Search results for: hospital management

Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

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Authors: Naritphol Boonyakiat

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This research attempts to investigate the effects of corporate social responsibility and knowledge management factors on students’ learning process of the Silpakorn University. The goal of this study is to fill the literature gap by gaining an understanding of corporate social responsibility and the knowledge management factors that fundamentally relate to students’ learning process within the university context. Thus, this study will focus on the outcomes that derive from a set of quantitative data that were obtained using Silpakorn university’s database of 200 students. The results represent the perceptions of students regarding the impact of corporate social responsibility and knowledge management factors on their learning process within the university. The findings indicate that corporate social responsibility and knowledge management have significant effects on students’ learning process. This study may assist us in gaining a better understanding of the integrated aspects of university and learning environments to discover how to allocate optimally university’s resources and management approaches to gain benefits from corporate social responsibility and knowledge management practices toward students’ learning process within the university bodies. Therefore, there is a sufficient reason to believe that the findings can contribute to research in the area of CSR, KM and students’ learning process as an essential aspect of university’s stakeholder.

Keywords: corporate social responsibility, knowledge management, learning process, university’s students

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Authors: Ilir Rexhepi, Naim Ismajli

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Quality and quality management are key factors of success nowadays. Public sector and quality management in this sector contains many challenges and difficulties, most notably in a new country like Kosovo. This study analyses the process of implementation of quality management system in public administration institutions in this country. The main objective is to show how to set up a quality management system and how does the quality management system setup affect the overall public administration services in Kosovo. This study shows how the efficiency and effectiveness of public institution services/performance is rapidly improving through the establishment and functionalization of Quality Management System. The specific impact of established QMC within the organization has resulted with the identification of mission related processes within the entire system including input identification, the person in charge and the way of conversion to the output of each activity though the interference with other service processes within the system. By giving detailed analyses of all steps of implementation of the Quality Management System, its effect and consequences towards the overall public institution service performance, we try to go one step further, by showing it as a very good example or tool of other public institutions for improving their service performance. Interviews with employees, middle and high level managers including the quality manager and general secretaries are also part of analyses in this paper.

Keywords: quality, quality management system, efficiency, public administration institutions

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Authors: Recep Keşli, Onur Türkyılmaz, Hayriye Tokay, Kasım Demir

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Objective: Coeliac disease (CD) is a primary small intestine disorder caused by high sensitivity to gluten which is present in the crops, characterized by inflammation in the small intestine mucosa. The goal of this study was to determine and to compare the sensitivity and specificity values of anti-endomysial IgA (EMA IgA) (IFA) and anti-tissue transglutaminase IgA (anti-tTG IgA) (ELISA) antibodies in the diagnosis of patients suspected with the CD. Methods: One thousand two hundred seventy three patients, who have applied to gastroenterology and pediatric disease polyclinics of Afyon Kocatepe University ANS Research and Practice Hospital were included into the study between 23.09.2010 and 30.05.2016. Sera samples were investigated by immunofluorescence method for EMA positiveness (Euroimmun, Luebeck, Germany). In order to determine quantitative value of Anti-tTG IgA (EIA) (Orgentec Mainz, Germany) fully automated ELISA device (Alisei, Seac, Firenze, Italy) were used. Results: Out of 1273 patients, 160 were diagnosed with coeliac disease according to ESPGHAN 2012 diagnosis criteria. Out of 160 CD patients, 120 were female, 40 were male. The EMA specificity and sensitivity were calculated as 98% and 80% respectively. Specificity and sensitivity of Anti-tTG IgA were determined as 99% and 96% respectively. Conclusion: The specificity of EMA for CD was excellent because all EMA-positive patients (n = 144) were diagnosed with CD. The presence of human anti-tTG IgA was found as a reliable marker for diagnosis and follow-up the CD. Diagnosis of CD should be established on both the clinical and serologic profiles together.

Keywords: anti-endomysial antibody, anti-tTG IgA, coeliac disease, immunofluorescence assay (IFA)

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Authors: Muhammad Umair Ahmed, Aftab Shoukat

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Today the global economy has become one of the key strategies in dealing with environmental issues. To allow for a round economy, organizations have begun to work to improve their sustainability management. The contribution of green resource management to the transformation of the global economy has not been investigated. The purpose of the study was to evaluate the effects of green labor management on the global economy, environmental and economic performance, and the organisation's environmental dignity. We strongly evaluate the different roles of the various processes of green personnel management (i.e., green recruitment, training, and engagement green, as well as green performance management and reward) in organizational operations. We are also investigating the leadership role of CEO Ethical. Our outcome will have a positive impact on the performance of the organization. Green Human Resource Management contributes to the evolution of a roundabout economy without the influence of different external factors such as market demand and commitment. Finally, the results of our research will provide a few aspects for future research, both academic and human.

Keywords: sustainability, green human resource management, circular economy, human capital

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Authors: Amina Oukennou, Zitouni Beidouri, Otmane Bouksour

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Small to Medium-sized enterprises are a very important component of the economy. They are present in the whole industries all over the world. They are considered as the engine for future growth in the economy. Project management is an economical international factor impacting all types of enterprises including the SMEs. This paper has the aim of measuring the weight of using projects and project management in Moroccan SMEs in comparison with the large companies. The study is based on interviews with experts: project managers, managers, directors, and consultants. They were asked questions measuring the weight of using projects, the level of using project management, and the resources employed. Eighteen Moroccan companies from a range of industries and sizes were consulted. All the companies consider projects as a key element in their strategy. Most of them affirm the great usefulness of the approach 'project', especially for the external activities. The main differences lie in the duration and the size of used projects. Despite the commonly shared idea about the importance of the project management, the interviewed persons believe that the project management knowledge has the same importance or less than the technical knowledge. All the companies affirm the need for a simpler version of project management. The content varies from one company to another.

Keywords: project dimension, project management, small to medium-sized entreprise, Morocco

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Authors: V. Mathad, S. Shivprasad, P. Shivsharannappa, M. K. Patil

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Introduction: Non-communicable diseases are emerging diseases in India. Government of India launched National Programme for Prevention and Control of Cardiovascular Diseases, Cancer and Stroke (NPCDCS) during the year 2008. The aim of the programme was to reduce the burden of non communicable diseases by health promotion and prompt treatment. Objective: The present study was intended to assess the impact of National Program for prevention and control of Cardiovascular Diseases, Diabetes, Cancer and Stroke Programme on biochemical and physiological factors influencing Type 2 diabetes in Kalaburagi District. Material and Method: NCD Clinic was established at District Hospital during April 2016. All the patients attending District Hospital Kalaburagi above the age of 30 years are screened for Non Communicable Diseases under NPCDCS Programme. A total sample of 7447 patients attending NCD Clinic situated at Kalaburagi district was assessed in this study. Pre structured and pretested schedule seeking information was obtained from all the patients by the counselor working under NPCDCS programme. All the Patients attending District Hospital were screened for Diabetes using Glucometer at NCD clinic. The suspected cases were further confirmed through Biochemical investigations like Fasting Blood glucose, HBA1c, Urine Glucose, Kidney Function test. SPSS 20 version was used for analysis of data. Chi square test, P values and odds ratio was used to study the association of factors. Results: A Total of 7447 patients attended NCD clinic during the year 2017-18 were analyzed, Diabetes was seen among 3028 individuals were as comorbidities along with Hypertension was seen among 757 individuals. The mean age of the population was 50 ± 2.84. 3440(46.2%) were males whereas Female constituted 4007(53.8%) of population. The incidence and prevalence of Diabetes being 8.6 and 12.8 respectively. Diabetes was more commonly seen during the age group of 40 to 69 years. Diabetes was significantly associated with Age group 40 to 69 years, obesity and female gender (p < 0.05). The risk of developing Hypertension and comorbidity conditions of hypertension and Diabetes was 1.224 and 1.305 times higher among males, whereas the risk of diabetes was 1.127 higher among females as compared to males. Conclusion: The screening for NCD has significantly increased after launching of NPCDCS programme. NCD was significantly associated with obesity, female gender, increased age as well as comorbid conditions like hypertension and tuberculosis.

Keywords: non-communicable diseases, NPCDCS programme, type 2 Diabetes, physiological factors

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Authors: Emmanuel Ademola Anigilaje, Ibraheem Ishola

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Background: Childhood steroid-sensitive idiopathic nephrotic syndrome (SSINS) is plagued with relapses that contribute to its morbidity and the cost of treatment. Materials and Methods: This is a retrospective review of relapses among children with SSINS at the University of Abuja Teaching Hospital from January 2016 to July 2020. Triggers related to relapse incidents were noted. Chi-square test was deployed for predictors (factors at the first clinical presentations that associate with subsequent relapses) of relapses. Predictors with p-values of less than 0.05 were considered significant and 95% confidence intervals (CI) and odd ratio (OR) were described. Results: Sixty SSINS comprising 52 males (86.7%), aged 23 months to 18 years, with a mean age of 7.04±4.16 years were studied. Thirty-eight (63.3%) subjects had 126 relapses including infrequent relapses in 30 (78.9%) and frequent relapses in 8 (21.1%). The commonest triggers were acute upper respiratory tract infections (68, 53.9%) and urinary tract infections (UTIs) in 25 (19.8%) relapses. In 4 (3.2%) relapses, no trigger was identified. The time-to-first relapse ranged 14 days to 365 days with a median time of 60 days. The significant predictors were hypertension (OR=3.4, 95% CI; 1.04-11.09, p=0.038), UTIs (OR=9.9, 95% CI; 1.16-80.71, p= 0.014), malaria fever (OR=8.0, 95% CI; 2.45-26.38, p˂0.001), micro-haematuria (OR=4.9, 95% CI; 11.58-15.16, p=0.004), elevated serum creatinine (OR=12.3, 95%CI; 1.48-101.20, p=0.005) and hypercholesterolaemia (OR=4.1, 95%CI; 1.35-12.63, p=0.011). Conclusion: While the pathogenesis of relapses remains unknown, it is prudent to consider relapse-specific preventive strategies against triggers and predictors of relapses in our setting.

Keywords: Patterns, triggers, predictors, steroid-sensitive idiopathic nephrotic syndrome, relapses, Nigeria

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Authors: Nazanin Pilevari, Kamyar Mahmoodi

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The purpose of this research is to provide a model based on fuzzy inference system for evaluating empowerment of Knowledge management. The first prototype of the research was developed based on the study of literature. In the next step, experts were provided with these models and after implementing consensus-based reform, the views of Fuzzy Delphi experts and techniques, components and Index research model were finalized. Culture, structure, IT and leadership were considered as dimensions of empowerment. Then, In order to collect and extract data for fuzzy inference system based on knowledge and Experience, the experts were interviewed. The values obtained from designed fuzzy inference system, made review and assessment of the organization's empowerment of Knowledge management possible. After the design and validation of systems to measure indexes ,empowerment of Knowledge management and inputs into fuzzy inference) in the AYANDEH Bank, a questionnaire was used. In the case of this bank, the system output indicates that the status of empowerment of Knowledge management, culture, organizational structure and leadership are at the moderate level and information technology empowerment are relatively high. Based on these results, the status of knowledge management empowerment in AYANDE Bank, was moderate. Eventually, some suggestions for improving the current situation of banks were provided. According to studies of research history, the use of powerful tools in Fuzzy Inference System for assessment of Knowledge management and knowledge management empowerment such an assessment in the field of banking, are the innovation of this Research.

Keywords: knowledge management, knowledge management empowerment, fuzzy inference system, fuzzy Delphi

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Authors: Ram Sharan Mehta

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The number of new cancer cases annually is estimated to rise from 10.9 million in 2002 to more than 16 million by 2020, if current trends continue. Much of this increase in absolute numbers derives from the ageing of populations worldwide. The objectives of this study were to find out the demographic characteristics of the admitted cancer patients in BPKIHS. It was hospital based descriptive cross-sectional study conducted reviewing all the records of admitted diagnosed cancer patients in BPKIHS from 15th October 2004 to 14th October 2012. Using total enumerative sampling technique all 1379 diagnosed cancer patients record were reviewed after obtaining the permission from concerned authorities. Using SPSS-15 software package data was analyzed. It was found that majority (71%) of cancer patients were of age more than 40 years and equal of both sexes. Most of the clients were form Sunsari (31.1%), Morang (16.6%) and Jhapa (17%) districts. The mean hospitalization day is 8.32 and very few patients (5.2%) were only cured. The numbers of cancer patients are markedly increases in BPKIHS, especially in advanced stage. It is mandatory to start the cancer information and education programme in eastern region of Nepal and proper management of cancer patients using chemotherapy, radiotherapy and surgery at BPKIHS for quality patient care.

Keywords: lung, cancer, patients, Nepal

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Authors: Phang Moon Leng

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Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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Authors: Sema Müge Özdemiray

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In line with the new public management approach to provide effective and efficient services necessary to achieve the social goals of public institutions, employees must have the knowledge and skills required by the age. In conjunction with the transition from personnel management to human resources management, it is seen that there is a change in the understanding of in-service training, the understanding of "required in-service training" has switched to the understanding of "continuous in-service training". However, in terms of in-service training in Turkey, it seems to be trouble at the point of adopting to change. The main purpose of this study is to primarily create a conceptual framework of in-service training and subsequently determine, analyze and discuss the developments and problems faced by in-service training in Turkey in the transition from personnel management to human resources management. In accordance with this purpose, the necessary data of this study were collected using qualitative approaches. Observation and document analysis was used and content analysis was performed on the data gathered in the study. The results of this study, according to data such as the number of institutions requesting in-service training, allocated budget of in-service training, the number of people participating in such training, transition of personnel management to human resources management should not lead to a paradigm shift in Turkey’s understanding of in-service training, although this is compulsory for public institutions in accordance with the law in Turkey. In-service training in Turkish public administration is still not implemented effectively and is seen as a social activity for employees and a formality for institutions.

Keywords: Human resources management, in service training, personnel management, public institutions

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Authors: Luksanaporn Krungkraipetch

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One hundred cataract patients with phacoemulsification were enrolled in the study to compare of visual acuity outcome and complication after phacoemulsification between diabetic and non-diabetic patients at Burapha University Hospital, Chonburi, Thailand. Fifty patients were diabetic (type II) group and 50 patients were non-diabetic group. All cases were operated by one doctor with the same pre-operative care, operation (phacoemulsification), and post-operative care. Visual acuity and complication after surgery were assessed after the operation for two years. There were no significant differences in demographic data between the two groups. The visual outcome values ≥ 2 lines and ≥ 20/40 had no significant differences between two groups after two years of surgery. The complication rate in diabetic group had cystoid macular edema 16%, rupture posterior capsule 8%, posterior capsule opacity 2%, uveitis 2 %, and 2% endophthalmitis. The non-diabetic group had cystoid macular edema 12%, rupture posterior capsule 8%, uveitis 2%, posterior capsule opacity 2%, and 2% wound leak. Comparison of visual acuity outcome and complication after phacoemulsification between diabetic and non-diabetic patients had no statistical significant differences between these two groups. It was found that cystoid macular edema was the most common complication in both groups and 10% of retinopathy progression was seen.

Keywords: cataract, visual acuity, cataract extraction, phacoemulsification, diabetic retinopathy

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Authors: Kowser Ali Jan, R. Balaji

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A disaster hurts those affected. It also spares many in the affected areas, yet those spared may be indirectly affected. The analytical framework of prevention and coping has proved useful in many circumstances. Historically and currently, there has been limited quantitative information available on flood management in Jammu and Kashmir. This study focuses on the Cost-benefit Analysis (CBA) of flood management by District Disaster Management Kulgam, and the assessment is based on secondary pooled data collected from government offices, NGOs, published Journals, and local and national newspapers. It also described the scenario, the approach adopted, and the sources of flood damage cost information. The estimated total benefits account for 78686.18 lakh of rupees, and that of total costs account for 2218.75lakh of rupees. The Benefit-Cost ratio greater than one (>1) shows that Flood Management in District Kulgam was economically feasible and successfully managed. The State of Jammu and Kashmir takes essential prevention and management measures to bring down the damages due to floods to significant status.

Keywords: cost-benefit analysis, nature, flood management, disaster

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Authors: C. M. Choi, H. C. Tsang, W. K. Fong, Y. K. Cheng, T. K. Chui, L. Y. Chan, K. W. Lee, C. K. Yuen, P. W. Lau, Y. L. To, K. C. Chow

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Six-minute walk test (6MWT) is a sub-maximal exercise test to assess aerobic capacity and exercise tolerance of patients with chronic respiratory disease and heart failure. This has been proven to be a reliable and valid tool and commonly used in clinical situations. Traditional 6MWT is labour-intensive and time-consuming especially for patients who require assistance in ambulation and oxygen use. When performing the test with these patients, one staff will assist the patient in walking (with or without aids) while another staff will need to manually record patient’s oxygen saturation, heart rate and walking distance at every minute and/or carry oxygen cylinder at the same time. Physiotherapist will then have to document the test results in bed notes in details. With the use of electronic 6MWT (E-6MWT), patients wear a wireless oximeter that transfers data to a tablet PC via Bluetooth. Real-time recording of oxygen saturation, heart rate, and distance are displayed. No manual work on recording is needed. The tablet will generate a comprehensive report which can be directly attached to the patient’s bed notes for documentation. Data can also be saved for later patient follow up. This study was carried out in North District Hospital. Patients who followed commands and required 6MWT assessment were included. Patients were assigned to study or control groups. In the study group, patients adopted the E-6MWT while those in control group adopted the traditional 6MWT. Manpower and time consumed were recorded. Physiotherapists also completed a questionnaire about the use of E-6MWT. Total 12 subjects (Study=6; Control=6) were recruited during 11-12/2017. An average number of staff required and time consumed in traditional 6MWT were 1.67 and 949.33 seconds respectively; while in E-6MWT, the figures were 1.00 and 630.00 seconds respectively. Compared to traditional 6MWT, E-6MWT required 67.00% less manpower and 50.10% less in time spent. Physiotherapists (n=7) found E-6MWT is convenient to use (mean=5.14; satisfied to very satisfied), requires less manpower and time to complete the test (mean=4.71; rather satisfied to satisfied), has better data management (mean=5.86; satisfied to very satisfied) and is recommended to be used clinically (mean=5.29; satisfied to very satisfied). It is proven that E-6MWT requires less manpower input with higher efficiency and better data management. It is welcomed by the clinical frontline staff.

Keywords: electronic, physiotherapy, six-minute walk test, 6MWT

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Authors: Nadia Fatima Zahra Malki

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The aim of the study is to show the role of total Quality Management on firm performance, research relied on the views of a sample managers working in the Marinel pharmaceutical company. The research aims to achieve many objectives, including increasing awareness of the concepts of Total Quality Management on Firm Performance, especially in the manufacturing firm, providing a future vision of the possibility of success, and the actual application of the Principles of Total Quality Management in the manufacturing company. The research adopted a default model was built after a review and analysis of the literature review in the context of one hypothesis's main points at the origin of a group of sub-hypotheses. The research presented a set of conclusions, and the most important of these conclusions was that there is a relationship between the Principles of TQM and Firm Performance.

Keywords: total quality management, competitive advantage, companies, objectives

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Authors: Aleksandra Ibragimow, Moritz Albrecht, Eerika Albrecht

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Close international cooperation between all countries within a river basin has become one of the key aspects of sustainable cross-border water management. This is due to the fact that water does not stop at administrative or political boundaries. Therefore, the preferred mode to protect and manage transnational water bodies is close cooperation between all countries and stakeholders within the natural hydrological unit of the river basin. However, past practices have demonstrated that combining interests of different countries and stakeholders with differing political systems and management approaches to environmental issues upstream as well as downstream can be challenging. The study focuses on particular problems and challenges of water management in international river basin districts by the example of the International Oder River Basin District. The Oder River is one of the largest cross-border rivers of the Baltic Sea basin passing through Poland, Germany, and the Czech Republic. Attention is directed towards the activities and the actions that were carried out during the Districts' first management cycle of transnational river basin management (2009-2015). The results show that actions of individual countries have been focused on the National Water Management Plans while a common appointment about identified supra-regional water management problems has not been solved, and conducted actions can be considered as preliminary and merely a basis for future management. This present state raises the question whether the achievement of main objectives of Water Framework Directive (2000/60/EC) can be a realistic task.

Keywords: International River Basin Districts, water management, water frameworkdirective, water management plans

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Authors: Tomohiro Uchida, Noriaki Satake, Toshimichi Nakaho, Akira Inoue, Hidemitsu Saito

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In this study, we assessed the bereavement risk of family caregivers of patients with cancer. In the palliative care unit of Tohoku University Hospital, we conducted a family psychoeducation session to support the family caregivers of patients with cancer. A total of 50 participants (8 males and 42 females; mean age = 62.98 years, SD = 11.10) were assessed after the session for bereavement risk using the Japanese version of the Bereavement Risk Assessment Tool (BRAT-J). According to the BRAT-J scores, eight participants were considered to be having no known risk (Level 1), seventeen had minimal risk (Level 2), twenty had a low risk (Level 3), four had a moderate risk (Level 4), and one had a high risk (Level 5). Of these participants, seven participants had completed the follow-up postal survey that assessed their psychological distress (the Kessler Psychological Distress Scale: K6) to compare the bereavement risk. According to the K6 scores, three-fourth of the individuals, who were considered to be at Level 3 on the BRAT-J, scored higher than the cutoff point (>10) for the detection of depressive disorder. On the other hand, one-third of the individuals, who were considered to be at Level 2 on the BRAT-J, scored higher than the cutoff point. Therefore, it appears that the BRAT-J can predict the likelihood of difficulties or complications in bereaved family caregivers. This research was approved by the Ethics Committee of Tohoku University Graduate School of Medicine and Tohoku University Hospital.

Keywords: palliative care, family caregivers, bereavement risk, BRAT, post-loss psychological distress

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Authors: Fatai O. Bakare

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This paper x-rays the liquidity problems exposed to by Islamic banks in terms of challenges in managing surplus as well as deficit liquidity positions and the attendant effects in the contemporary system of Islamic banking. Effective liquidity management is understood to be a cardinal consideration for sustainability of Islamic/non-interest banking in Nigeria and the world over. While a background is laid by considering the general situations at a global scale, a particular attention is devoted to the peculiar circumstances of the non-interest banking in Nigeria. In bring home the points various efforts of major notable supra-national institutions in bridging liquidity management gap in Islamic banks are presented. While it is believed that a good lesson could be learnt from the developmental phases of Malaysian Islamic banking system and the approaches to meeting its liquidity management problems, much emphasis is laid in maintaining that, although in the absence of political will to provide systemic support for non-interest banking in Nigeria, the challenge of liquidity management is not unsurmountable.

Keywords: deficit, liquidity management, non-interest, surplus

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Authors: Raheel Shakoor Siddiqui, Calvin Mathias, Manikandar Srinivas Cheruvu, Bobin Varghese

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A 58 year old gentleman presented to accident and emergency at the district general hospital with worsening shortness of breath and a non-productive cough over a period of five days. He was initially admitted under the medical team for suspicion of SARS-CoV-2 (COVID-19) pneumonitis. Subsequently, upon deterioration of observations and a positive COVID-19 PCR, he was taken to intensive care for invasive mechanical ventilation. He required frequent proning, inotropic support and was intubated for thirty-three days. After successful extubation, he developed myopathy with a limited range of motion to his right knee and right shoulder. Plain film imaging of these limbs demonstrated an unusual formation of heterotopic ossification without any precipitating trauma or surgery. Current literature demonstrates limited case series portraying heterotopic ossification post-COVID-19. There has been negligible evidence of heterotopic ossification in the ipsilateral knee and shoulder post-prolonged immobility secondary to a critical illness. Physiotherapy and rehabilitation are post-intensive care can be prolonged due to the formation of heterotopic ossification around joints. Prolonged hospital stays may lead to a higher risk of developing infections of the chest, urine and pressure sores. This raises the question of whether a severe systemic inflammatory immune response from the SARS-CoV-2 virus results in histopathological processes leading to the formation of heterotopic ossification not previously seen, requiring prolonged physiotherapy.

Keywords: orthopaedics, rehabilitation, physiotherapy, heterotopic ossification, COVID-19

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Authors: Ranjini Ramanath, Nanjunda P. Swamy

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Construction has existed in our lives since time immemorial. However, unlike any other industry, construction projects have their own unique challenges – project type, purpose and end use of the project, geographical conditions, logistic arrangements, largely unorganized manpower and requirement of diverse skill sets, etc. These unique characteristics bring in their own level of risk and uncertainties to the project, which cause the project to deviate from its planned objectives of time, cost, quality, etc. over the many years, there have been significant developments in the way construction projects are conceptualized, planned, and managed. With the rapid increase in the population, increased rate of urbanization, there is a growing demand for infrastructure development, and it is required that the projects are delivered timely, and efficiently. In an age where ‘Time is Money,' implementation of new techniques of project management is required in leading to successful projects. This paper proposes a different approach to project management, which if applied in construction projects, can help in the accomplishment of the project objectives in a faster manner.

Keywords: critical chain project management methodology, critical chain, project management, construction management

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Authors: Raeda F. Abualrub, Amani Abdulnabi

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Aim: The aims of this study were to (a) examine the levels of nurses' political efficacy and involvement in health policy; and (b) explore the relationships between political efficacy, involvement in health policy, and participants’ background variables. Background: Nurses as citizens and health care providers have the right to express their opinions and beliefs in regard to issues that are concerned with the health care system or the public health domain. Methods: A descriptive, cross-sectional design using was utilized. A self-administered questionnaire (Political Efficacy Scale & Involvement in Health Policy Scale) was completed by a convenience sample of 302 nurses. Results: The results of this study showed low levels of involvement in health policy and political efficacy and a positive weak correlation between political efficacy and involvement in health policy. The perceived level of political efficacy was associated positively with nurses’ age and experience. Conclusions: Nurse administrators and managers may empower, support, and encourage nurses to enhance their involvement in health policy. Implications for Nursing Management: The findings have implications for nursing leaders and administrators to design appropriate strategies to enhance nurses’ involvement in health policy development.

Keywords: health policy, Jordan, nurses, political efficacy

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Authors: L. José, S. Vieira, E. Melo, A. R. Pinheiro

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Objectives: This study aims to characterize the stroke profile and the health care provided for people with a stroke in Luanda, Angola. Methods: A prospective longitudinal study was conducted at two Health centers, from March to November 2023, enrolling stroke patients. Data was gathered using a survey created by the researchers and validated by a health panel of experts from Angola. The analysis focused on demographic and stroke characteristics, as well as the care provided. Ethical approval and informed consent were obtained. Results: Preliminary results of a total of 186 patients are described, 122 from a Central Acute Care Hospital, with a mean age of 51.3±14.35 years old, a BMI of 26.7±4.15 kg/m2, 41% male, and 64 patients from a Rehabilitation Center, with 55.6±11.55 years old, a BMI of 27.0±3.8 kg/m2, 53% male. Ischemic stroke was reported as the most representative type in both centers (71.3% and 70.3%, respectively), though 100% of patients had no imaging diagnosis confirmation, neither data about the subtype was given. For patients admitted to the Hospital, discharge occurred before rehabilitation, and no follow-up was possible. No rehabilitation care was delivered in the first 7 days after the stroke. In the Rehabilitation Center, patient’s rehabilitation started in the late subacute phase, after a mean of 171.8±11.5 days. Conclusions: Stroke diagnosis lacks imaging confirmation, which is decisive for proper treatment, and rehabilitation starts during the late subacute phase, which is too late considering the international guidelines and the best window of opportunity for neuroplasticity and recovery. These results highlight the urgent need for the definition of Stroke-directed Health Care Policies in Angola.

Keywords: stroke, personalized health care, functional recovery, quality of life, health policies

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Authors: Nabaweesi Josephine, Namwanje Regina Germina

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Antenatal care is referred to as the totality of care given to pregnant women from conception to delivery from a certified health care setting. A number of 8 contacts is recommended throughout pregnancy, according to WHO, 2016. Antenatal services are free in Uganda courtesy of the government of Uganda, though attendance is still very low, which has continued to cause maternal and infant mortality and morbidity from preventable causes. Early booking has an advantage for proper pregnancy information sharing and pregnancy monitoring. The purpose of this study was to determine pregnant women's knowledge, attitudes, and practices towards attendance of antenatal care at Mukono General Hospital. A sample of 60 pregnant women was used, and a descriptive quantitative design was employed. Data was collected using a structured questionnaire consisting of questions about socio-demographic factors, knowledge, attitude, and practice, and this was affected using the structured interview method. Pregnant women had good practice at 90.2%, a positive attitude of 94.6%, and slightly less knowledge of 66.7%. Only 12% were knowledgeable about the number of antenatal care visits recommended, 45% had knowledge about when to initiate first antenatal care visit, and 79% had a positive attitude towards the early booking. We recommend that pregnant women are given all the necessary information regarding antenatal care with special emphasis on the recommended number of visits and when to initiate their first visit and encourage early booking in order to achieve the 8 contacts WHO policy for antenatal care since when we increase knowledge, we increase antenatal care utilization according to Anderson's behavioral model.

Keywords: ANC- antenatal care, contacts, mortality, morbidity

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Authors: Hadjer Chellia

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In the light of the recent global pandemic, different issues in educational research seem to invite careful considerations. Following this perspective, this study sets out to question the concept of classroom management in an EFL higher education context during Covid-19. In order to gain an in-depth understanding of their experiences, 6 EFL teachers from different Algerian universities took part in semi-structured interviews. The main emerging themes revealed that EFL teachers have different pedagogical practices in relation to classroom management during the global crisis than those of normal times. In relation to flexible education theory, the teachers’ experiences suggest flexible classroom management during Covid-19; flexibility in the teaching methods, approach and design, flexibility in time, flexibility in space and pace (speed), flexibility in assessment modes and flexibility in coping with students’ well-being. The flexibility awareness helps them to develop readiness towards the future, mainly in terms of maintaining an appropriate pedagogy to face the future crisis. In terms of theoretical concepts, working on classroom management under unusual circumstances in relation to flexible education helped come out with the concept of flexible classroom management (FCM) and virtual classroom management (VCM). It is then important for educators and researchers to rethink different pedagogical concepts and mind a careful application in the case of unusual times.

Keywords: Covid-19, EFL educators, flexible classroom management, flexible education, virtual classroom management

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Authors: Mustafa Dogru, Ruveyda Komurlu

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Companies and professionals in the construction sector face various risks in every project depending on the characteristics, size, complexity, the location of the projects and the techniques used. Some risks’ effects may increase as the project progresses whereas new risks may emerge. Because of the ever-changing nature of the risks, risk management is a cyclical process that needs to be repeated throughout the project. Since the risks threaten the success of the project, risk management is an important part of the entire project management process. The aims of this study are to emphasize the importance of risk management in construction projects, summarize the risk identification process, and introduce a number of methods for preventing risks such as alternative design, checklists, prototyping and test-analysis-correction technique etc. Following the literature review conducted to list the techniques for preventing risks, case studies has been performed to compare and evaluate the success of the techniques in a number of completed projects with the same typology, performed domestic and international. Findings of the study suggest that controlling and minimizing the level of the risks in construction projects, taking optimal precautions for different risks, and mitigating or eliminating the effects of risks are important in order to prevent additional costs for the project. Additionally, focusing on the risks that have highest impact is the most rational way to minimize the effects of the risks on projects.

Keywords: construction projects, construction management, project management, risk management

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Authors: Hakan Erol, Altan Elibol, Ömer Eryılmaz, Mehmet Şimşek

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Organizations aim to manage information in a most possible effective way for sustainment and development. In doing so, they apply various procedures and methods. The very same situation is valid for each service of Armed Forces. During long-lasting endeavors such as shaping and maintaining security environment, supporting and securing peace, knowledge management is a crucial asset. Optimum Balance Model aims to promote the system from a decisive point to a higher decisive point. In this context, this paper analyses the application of optimum balance model to knowledge management in Armed Forces and tries to find answer to the question how Optimum Balance Model is integrated in knowledge management.

Keywords: optimum balance model, knowledge management, security environment, supporting peace

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Authors: Jiri Barta

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This paper deals with a simulation programs and technologies using in the educational process for members of the crisis management. Risk analysis, simulation, preparation and planning are among the main activities of workers of crisis management. Made correctly simulation of emergency defines the extent of the danger. On this basis, it is possible to effectively prepare and plan measures to minimize damage. The paper is focused on simulation programs that are trained at the University of Defence. Implementation of the outputs from simulation programs in decision-making processes of crisis staffs is one of the main tasks of the research project.

Keywords: crisis management, continuity, critical infrastructure, dangerous substance, education, flood, simulation programs

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Authors: Zohreh Hajiha

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Culture affects the ability of the organization in expressing and achieving the goals. Organizational culture influences the selection of instruments applied in the management of organizations. All the instruments applied in organizations to control, promote and create innovations are influenced by organizational culture. This research studies organizational culture based on the cultural model of Muijen and its relationship with applying management accounting innovations in Iranian listed firms. Management accounting innovations of this study include activity-based costing, activity-based management, balanced scorecard, target costing, standard costing, quality costing, Kaizen costing and dimensions of organizational culture include support orientation, innovation orientation, rules orientation and goal orientation. 105 questionnaires were sent to financial executives of production companies and 73 questionnaires were returned. The findings show that there is a significant difference between organizational culture of firms that have applied management accounting innovations and those which have used these innovations less. Also, dimensions of support orientation and culture goal orientation are the highest in groups that apply management accounting innovations. The findings suggest that proper organization culture could promote the use od management accounting tools in Iranian firms.

Keywords: organizational culture, innovation, management accounting, muijen model

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Authors: Nassim Salmi

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This study aimed to identify the administrative, social, cultural, economic and psychological challenges facing the nursing s ector in the Tebessa Algeria. It also seeks to identify whether there are differences between the opinions of managers in public and private hospitals about these challenges. To achieve the objectives of the study, the descriptive analytical method was adopted. The study also used the questionnaire as a tool for collecting the necessary data and information, which was applied to a sample of directors of public and private hospitals in the Tebessa, which amounted to (114) individuals. The study reached a set of results, including: that there are no statistically significant differences between the opinions of managers in public and private hospitals about the administrative, social, cultural, economic and psychological challenges facing the nursing sector in the Tebessa . The results also showed agreement between the views of managers in private public hospitals that the most important administrative challenges are the lack of training programs that affect the efficiency and performance of nursing work, and that the most important social and cultural challenges are the hospital’s failure to provide suitable nurseries for Saudi female nurses, and that the most important economic challenges are the lack of Availability of medical equipment and devices, and the most important psychological challenge is the tense relationship between the administration and the hospital's nursing staff. The study recommended focusing on the importance of rehabilitation and training together, activating the role of training in the ministry and making it compulsory and a condition of renewal for practicing and continuing the nursing profession, and providing the social and economic needs of the nursing staff.

Keywords: postoperative care, gynecology, nursing documentation, database

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