Work-Life on Quality of Care among Health Professionals in Southwest Nigeria

Authors: Adesola C. Odole, Michael O. Ogunlana, Nse A. Odunaiya, Olufemi O. Oyewole, Chidozie E. Mbada, Ogochukwu K. Onyeso, Ayomikun F. Ayodeji, Opeyemi M. Adegoke, Iyanuoluwa Odole, Comfort T. Sanuade, Moyosooreoluwa E. Odole, Oluwagbohunmi A. Awosoga

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Purpose: The Nigerian healthcare industry is bedeviled with infrastructural decay, inadequate funding and staffing, and a dysfunctional healthcare system. This study investigated the influence of health professionals’ well-being and quality of work-life (QoWL) on the quality of care (QoC) of patients in Nigeria. Methods: The study was a multicentre cross-sectional survey conducted at four tertiary health institutions in southwest Nigeria. Participants’ demographic information, well-being, quality of work-life, and quality of care were obtained using four standardized questionnaires. Data were summarized using descriptive statistics of frequency (percentage) and mean (standard deviation). Inferential statistics included Chi-square, Pearson’s correlation, and independent samples t-test analyses. Results: Medical practitioners (n=609) and nurses (n=570) constituted 74.6% of all the health professionals, with physiotherapists, pharmacists, and medical laboratory scientists constituting 25.4%. The mean (SD) participants’ well-being = 71.65% (14.65), quality of life = 61.8% (21.31), quality of work-life = 65.73% (10.52) and quality of care = 70.14% (12.77). Participants’ quality of life had a significant negative correlation with the quality of care, while well-being and quality of work-life had a significant positive correlation with the quality of care. Conclusion: We concluded that health professionals’ well-being and quality of work-life are important factors that influence their productivity and, ultimately, the quality of care rendered to patients. The hospital management and policymakers should ensure improved work-related factors to improve the well-being of health professionals. This will enhance the quality of care given to patients and ultimately reduce brain drain and medical tourism.

Keywords: health professionals, quality of care, quality of life, quality of work-life, well-being

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424 Integration of an Innovative Complementary Approach Inspired by Clinical Hypnosis into Oncology Care: Nurses’ Perception of Comfort Talk

Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

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Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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423 Mediation Role of Teachers’ Surface Acting and Deep Acting on the Relationship between Calling Orientation and Work Engagement

Authors: Yohannes Bisa Biramo

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This study examined the meditational role of surface acting and deep acting on the relationship between calling orientation and work engagement of teachers in secondary schools of Wolaita Zone, Wolaita, Ethiopia. A predictive non-experimental correlational design was performed among 300 secondary school teachers. Stratified random sampling followed by a systematic random sampling technique was used as the basis for selecting samples from the target population. To analyze the data, Structural Equation Modeling (SEM) was used to test the association between the independent variables and the dependent variables. Furthermore, the goodness of fit of the study variables was tested using SEM to see and explain the path influence of the independent variable on the dependent variable. Confirmatory factor analysis (CFA) was conducted to test the validity of the scales in the study and to assess the measurement model fit indices. The analysis result revealed that calling was significantly and positively correlated with surface acting, deep acting and work engagement. Similarly, surface acting was significantly and positively correlated with deep acting and work engagement. And also, deep acting was significantly and positively correlated with work engagement. With respect to mediation analysis, the result revealed that surface acting mediated the relationship between calling and work engagement and also deep acting mediated the relationship between calling and work engagement. Besides, by using the model of the present study, the school leaders and practitioners can identify a core area to be considered in recruiting and letting teachers teach, in giving induction training for newly employed teachers and in performance appraisal.

Keywords: calling, surface acting, deep acting, work engagement, mediation, teachers

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422 Risk Issues for Controlling Floods through Unsafe, Dual Purpose, Gated Dams

Authors: Gregory Michael McMahon

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Risk management for the purposes of minimizing the damages from the operations of dams has met with opposition emerging from organisations and authorities, and their practitioners. It appears that the cause may be a misunderstanding of risk management arising from exchanges that mix deterministic thinking with risk-centric thinking and that do not separate uncertainty from reliability and accuracy from probability. This paper sets out those misunderstandings that arose from dam operations at Wivenhoe in 2011, using a comparison of outcomes that have been based on the methodology and its rules and those that have been operated by applying misunderstandings of the rules. The paper addresses the performance of one risk-centric Flood Manual for Wivenhoe Dam in achieving a risk management outcome. A mixture of engineering, administrative, and legal factors appear to have combined to reduce the outcomes from the risk approach. These are described. The findings are that a risk-centric Manual may need to assist administrations in the conduct of scenario training regimes, in responding to healthy audit reporting, and in the development of decision-support systems. The principal assistance needed from the Manual, however, is to assist engineering and the law to a good understanding of how risks are managed – do not assume that risk management is understood. The wider findings are that the critical profession for decision-making downstream of the meteorologist is not dam engineering or hydrology, or hydraulics; it is risk management. Risk management will provide the minimum flood damage outcome where actual rainfalls match or exceed forecasts of rainfalls, that therefore risk management will provide the best approach for the likely history of flooding in the life of a dam, and provisions made for worst cases may be state of the art in risk management. The principal conclusion is the need for training in both risk management as a discipline and also in the application of risk management rules to particular dam operational scenarios.

Keywords: risk management, flood control, dam operations, deterministic thinking

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421 A Use Case-Oriented Performance Measurement Framework for AI and Big Data Solutions in the Banking Sector

Authors: Yassine Bouzouita, Oumaima Belghith, Cyrine Zitoun, Charles Bonneau

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Performance measurement framework (PMF) is an essential tool in any organization to assess the performance of its processes. It guides businesses to stay on track with their objectives and benchmark themselves from the market. With the growing trend of the digital transformation of business processes, led by innovations in artificial intelligence (AI) & Big Data applications, developing a mature system capable of capturing the impact of digital solutions across different industries became a necessity. Based on the conducted research, no such system has been developed in academia nor the industry. In this context, this paper covers a variety of methodologies on performance measurement, overviews the major AI and big data applications in the banking sector, and covers an exhaustive list of relevant metrics. Consequently, this paper is of interest to both researchers and practitioners. From an academic perspective, it offers a comparative analysis of the reviewed performance measurement frameworks. From an industry perspective, it offers exhaustive research, from market leaders, of the major applications of AI and Big Data technologies, across the different departments of an organization. Moreover, it suggests a standardized classification model with a well-defined structure of intelligent digital solutions. The aforementioned classification is mapped to a centralized library that contains an indexed collection of potential metrics for each application. This library is arranged in a manner that facilitates the rapid search and retrieval of relevant metrics. This proposed framework is meant to guide professionals in identifying the most appropriate AI and big data applications that should be adopted. Furthermore, it will help them meet their business objectives through understanding the potential impact of such solutions on the entire organization.

Keywords: AI and Big Data applications, impact assessment, metrics, performance measurement

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420 Extent of Derivative Usage, Firm Value and Risk: An Empirical Study on Pakistan Non-Financial Firms

Authors: Atia Alam

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Growing liberalisation and intense market competition increase firm’s risk exposure and induce corporations to use derivatives extensively as a risk management instrument, which results in decrease in firm’s risk, and increase in value. Present study contributes towards existing literature by providing an in-depth analysis regarding the effect of extent of derivative usage on firm’s risk and value by using panel data models and seemingly unrelated regression technique. New evidence is established in current literature by dividing the sample data based on firm’s Exchange Rate (ER) and Interest Rate (IR) exposure. Analysis is performed for the effect of extent of derivative usage on firm’s risk and value and its variation with respect to the ER and IR exposure. Sample data consists of 166 Pakistani firms listed on Pakistan stock exchange for the period of 2004-2010. Results show that extensive usage of derivative instruments significantly increases firm value and reduces firm’s risk. Furthermore, comprehensive analysis depicts that Pakistani corporations having higher exchange rate exposure, with respect to foreign sales, and higher interest rate exposure, on the basis of industry adjusted leverage, have higher firm value and lower risk. Findings from seemingly unrelated regression also provide robustness to results obtained through panel data analysis. Study also highlights the role of derivative usage as a risk management instrument in high and low ER and IR risk and helps practitioners in understanding how value increasing effect of extent of derivative usage varies with the intensity of firm’s risk exposure.

Keywords: extent of derivative usage, firm value, risk, Pakistan, non-financial firms

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419 Modeling Factors Influencing Online Shopping Intention among Consumers in Nigeria: A Proposed Framework

Authors: Abubakar Mukhtar Yakasai, Muhammad Tahir Jan

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Purpose: This paper is aimed at exploring factors influencing online shopping intention among the young consumers in Nigeria. Design/Methodology/approach: The paper adopted and extended Technology Acceptance Model (TAM) as the basis for literature review. Additionally, the paper proposed a framework with the inclusion of culture as a moderating factor of consumer online shopping intention among consumers in Nigeria. Findings: Despite high rate of internet penetration in Nigerian, as well as the rapid advancement of online shopping in the world, little attention was paid to this important revolution specifically among Nigeria’s consumers. Based on the review of extant literature, the TAM extended to include perceived risk and enjoyment (PR and PE) was discovered to be a better alternative framework for predicting Nigeria’s young consumers’ online shopping intention. The moderating effect of culture in the proposed model is shown to help immensely in ascertaining differences, if any, between various cultural groups among online shoppers in Nigeria. Originality/ value: The critical analysis of different factors will assist practitioners (like online retailers, e-marketing managers, website developers, etc.) by signifying which combinations of factors can best predict consumer online shopping behaviour in particular instances, thereby resulting in effective value delivery. Online shopping is a newly adopted technology in Nigeria, hence the paper will give a clear focus for effective e-marketing strategy. In addition, the proposed framework in this paper will guide future researchers by providing a tool for systematic evaluation and testing of real empirical situation of online shopping in Nigeria.

Keywords: online shopping, perceived ease of use, perceived usefulness, perceived enjoyment, technology acceptance model, Nigeria

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418 Positioning Organisational Culture in Knowledge Management Research

Authors: Said Al Saifi

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This paper proposes a conceptual model for understanding the impact of organisational culture on knowledge management processes and their link with organisational performance. It is suggested that organisational culture should be assessed as a multi-level construct comprising artifacts, espoused beliefs and values, and underlying assumptions. A holistic view of organisational culture and knowledge management processes, and their link with organisational performance, is presented. A comprehensive review of previous literature was undertaken in the development of the conceptual model. Taken together, the literature and the proposed model reveal possible relationships between organisational culture, knowledge management processes, and organisational performance. Potential implications of organisational culture levels for the creation, sharing, and application of knowledge are elaborated. In addition, the paper offers possible new insight into the impact of organisational culture on various knowledge management processes and their link with organisational performance. A number of possible relationships between organisational culture factors, knowledge management processes, and their link with organisational performance were employed to examine such relationships. The research model highlights the multi-level components of organisational culture. These are: the artifacts, the espoused beliefs and values, and the underlying assumptions. Through a conceptualisation of the relationships between organisational culture, knowledge management processes, and organisational performance, the study provides practical guidance for practitioners during the implementation of knowledge management processes. The focus of previous research on knowledge management has been on understanding organisational culture from the limited perspective of promoting knowledge creation and sharing. This paper proposes a more comprehensive approach to understanding organisational culture in that it draws on artifacts, espoused beliefs and values, and underlying assumptions, and reveals their impact on the creation, sharing, and application of knowledge which can affect overall organisational performance.

Keywords: knowledge application, knowledge creation, knowledge management, knowledge sharing, organisational culture, organisational performance

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417 Wait-Optimized Scheduler Algorithm for Efficient Process Scheduling in Computer Systems

Authors: Md Habibur Rahman, Jaeho Kim

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Efficient process scheduling is a crucial factor in ensuring optimal system performance and resource utilization in computer systems. While various algorithms have been proposed over the years, there are still limitations to their effectiveness. This paper introduces a new Wait-Optimized Scheduler (WOS) algorithm that aims to minimize process waiting time by dividing them into two layers and considering both process time and waiting time. The WOS algorithm is non-preemptive and prioritizes processes with the shortest WOS. In the first layer, each process runs for a predetermined duration, and any unfinished process is subsequently moved to the second layer, resulting in a decrease in response time. Whenever the first layer is free or the number of processes in the second layer is twice that of the first layer, the algorithm sorts all the processes in the second layer based on their remaining time minus waiting time and sends one process to the first layer to run. This ensures that all processes eventually run, optimizing waiting time. To evaluate the performance of the WOS algorithm, we conducted experiments comparing its performance with traditional scheduling algorithms such as First-Come-First-Serve (FCFS) and Shortest-Job-First (SJF). The results showed that the WOS algorithm outperformed the traditional algorithms in reducing the waiting time of processes, particularly in scenarios with a large number of short tasks with long wait times. Our study highlights the effectiveness of the WOS algorithm in improving process scheduling efficiency in computer systems. By reducing process waiting time, the WOS algorithm can improve system performance and resource utilization. The findings of this study provide valuable insights for researchers and practitioners in developing and implementing efficient process scheduling algorithms.

Keywords: process scheduling, wait-optimized scheduler, response time, non-preemptive, waiting time, traditional scheduling algorithms, first-come-first-serve, shortest-job-first, system performance, resource utilization

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416 Establishment of Virtual Fracture Clinic in Princess Royal Hospital Telford: Experience and Recommendations during the First 9 Months

Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

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Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

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415 The Association of Smoking and Body Mass Index with Acne Vulgaris in Adolescents and Young Adults

Authors: Almutazballlah Qablan, Jihan M. Muhaidat, Bana Abu Rajab

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Background: Acne vulgaris is the most common skin condition that general practitioners and dermatologists encounter. It represents a chronic inflammatory disease affecting the pilosebaceous unit. Although acne vulgaris is not a life-threatening condition, it has a considerable psychological impact on the affected person. Acne patients have poor body image, low self-esteem, social isolation, and restricted activities. As part of the emotional impact, increased levels of anxiety, anger, depression, and frustration have also been observed in acne patients. (1) In this study, we want to assess the association between two modifiable risk factors; BMI and smoking, regarding acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Irbid, north Jordan in 2019/2020. A total number of 163 Acne cases were collected and interviewed by the author; on the other hand, there were 162 control cases. Anthropometric measures for Acne patients and control individuals were taken, and BMI was calculated. Both groups were asked about smoking habits. Data on subjects between 14 and 33 years of age were extracted. The characteristics of people who reported acne were compared with those with no acne using univariate and multivariate analysis. The Statistical Package for Social Sciences (SPSS) was relied on to analyze the collected data. The crosstabs methods (chi-square) and odd ratios were relied on to test the study hypothesis. Results: Cigarette smoking was highly associated with no-acne, with an odds ratio of 0.4 (95% CI: 0.2–0.9), P-value = 0.018. BMI and waterpipe smoking were not significantly associated with acne in the multivariate analysis. Conclusion: Cigarette smoking was found to be protective from Acne. No significant relation between BMI nor waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, BMI, smoking, case-control

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414 Understanding Algerian International Student Mental Health Experiences in UK (United Kingdom) Universities: Difficulties of Disclosure, Help-Seeking and Coping Strategies

Authors: Nesrine Boussaoui

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Background: International students often encounter challenges while studying in the UK, including communication and language barriers, lack of social networks, and socio-cultural differences that adversely impact on their mental health. For Algerian international students (AISs), these challenges may be heightened as English is not their first language and the culture of their homeland is substantially different from British culture, yet research has to incorporate their experiences and perspectives. Aim: The current study aimed to explore AISs’ 1) understandings of mental health; 2) issues of disclosure for mental health difficulties; and 3) mental health help-seeking and coping strategies. Method: In-depth, audio recorded semi-structured interviews (n = 20) with AISs in UK universities were conducted. An inductive, reflective thematic approach analysis was used. Finding: The following themes and associated sub-themes were developed: (1) Algerian cultural influences on mental health understanding(socio-cultural comparisons); (2) the paradox of the family (pressure vs. support); (3) stigma and fear of disclosure; (4) Barriers to formal help-seeking (informal disclosure as first step to seeking help); (5) Communication barriers (resort to mother tongue to disclose); (6) Self-reliance and religious coping. Conclusion: Recognising and understanding the challenges faced by AISs in terms of disclosure and mental health help-seeking is essential to reduce barriers to formal help-seeking. Informal disclosure among peers is often the first step to seeking help. Enhancing practitioners’ cultural competences and awareness of diverse understandings of mental health and the role of religious coping among AISs’ may have transferable benefits to a wider international student population.

Keywords: mental health, stegma, coping, disclosure

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413 Role of Green Ecology in Business Development

Authors: Ashfaq Ahmed Kharal

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The study asserts that environment-friendly practices are increasingly being used by businesses throughout the world. Today, there is a great deal of interest in green management from both practitioners and academics. People expect managers to use resources intelligently and responsibly and to minimize the use of water, minerals, and other components in the finished products, as a crucial factor in this passion. The ethical or moral relevance of green management cannot be overstated. Employee Green Behavior (EGB) and environmental sustainability were shown to be significantly influenced by green human resource management (GHRM) in this study. Environmental issues, such as climate change, global warming, and resource conservation have a direct impact on business activities. The environment, society, and economy all suffer as a result of such obstacles. The depletion of natural resources needs immediate replenishment. As a result of government, non-governmental organizations (NGOs), environmental activists, and labor unions putting pressure on businesses and firms are now required to operate in ecologically responsible ways. Organizations are increasingly concerned about environmental sustainability in light of contemporary environmental circumstances and commercial marketplaces. Companies that emphasize long-term viability will benefit from integrating green employee behavior, green human resource management techniques, and environmental sustainability. Competition drives firms to respond to external causes, adapt, and evolve in response to changing conditions in the marketplace. Organizations develop strategic capabilities to transform their resources and acquire a competitive edge while implementing a business plan. The study of GHRM's function is being prioritized since environmental sustainability is becoming a more important strategic goal.

Keywords: EGB, GHRM, environment sustainability, green ecology

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412 The Development of an Anaesthetic Crisis Manual for Acute Critical Events: A Pilot Study

Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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