Search results for: nurse leadership

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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Authors: Amir Ahmadi, Hossein Ahmadi, Alireza Ahmadi

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Emotional Intelligence (EI) has been defined as the ability to empathize, persevere, control impulses, communicate clearly, make thoughtful decisions, solve problems, and work with others in a way that earns friends and success. These abilities allow an individual to recognize and regulate emotion, develop self-control, set goals, develop empathy, resolve conflicts, and develop skills needed for leadership and effective group participation. Due to the increasing complexity of organizations and different ways of thinking, attitudes and beliefs of individuals, conflict as an important part of organizational life has been examined frequently. The main point is that the conflict is not necessarily in organization, unnecessary; but it can be more creative (increase creativity), to promote innovation. The purpose of this study was to investigate the relation between principals emotional intelligence as one of the factors affecting conflict management among teachers. This relation was analyzed through cluster sampling with a sample size consisting of 120 individuals. The results of the study showed that at the 95% level of confidence, the two secondary hypotheses (i.e. relation between emotional intelligence of principals and use of competition and cooperation strategies of conflict management among teachers) were confirmed, but the other three secondary hypotheses (i.e. the relation between emotional intelligence of managers and use of avoidance, adaptation and adaptability strategies of conflict management among teachers) were rejected. The primary hypothesis (i.e. relation between emotional intelligence of principals with conflict management among teachers) is supported.

Keywords: emotional intelligence, conflict, conflict management, strategies of conflict management

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Authors: Kirsty Liddiard

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In this paper, we detail the politics and practicalities of co-produced disability research with disabled young people with life-limiting and life-threatening impairments in our ESRC funded project, Life, Death, Disability and the Human: Living Life to the Fullest. We centre our Co-Researcher Collective of disabled young people who, through virtual research methods and social technologies, are co-leading this innovative project exploring the lives, hopes, desires and ambitions of young disabled people living short(er) lives. Co-production is an established approach; however, our co-researchers have led us to develop inclusive and transformative research practices that engage with online social research methods in innovative ways. Through this discussion, we demarcate the Academy and ‘research process’ as potentially deeply ableist spaces that propogate the normative researcher as non-disabled; someone integrated into the Academy and insecure employment; and who enacts normative modes of leadership. We use our experiences of co-production in Living Life to the Fullest, then, to show that research – as a discipline, a set of politics, and scholarly practice – must be transformed in order to enable new inclusive research futures that support meaningful co-production with marginalised young people. In conclusion, as we detail our experiences, we aim to encourage disability studies researchers and others to adopt virtual environments and social technologies when researching with and for the lives of disabled people.

Keywords: co-production, illness, youth, technology

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Authors: Agustinus Bandur, Dyah Budiastuti

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With the rapid development of information and communication technology (ICT) in globalisation era, higher education (HE) internationalisation has become a worldwide phenomenon. However, even though various studies have been widely published in existing literature, the settings of these studies were taken places in developed countries. Accordingly, the major purpose of this article is to explore the current trends of higher education internationalisation programs with particular reference to identify the benefits and challenges confronted by participating staff and students. For these purposes, ethnographic qualitative study with the usage of NVivo 11 software was applied in coding, analyzing, and visualization of non-numeric data gathered from interviews, videos, web contents, social media, and relevant documents. Purposive sampling technique was applied in this study with a total of ten high-ranked accredited government and private universities in Indonesia. On the basis of thematic and cross-case analyses, this study indicates that while Australia has led other countries in dual-degree programs, partner universities from Japan and Korea have the most frequent collaboration on student exchange programs. Meanwhile, most visiting scholars who have collaborated with the universities in this study came from the US, the UK, Japan, Australia, Netherlands, and China. Other European countries such as Germany, French, and Norway have also conducted joint research with Indonesian universities involved in this study. This study suggests that further supports of government policy and grants are required to overcome the challenges as well as strategic leadership and management roles to achieve high impacts of such programs on higher education quality.

Keywords: higher education, internationalisation, challenges, Indonesia

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Authors: Minakshi Jain, Sachin Yadav

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Gram Panchayat is the smallest unit of Democracy in India. Grassroots Democracy has been further strengthened by implementation of the 73rd Constitutional Amendment act (CAA) in 1992. To analyse the impact of grassroots democracy the three villages are selected, which have the representation of each section of the society. The selected villages belongs to the same block and district of Haryana state. Villages are selected to access the marginalized group such as women and other backward class. These groups are isolated and do not participate in the grassroots level development process. The caste continue to be a relevant factor in determining the rural leadership. The earlier models of Panchayati Raj failed to benefit the marginalized groups of the society. The 73rd CAA, advocates a uniform three tier system of Panchayat at District level (Zilla Panchayat), Taluka/Block level (Block Panchayat), and village level (Gram Panchayat). The socio-economic profile of representatives in each village is important factor in rural development. The study will highlight the socio-economic profile of elected members at gram Panchayat level, Block Level and District level. The analysis reveals that there is a need to educate and develop the capacity and capability of the elected representative. Training must be imparted to all of them to enable them to function as per provision in the act. The paper will analyse the impact of act on rural development than propose some measures to further strengthen the Panchayati Raj Institution (PRI’s) at grassroots level.

Keywords: democracy, rural development, marginalized people, function

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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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Authors: Larry Audet

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Creativity is suddenly and fortunately a new educational focus in the United Arab Emirates and around the world. Yet still today many leaders of creativity are not sure how to introduce it to their teachers. It is impossible to simultaneously introduce every aspect of creativity into a work climate and reach any degree of organizational coherence. The number of alternatives to explore is so great; the information teachers need to learn is so vast, that even an approximation to including every concept and theory of creativity into the school organization is hard to conceive. Effective leaders of creativity need evidence-based and practical guidance for introducing and stimulating creativity in others. Machine learning models reveal new findings from KEYS Survey© data about teacher perceptions of stimulants and barriers to their individual and collective creativity. Findings from predictive and causal models provide leaders with a rational for decision-making when introducing creativity into their organization. Leaders should focus on management practices first. Analyses reveal that creative outcomes are more likely to occur when teachers perceive supportive management practices: providing teachers with challenging work that calls for their best efforts; allowing freedom and autonomy in their practice of work; allowing teachers to form creative work-groups; and, recognizing them for their efforts. Once management practices are in place, leaders should focus their efforts on modeling risk-taking, providing optimal amounts of preparation time, and evaluating teachers fairly.

Keywords: creativity, leadership, KEYS survey, teaching, work climate

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Authors: Anacletus Ogbunkwu

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It is very disheartening that fake news or inaccurate information spread like wide fire and even with greater speed than fact based news/information. The peak of this anomaly is manifest in information management on the Corona virus pandemic, political/leadership based information, ethnic bigotry, unwarranted panics, false alarms, religious fanaticism, and business moguls in their advertorials, comedies, etc. This ugly situation has left Nigeria and her citizens with emotional trauma, unguided agitations, incessant tribal wars, lost of life and property, widened disunity among Nigerian ethnic and religious groups, amplified insecurity, aided election violence, etc. Unfortunately, among the major driving factors to this misinformation and conspiracy are the official/government and private news agencies, gossip, comedians, and social media handles such as; facebook, twitter, whatsapp, instagram, and online news agencies, etc. Thus this paper examines the impact of misinformation here referred to as infodemic. Also, it studies the epistemic effect of misinformation on the citizens of Nigeria in order to find ways of abating this anomaly for a better society. The methods of exposition and hermeneutics will be used in order to gain in-depth study of the details of infodemic in Nigeria and to offer philosophical analysis/interpretation of data as gathered, respectively. This paper concludes that misinformation or fake news has a perilous effect of epistemic mistrust to Nigeria and her citizens; hence infodemic is a cog in the wheel of National progress.

Keywords: nigeria, infodemic, language, media, news, progress

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Authors: Save Kumwenda, Khumbo Kalulu, Kondwani Chidziwisano, Limbani Kalumbi, Vincent Doyle, Bagrey Ngwira

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Introduction: The Malawi Government in partnership with Non-Governmental Organizations adopted Community Led Total Sanitation (CLTS) in 2008 as an approach in sanitation and hygiene promotion with an aim of declaring Malawi Open Defeacation Free (ODF) by 2015. While there is a significant body of research into CLTS available in public domain, there is little research done on challenges faced in implementing CLTS in Malawi. Methods: A cross-sectional qualitative study was carried out in three districts of Ntcheu, Balaka, and Phalombe. Data was collected using Focus Group Discussions (FGDs) and Key informant interviews (KII) and analysed manually. Results: In total, 96 people took part in FGDs and 9 people in KII. It was shown that choice of leaders after triggering was commonly done by chiefs, facilitators, and VHC without following CLTS principles as opposed to identifying individuals who showed leadership skills. Despite capacity building initiatives involving District Coordinating Teams, lack of resources to undertake follow-ups contributed to failure to sustain ODF in the community. It was also found that while most respondents appreciating the need for no subsidies, the elderly and those with disabilities felt the need for external support because do not have money for buying strong logs, slabs for durable toilet floor and also to hire people to build latrines for them. Conclusion: Effective implementation of CLTS requires comprehensive consideration of various issues that may affect its success.

Keywords: open defecation, community-led, sanitation, faecal matter, hygiene, Malawi

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Authors: Rania Al Namara

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During the Covid-19 pandemic, women disproportionately left the workforce compared to men, and many remained outside of the labor market during the Covid-19 recovery period—a phenomenon referred to as the “she-recession” or “shecession.” While the number of women returning to work has increased, long-standing systemic inequalities interfere with women's equal participation in the workforce. Previous research on media framing has explored the importance of news coverage of women’s issues in print and magazines to shaping the public’s views on an issue and the national response. This study adopts textual analysis to examine how 50 news stories published on CNN and CBS in March 2023 frame women’s employment challenges as a matter of choice or as a matter of insufficient systems and analyzes the narratives portrayed to understand how this discourse affects national policies regarding women’s equality in the workforce. Findings suggest that media coverage centers on four themes: unequal wages at work, work-life integration, experiences of minority women, and the struggle to acquire leadership positions. Media coverage gives space to women to tell personal stories about facing these four societal challenges. However, little coverage is devoted to the political figures and institutions that either reinforce gender inequalities or advance women’s rights in these areas. These findings highlight the need for media stories that discuss policies and reforms that broaden the choices available to women in the first place.

Keywords: Covid-19 recovery, media coverage, shecession, women’s employment

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Authors: Dinamarie Fonzone

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Employer-sponsored health insurance (ESI) strategic decision-making processes rely on financial analysis to guide leadership in choosing plans that will produce optimal organizational spending outcomes. These financial decision-making methods have not abated ESI costs. Previously unrecognized external social determinants, the impact on ESI plan spending, and other organizational strategies are emerging and are important considerations for organizational decision-makers and change management practitioners. The purpose of thisstudy is to examine the relationship between the social determinants of health (SDoH), employer-sponsored health insurance (ESI) plans, andthe unintended consequence of health inequity. A quantitative research design using selectemployee records from an existing employer human capital management database will be analyzed. Statistical regressionmethods will be used to study the relationships between certainSDoH (employee income, neighborhood geographic living area, and health care access) and health plan utilization, cost, and chronic disease prevalence. The discussion will include an application of the social gradient of health theory to the study findings, organizational transformation through changes in ESI decision-making mental models, and the connection of ESI health inequity to organizational development and changediversity, equity, and inclusion strategies.

Keywords: employer-sponsored health insurance, social determinants of health, health inequity, mental models, organizational development, organizational change, social gradient of health theory

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Authors: Amir Ahmadi, Hossein Ahmadi, Alireza Ahmadi

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Emotional Intelligence (EI) has been defined as the ability to empathize, persevere, control impulses, communicate clearly, make thoughtful decisions, solve problems, and work with others in a way that earns friends and success. These abilities allow an individual to recognize and regulate emotion, develop self-control, set goals, develop empathy, resolve conflicts, and develop skills needed for leadership and effective group participation. Due to the increasing complexity of organizations and different ways of thinking, attitudes and beliefs of individuals, Conflict as an important part of organizational life has been examined frequently. The main point is that the conflict is not necessarily in organization, unnecessary; But it can be more creative (increase creativity), to promote innovation, or may avoid wasting energy and resources of the organization. The purpose of this study was to investigate the relation between principals emotional intelligence as one of the factors affecting conflict management among teachers. This relation was analyzed through cluster sampling with a sample size consisting of 120 individuals. The results of the study showed that, at the 95% level of confidence, the two secondary hypotheses (i.e. relation between emotional intelligence of principals and use of competition and cooperation strategies of conflict management among teachers)were confirmed, but the other three secondary hypotheses (i.e. the relation between emotional intelligence of managers and use of avoidance, adaptation and adaptability strategies of conflict management among teachers) were rejected. The primary hypothesis (i.e. relation between emotional intelligence of principals with conflict management among teachers) is supported.

Keywords: emotional intelligence, conflict, conflict management, strategies of conflict management

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Authors: Marcelo Sifuentes López

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Strategic performance definition and follow-up processes have to be clear in order to provide value in today’s competitive world. Customer expectations must be linked to internal organization strategic objectives leading to profitability and supported by visibility and flexibility among others.By taking a whole picture of the supply chain, the executive, and its team will define the current supply chain situation and an insight into potential opportunities to improve processes and provide value to main stakeholders. A systematic performance evaluation process based on operational and financial indicators defined by customer requirements needs to be implemented and periodically reviewed in order to mitigate costs and risks on time.Supplier long term relationship and collaboration plays a key role using resources available, real-time communication, innovation and new ways to capitalize global opportunities like emerging markets; efforts have to focus on the reduction of uncertainties in supply and demand. Leadership has to promote consistency of communication and execution involving suppliers, customers, and the entire organization through the support of a strategic sourcing methodology that assure the targeted competitive strategy and sustainable growth. As customer requirements and expectations are met, results could be captured in a casual picture like a “selfie”; where outcomes could be perceived from any desired angle by them; or like most “selfies”, can be taken with a camera held at arm's length by a third party company rather than using a self-timer.

Keywords: supply chain management, competitive advantage, value creation, collaboration and innovation, global marketplace

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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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Authors: Aneta Binkowska, Artur Kamecki

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The ability to provide first aid should be one of the basic skills of each of us. First aid by the Law on National Medical Emergency dated 8 September 2006 as amended, is a set of actions undertaken to save a person at the scene of an accident. In Poland, on the basis of Article 162 of the Criminal Code, we are obliged to provide first aid to the victim. In addition, according to a large part of society, unselfishness towards others in need of help is our moral obligation. The aim of the study was to learn the opinion of the members of Medical Rescue Teams (MRT) of the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service (PA and STS ‘Meditrans’) in Warsaw on how people react in real situations threatening life or health of the injured person. The study was conducted in the third quarter of 2015 on 335 members of medical rescue teams, including 77 W and 258 M, who provided medical services in the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service MRT in Warsaw. The research tool was an anonymous questionnaire survey of own design, which consisted of 12 questions: closed, half open and one open question. Respondents were divided into 3 age groups and by individual medical professions (doctor, paramedic, nurse). The straight majority of respondents encountered granting the first aid the event on the spot. However, the frequency of appearing in such proceedings isn’t too high. The first aid has most often been given in the street and in houses. The final audited fairly important element is the reason not to provide first aid by bystanders in the opinion of members of the medical teams. Respondents to this question, which was an open question were asked to name the reason for not taking any action while waiting for an ambulance. Over 50% of respondents could not answer. The most common answers were: fear, lack of knowledge and skills, reluctance, indifference, lack of training, lack of experience and fear that harm. Conclusion: The majority of respondents have encountered instances of first aid provision, but respondents assessed the frequency of such situations as low. Placing the victim in the recovery position is the simplest and most common form of first aid. Therefore, training should be introduced not only on CPR but also in the scope of helping persons in sudden health emergency, who do not have a sudden cardiac arrest. A statement can be formulated, as a main conclusion of the analysis, that only continuous education and in particular practical training will help people to overcome the barrier of their limitations in order to help others. Among the largest group of witnesses providing first aid are the elderly and youth, who are subjected to various forms of education related to first aid provision.

Keywords: BLS, first aid, medical rescue, resuscitation

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Authors: Prakash Singh, Piet Maphodisa Kgohlo

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Knowledge-worker productivity is one of the biggest leadership challenges facing all organizations in the twenty-first century. It cannot be denied that knowledge-worker productivity affects all organizations. The work and the workforce are both undergoing greater changes currently than at any time, since the beginning of the industrial revolution two centuries ago. Employees welcome collegial teaming (CT) as an innovative way to develop their work-integrated learning competencies. Human resource development policies must evoke the symbiotic relationship between CT and work-integrated learning, seeing that employees need to be endowed with the competence to move from one skill to another, as each one becomes obsolete, and to simultaneously develop their cognitive and emotional intelligence. The outcome of this relationship must culminate in the development of highly productive knowledge-workers. While this study focuses on teachers, the conceptual framework and the findings of this research can be beneficial for any organization, public or private sector, business or non-business. Therefore, in this quantitative study, the benefits of CT are considered in developing human resources to sustain knowledge-worker productivity. The ANOVA p-values reveal that the majority of teachers agree that CT can empower them to overcome the challenges of managing curriculum change. CT can equip them with continuous and sustained learning, growth and improvement, necessary for knowledge-worker productivity. This study, therefore, confirms that CT benefits all workers, immaterial of their age, gender or experience. Hence, this exploratory research provides a new perspective of CT in addressing knowledge-worker productivity when organizational change alters the vision of the organization.

Keywords: collegial teaming, human resource development, knowledge-worker productivity, work-integrated learning

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Authors: Vanlounni Sibounheuang, Wanarat Anusornsangiam, Pattarin Kittiboonyakun, Chanthanom Manithip

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In worldwide, one of the most common use of oral anticoagulant is warfarin. Its margin between therapeutic inhibition of clot formation and bleeding complications is narrow. Mahosot Hospital, warfarin clinic had not been established yet. The descriptive study was conducted by investigating drug-related problems of outpatients using warfarin, the value of the international normalized ratio (INR) higher than normal ranges (25.40 % of the total 272 outpatients) were mostly identified at Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. This result led to the present study conducting qualitative interviews in order to help establish a warfarin clinic at Mahosot Hospital for the better outcomes of patients using warfarin. The purpose of this study was to explore perspectives of healthcare professional providing services for outpatients using warfarin. The face to face, in-depth interviews were undertaken among nine healthcare professionals (doctor=3, nurse=3, pharmacist=3) working at out-patient clinic, Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. The interview guides were developed, and they were validated by the experts in the fields of qualitative research. Each interview lasted approximately 20 minutes. Three major themes emerged; healthcare professional’s experiences of current practice problems with warfarin therapy, healthcare professionals’ views of medical problems related to patients using warfarin, and healthcare professionals’ perspectives on ways of service improvement. All healthcare professionals had the same views that it’s difficult to achieve INR goal for individual patients because of some important patient barriers especially lack of knowledge about to use warfarin properly and safety, patients not regularly follow-up due to problems with transportations and financial support. Doctors and nurses agreed to have a pharmacist running a routine warfarin clinic and provided counselling to individual patients on the following points: how to take drug properly and safety, drug-drug and food-drug interactions, common side effects and how to manage them, lifestyle modifications. From the interviews, some important components of the establishment of a warfarin clinic included financial support, increased human resources, improved the system of keeping patients’ medical records, short course training for pharmacists. This study indicated the acceptance of healthcare professionals on the important roles of pharmacists and the feasibility of setting up warfarin clinic by working together with the multidisciplinary health care team in order to help improve health outcomes of patients using warfarin at Mahosot Hospital, Lao PDR.

Keywords: perspectives, healthcare professional, warfarin therapy, Mahosot Hospital

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Authors: Muhammad Zafarullah Khan, Sumeera Abbasi

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The Farmers Field School (FFS) learning approach aims to improve knowledge of the farmers through integrated crop management and provide leadership in their decision making process. The study was conducted to assess the impact of FFS on vegetables production before and after FFS intervention in four villages of district Peshawar in cropping season 2012, by interviewing 80 FFS respondents, twenty from each selected village. It was observed from the study results that all the respondents were satisfied from the impact of FFS and they informed an increased in production in vegetables. It was further observed that after the implementation of FFS the sowing seed rate of tomato and cucumber were decreased from 0.185kg/kanal to 0.100 kg/ kanal and 0.120kg/kanal to 0.010kg/kanal where as the production of tomato and cucumber were increased from 8158.75kgs/kanal to 10302. 5kgs/kanal and 3230kgs/kanal to 5340kgs/kanal, respectively. The cost of agriculture inputs per kanal including seed cost, crop management, Farm Yard Manure, and weedicides in case of tomato were reduced by Rs.28, Rs. 3170, Rs.658and Rs 205 whereas in cucumber reduced by Rs.35, Rs.570, Rs 80 and Rs.430 respectively. Only fertilizers cost was increased by Rs. 2200 in case of tomato and Rs 465 in case of cucumber. Overall the cost was reduced to Rs 545 in tomato and Rs 490 in cucumber production.FFS provided a healthy vegetables and also reduced input cost by adopting integrated crop management. Therefore the promotion of FFS is needed to be planned for farmers to reduce cost of production, so that the more farmers should be benefited.

Keywords: impact, farmer field schools, vegetable production, Peshawar Khyber Pakhtunkhwa

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Authors: Fariba Ebrahimi, Mehdi Ghorbani

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Comprehensive water management considers economic, environmental, technical and social sustainability of water resources for future generations. Integrated water management implies cooperative approach and involves all stakeholders and also introduces issues to managers and decision makers. Solving these issues needs integrated and system approach according to the recognition of actors or key persons in necessary to apply cooperative management of water resources. Therefore, social network analysis can be used to demonstrate the most effective actors for environmental base decisions. The linkage of diverse sets of actors and knowledge systems across management levels and institutional boundaries often poses one of the greatest challenges in adaptive water management. Bridging stakeholder can facilitate interactions among actors in management settings by lowering the transaction costs of collaboration. This research examines how network connections between group members affect in co- management. Cohesive network structures allow groups to more effectively achieve their goals and objectives Strong; centralized leadership is a better predictor of working group success in achieving goals and objectives. Finally, geometric position of each actor was illustrated in the network. The results of the research based on between centrality index have a key and bridging actor in recognition of cooperative management of water resources in Darbandsar village and also will help managers and planners of water in the case of recognition to organization and implementation of sustainable management of water resources and water security.

Keywords: co-management, water management, social network, bridging stakeholder, darbandsar village

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Authors: Lucia Perez, Maria Gaton y Santa Palella

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Starting from the etymology of the word culture, the Latin term ‘colere’, whose meaning is to cultivate, we understand that the society that cultivates its knowledge is laying the foundations for new possibilities. In this sense, art and fashion contain the same attributes: concept, aesthetic principles, and refined techniques. Both play a crucial role, communication, and this implies a sense of community, relationship with tradition, and innovation. This is the mirror in which to contemplate, but also the space that helps to grow. This is the framework where our object of study opens up: the anthropological management or the mission management model applied to fashion exhibitions in museums and cultural institutions. For this purpose, a bibliographic review has been carried out with its subsequent analysis, a case study of three successful exhibitions: ‘Christian Dior: designer of dreams’, ‘Balenciaga and the Spanish painting’, and ‘China: Through the Looking Glass’. The methodology has been completed with interviews focused on the curators. Amongst the results obtained, it is worth highlighting the fundamental role of transcendent leadership, which, in addition to being results-oriented, must align the motivations of the collaborators with the mission. The anthropological management model conceives management as a service, and it is oriented to the interests of the staff and the public, in short, of the person; this is what enables the objectives of effectiveness, efficiency, and social value to be achieved; dimensions, all necessary for the proper development of the mission of the exhibitions. Fashion, understood as art, is at the service of culture, and therefore of the human being, which defines a transcendent mission. We conclude that the profile of an anthropological management model applied to fashion exhibitions in museums is the ideal one to achieve the purpose of these institutions.

Keywords: art, culture, fashion, anthropological model, fashion exhibitions

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Authors: Norshima Humaidi, Saif Hussein Abdallah Alghazo

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Cybersecurity threat have become a serious issue recently, and one of the cause is because human error, which is usually constituted by carelessness, ignorance, and failure to practice cybersecurity behaviour adequately. Using a data from a quantitative survey, Partial Least Squares-Structural Equation Modelling (PLS-SEM) analysis was used to determine the factors that affect cybersecurity protective behaviour (CPB). This study adapts cybersecurity protective behaviour model by focusing on two constructs that can enhance CPB: manager’s information security competencies (MISI) and procedural information security countermeasure (PCM) awareness. Theory of leadership competencies were adapted to measure user’s perception towards competencies among security managers/leader in the organization. Confirmatory factor analysis (CFA) testing shows that all the measurement items of each constructs were adequate in their validity individually based on their factor loading value. Moreover, each constructs are valid based on their parameter estimates and statistical significance. The quantitative research findings show that PCM awareness strongly influences CPB compared to MISI. Meanwhile, MISI was significantlyPCM awarenss. This study believes that the research findings can contribute to human behaviour in IS studies and are particularly beneficial to policy makers in improving organizations’ strategic plans in information security, especially in this new era. Most organizations spend time and resources to provide and establish strategic plans of information security; however, if employees are not willing to comply and practice information security behaviour appropriately, then these efforts are in vain.

Keywords: cybersecurity, protection behaviour, information security, information security competencies, countermeasure awareness

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Authors: Muhammad Naveed Babur, Maria Liaqat

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Background & Objective: People with disabilities especially neurological disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. There are not sufficient epidemiological studies from Pakistan which assess barriers to neurorehabilitation and ways to counter it. Objectives: The objective of the study was to determine the challenges and to evaluate the barriers for neuro-rehabilitation services in developing countries. Methods: This is Exploratory sequential qualitative study based on the Panel discussion forum in International rehabilitation sciences congress and national rehabilitation conference 2017. Panel group discussion has been conducted in February 2017 with a sample size of eight professionals including Rehabilitation medicine Physician, Physical Therapist, Speech Language therapist, Occupational Therapist, Clinical Psychologist and rehabilitation nurse working in multidisciplinary/Interdisciplinary team. A comprehensive audio-videography have been developed, recorded, transcripted and documented. Data was transcribed and thematic analysis along with characteristics was drawn manually. Data verification was done with the help of two separate coders. Results: After extraction of two separate coders following results are emerged. General category themes are disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. Barriers identified at the level are high cost, stigma, lengthy course of recovery. Hospital related barriers are lack of social support and individually tailored goal setting processes. Organizational barriers identified are lack of basic diagnostic facilities, lack of funding and human resources. Recommendations given by panelists were investment in education, capacity building, infrastructure, governance support, strategies to promote communication and realistic goals. Conclusion: It is concluded that neurorehabilitation in developing countries need attention in following categories i.e. disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. This study also revealed barriers at the level of patient, hospital, organization. Recommendations were also given by panelists.

Keywords: disability, neurorehabilitation, telerehabilitation, disability

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Authors: Juan-Gabriel Cegarra-Navarro, Alexeis Garcia-Perez, Denise Bedford

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This paper provides guidelines for what constitutes a knowledge worker. Many graduates from non-managerial domains adopt, at some point in their professional careers, management roles at different levels, ranging from team leaders through to executive leadership. This is particularly relevant for professionals from an engineering background. Moving from a technical to an executive-level requires an understanding of those behaviour management techniques that can motivate and support individuals and their performance. Further, the transition to management also demands a shift of contextual enablers from tangible to intangible resources, which allows individuals to create new capacities, competencies, and capabilities. In this dynamic process, the knowledge worker becomes that key individual who can help members of the management board to transform information into relevant knowledge. However, despite its relevance in shaping the future of the organization in its transition to the knowledge economy, the role of a knowledge worker has not yet been studied to an appropriate level in the current literature. In this study, the authors review both the contextual enablers and behaviour outputs related to the role of the knowledge worker and relate these to their ability to deal with everyday management issues such as knowledge heterogeneity, varying motivations, information overload, or outdated information. This study highlights that the aggregate of capacities, competences and capabilities (CCCs) can be defined as knowledge structures, the study proposes several contextual enablers and behaviour outputs that knowledge workers can use to work cooperatively, acquire, distribute and knowledge. Therefore, this study contributes to a better comprehension of how CCCs can be managed at different levels through their contextual enablers and behaviour outputs.

Keywords: knowledge workers, capabilities, capacities, competences, knowledge structures

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Authors: E. Sahar

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Civic political knowledge is crucial for the stability of democratic countries. In the USA, Americans have poor knowledge about their constitution and their political systems. Some states such as Florida State suffers from a huge decline in civics comparing to the National Average. This study concerns with using new technologies such as augmented reality to engage students in learning civics in classrooms. This is a participatory study, which engage teachers in the process of designing augmented reality civic games. The researcher used survey to find out the materials that teachers struggle with while teaching civics. Four lessons were found the most difficult to teach for middle school students: SS7C1.1 Enlightenment thinkers, SS7C1.2 influencing documents, SS7C1.7-Weakness of the Articles of Confederation, and Forms and systems of governments. For the limited scope of this study, we focused on “Forms and Systems of governments’ as the main project. Augmented Reality is used to help students to engage in learning civics through building a game that is based on the pedagogy constructivism theory. The resulted project meets the educational requirements for civics, provide students with more knowledge in at stake issues such as migration and citizenship, and help them to build leadership skills while playing in groups. The augmented reality game is also designed to test the students learning for each stage. This study helps to generate insightful implications for the use of augmented reality by educators, researchers, instructional designers, and developers who are interested in integrating technology in teaching civics for students in middle school classrooms.

Keywords: augmented reality, games, civics teaching, Florida middle school

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Authors: Vania Helena Tonussi Vidal, Ester Eliane Jeunon

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This article aims to analyze the change processes of management related bureaucracy and learning organization model. The theoretical framework was based on Beer and Nohria (2001) model, identified as E and O Theory. Based on this theory the empirical research was conducted in connection with six key dimensions: goal, leadership, focus, process, reward systems and consulting. We used a case study of an educational Institution located in Barbacena, Minas Gerais. This traditional center of technical knowledge for long time adopted the bureaucratic way of management. After many changes in a business model, as the creation of graduate and undergraduate courses they decided to make a deep change in management model that is our research focus. The data were collected through semi-structured interviews with director, managers and courses supervisors. The analysis were processed by the procedures of Collective Subject Discourse (CSD) method, develop by Lefèvre & Lefèvre (2000), Results showed the incremental growing of management model toward a learning organization. Many impacts could be seeing. As negative factors we have: people resistance; poor information about the planning and implementation process; old politics inside the new model and so on. Positive impacts are: new procedures in human resources, mainly related to manager skills and empowerment; structure downsizing, open discussions channel; integrated information system. The process is still under construction and now great stimulus is done to managers and employee commitment in the process.

Keywords: bureaucracy, organizational learning, organizational change, E and O theory

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Authors: Priyanka Gupta, Nilanjana Bairagi, Deepti Gupta

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New pathogenic strains of microbes are continually emerging and resistance of bacteria to antibiotics is growing. Hospitals in India have a high burden of infections in their intensive care units and general wards. Rising incidence of hospital infections is a matter of great concern in India. This growth is often attributed to the absence of effective infection control strategies in healthcare facilities. Government, therefore, is looking for cost effective strategies that are effective against HAIs. One possible method is by application of an antimicrobial finish on the uniform. But there are limited studies to show the effect of antimicrobial activity of antimicrobial finish treated nurses’ uniforms in a real hospital set up. This paper proposes a prospective non-destructive sampling technique, based on the use of a detachable fabric patch, to assess the effectiveness of silver based antimicrobial agent across five wards in a tertiary care government hospital in Delhi, India. Fabrics like polyester and polyester cotton blend fabric which are more prevalent for making coats were selected for the study. Polyester and polyester cotton blend fabric was treated with silver based antimicrobial (AM) finish. At the beginning of shift, a composite patch of untreated and treated fabric respectively was stitched on the abdominal region on the left and right side of the washed white coat of participating nurse. At the end of the shift, the patch was removed and taken for bacterial sampling on Brain Heart Infusion (BHI) plates. Microbial contamination on polyester and blend fabrics after 6 hours shift was compared in Brain Heart Infusion broth (BHI). All patches treated with silver based antimicrobial agent showed decreased bacterial counts. Percent reduction in the bacterial colonies after the antimicrobial treatment in both fabrics was 81.0 %. Antimicrobial finish was equally effective in reducing microbial adhesion on both fabric types. White coats of nurses become progressively contaminated during clinical care. Type of fabric used to make the coat can affect the extent of contamination which is higher on polyester cotton blend as compared to 100% polyester. The study highlights the importance of silver based antimicrobial finish in the area of uniform hygiene. Bacterial load can be reduced by using antimicrobial finish on hospital uniforms. Hospital staff uniforms endowed with antimicrobial properties may be of great help in reducing the occurrence and spread of infections.

Keywords: antimicrobial finish, bacteria, infection control, silver, white coat

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Authors: Ehsan Ahmed Yahia

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Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

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Authors: Monsuru Oyenola Popoola, Oladapo Samson Abiola, Wusamotu Alao Adeniji

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The prevalent and incessant abandonment of road construction projects are alarming that it creates several negative effects to social, economic and environmental values of the project. The purpose of this paper is to investigate and determined the various causes and effects of abandoning road construction projects in Nigeria. Likert Scale questionnaire design was used to administered and analysed the data obtained for the stydy. 135 (Nr) questionnaires were completed and retrieved from the respondents, out of 200 (Nr) questionnaires sent out, representing a response rate of 67.5%. The analysis utilized the Relative Importance Index (R.I.I.) method and the results are presented in tabular form. The findings confirms that at least 20 factors were the causes of road projects abandonment in Nigeria with most including Leadership Instability, Improper Project Planning, Inconsistence in government policies and Design, Contractor Incompetence, Economy Instability and Inflation, Delay in remittance of money, Improper financial analysis, Poor risk management, Climatic Conditions, Improper Project Estimates etc. The findings also show that at least eight (8) effect were identified on the system, and these include; Waste of Financial Resources, Loss of economic value, Environmental degradation, Loss of economic value, Reduction in standard of living, Litigation and Arbitration, etc. The reflection is that allocating reasonable finance, developing appropriate and effective implementation plans and monitoring, evaluation and reporting on development project activities by key actors should enhance in resolving the problem of road projects abandonment.

Keywords: road construction, abandonment of road projects, climatic condition, project planning, contractor

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Authors: Mariko Nishikawa, Masaaki Yamanaka, Ayami Kondo

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Background: International visitors to Japan are at a risk of travel-related illnesses or injury that could result in hospitalization in a country where the language and customs are unique. Over twelve million international visitors came to Japan in 2015, and more are expected leading up to the Tokyo Olympics. One aspect of this is the potentially greater demand on healthcare services by foreign visitors. Nurses who take care of them have anxieties and concerns of their knowledge of the Japanese health system. Objectives: An effective distribution of travel-health information is vital for facilitating care for international visitors. Our research investigates whether a four-minute digital animation (Mari Info Japan), designed and developed by the authors and applied to a survey of 513 nurses who take care of foreigners daily, could clarify travel health procedures, reduce anxieties, while making it enjoyable to learn. Methodology: Respondents to a survey were divided into two groups. The intervention group watched Mari Info Japan. The control group read a standard guidebook. The participants were requested to fill a two-page questionnaire called Mari Meter-X, STAI-Y in English and mark a face scale, before and after the interventions. The questions dealt with knowledge of health promotion, the Japanese healthcare system, cultural concerns, anxieties, and attitudes in Japan. Data were collected from an intervention group (n=83) and control group (n=83) of nurses in a hospital, Japan for foreigners from February to March, 2016. We analyzed the data using Text Mining Studio for open-ended questions and JMP for statistical significance. Results: We found that the intervention group displayed more confidence and less anxiety to take care of foreign patients compared to the control group. The intervention group indicated a greater comfort after watching the animation. However, both groups were most likely to be concerned about language, the cost of medical expenses, informed consent, and choice of hospital. Conclusions: From the viewpoint of nurses, the provision of travel-health information by digital animation to international visitors to Japan was more effective than traditional methods as it helped them be better prepared to treat travel-related diseases and injury among international visitors. This study was registered number UMIN000020867. Funding: Grant–in-Aid for Challenging Exploratory Research 2010-2012 & 2014-16, Japanese Government.

Keywords: digital animation, health promotion, international visitor, Japan, nurse

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Authors: Livhuwani Muthelo, R. N. Malema, T. M. Mothiba

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Long term exposure to excessive noise in the mining industry increases the risk of noise induced hearing loss, with consequences for employee’s health, productivity and the overall quality of life. Objective: The objective of this study was to investigate the factors that contribute to Noise Induced Hearing Loss amongst employees at the Platinum mine in the Limpopo Province, South Africa. Study method: A qualitative, phenomenological, exploratory, descriptive, contextual design was applied in order to explore and describe the contributory factors. Purposive non-probability sampling was used to select 10 male employees who were diagnosed with NIHL in the year 2014 in four mine shafts, and 10 managers who were involved in a Hearing Conservation Programme. The data were collected using semi-structured one-on-one interviews. A qualitative data analysis of Tesch’s approach was followed. Results: The following themes emerged: Experiences and challenges faced by employees in the work environment, hearing protective device factors and management and leadership factors. Hearing loss was caused by partial application of guidelines, policies, and procedures from the Department of Minerals and Energy. Conclusion: The study results indicate that although there are guidelines, policies, and procedures available, failure in the implementation of one element will affect the development and maintenance of employees hearing mechanism. It is recommended that the mine management should apply the guidelines, policies, and procedures and promptly repair the broken hearing protective devices.

Keywords: employees, factors, noise induced hearing loss, noise exposure

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