Search results for: organization of multi-field hospital’s

Authors: Syed Qasim Gilani, Muhammad Umair, Muhammad Noman, Syed Bilawal Shah, Aqib Abbasi, Muhammad Waheed

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Cardiovascular Diseases(CVD's) are the major cause of death in the world. The main reason for these deaths is the unavailability of first aid for heart failure. In many cases, patients die before reaching the hospital. We in this paper are presenting innovative online health service for Cardiac Patients. The proposed online health system has two ends. Users through device developed by us can communicate with their doctor through a mobile application. This interface provides them with first aid.Also by using this service, they have an easy interface with their doctors for attaining medical advice. According to the proposed system, we developed a device called Cardiac Care. Cardiac Care is a portable device which a patient can use at their home for monitoring heart condition. When a patient checks his/her heart condition, Electrocardiogram (ECG), Blood Pressure(BP), Temperature are sent to the central database. The severity of patients condition is checked using Artificial Intelligence Algorithm at the database. If the patient is suffering from the minor problem, our algorithm will suggest a prescription for patients. But if patient's condition is severe, patients record is sent to doctor through the mobile Android application. Doctor after reviewing patients condition suggests next step. If a doctor identifies the patient condition as critical, then the message is sent to the central database for sending an ambulance for the patient. Ambulance starts moving towards patient for bringing him/her to hospital. We have implemented this model at prototype level. This model will be life-saving for millions of people around the globe. According to this proposed model patients will be in contact with their doctors all the time.

Keywords: cardiovascular disease, classification, electrocardiogram, blood pressure

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Authors: Mohsen Yaghmoor, Sima Radmanesh

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Rapid environmental changes have been threaten the life of many organizations .Enabling and productivity of human resource should be considered as the most important issue in order to increase performance and ensure survival of the organizations. In this research, the effectiveness of management factory in productivity & inability of human resource have been identified and reviewed at glance. Afterward there were two questions they are “what are the factors effecting productivity and enabling of human resource” . And ”what are the priority order based on effective management of human resource in Fars Poultry Complex". A specified questionnaire has been designed in order to priorities and effectiveness of the identified factors. Six factors specify to consist of: Individual characteristics, teaching, motivation, partnership management, authority or power submission and job development that have most effect on organization. Then specify a questionnaire for priority and effect measurement of specified factor that reach after collect information and using statistical tests of keronchbakh alpha coefficient r=0.792 that we can say the questionnaire has sufficient reliability. After information analysis of specified six factors by Friedman test categorize their effect. Measurement on organization respectively consists of individual characteristics, job development or enrichment, authority submission, partnership management, teaching and motivation. At last it has been indicated to approaches to increase making power full and productivity of manpower.

Keywords: productivity, empowerment, enrichment, authority submission, partnership management, teaching, motivation

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Authors: Artitaya Sabangbal, Darawan Augsornwan, Palakorn Surakunprapha, Lalida Petphai

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Background: Srinagarind Hospital Ward 3C has about 180 cases of patients with head and neck cancer per year. Almost all of these patients suffer with pain, fatigue, low self image, swallowing problem and when the tumor is larger they will have breathing problem. Many of them have complication after operation such as pressure sore, pneumonia, deep vein thrombosis. Nursing activity is very important to prevent the complication especially promoting patients early ambulation. The objective of this study was to develop early ambulation protocol for patients with head and neck cancer undergoing operation. Method: this study is one part of nursing system development in patients undergoing operation in Ward 3C. It is a participation action research divided into 3 phases Phase 1 Situation review: In this phase we review the clinical outcomes, process of care, from document such as nurses note and interview nurses, patients and family about early ambulation. Phase 2 Searching nursing intervention about early ambulation from previous study then establish protocol . This phase we have picture package of early ambulation. Phase 3 implementation and evaluation. Result: Patients with head and neck cancer after operation can follow early ambulation protocol 100%, 85 % of patients can follow protocol within 2 days after operation and 100% can follow protocol within 3 days. No complications occur. Patients satisfaction in very good level is 58% and in good level is 42% Length of hospital stay is 6 days in patients with wide excision and 16 day in patients with flap coverage. Conclusion: The early ambulation protocol is appropriate for patients with head and neck cancer who undergo operation. This can restore physical health, reduce complication and increase patients satisfaction.

Keywords: nursing system, early ambulation, head and neck cancer, operation

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Authors: Jean Paul Muambangu Milambo, Peter Nyasulu, John Akudugu, Leonidas Ndayisaba, Joyce Tsoka-Gwegweni, Lebwaze Massamba Bienvenu, Mitshindo Mwambangu Chiro

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In 2018, non-communicable diseases (NCDs) were responsible for 48% of deaths in the Democratic Republic of Congo (DRC), with cancer contributing to 5% of these deaths. There is a notable absence of cancer registries, capacity-building activities, budgets, and treatment roadmaps in the DRC. Current cancer estimates are primarily based on mathematical modeling with limited data from neighboring countries. This study aimed to assess cancer subtype prevalence in Kinshasa hospitals and compare these findings with WHO model estimates. Methods: A retrospective observational study was conducted from 2018 to 2020 at HJ Hospitals in Kinshasa. Data were collected using American Cancer Society (ACS) questionnaires and physician logs. Descriptive analysis was performed using STATA version 16 to estimate cancer burden and provide evidence-based recommendations. Results: The results from the chart review at HJ Hospitals in Kinshasa (2018-2020) indicate that out of 6,852 samples, approximately 11.16% were diagnosed with cancer. The distribution of cancer subtypes in this cohort was as follows: breast cancer (33.6%), prostate cancer (21.8%), colorectal cancer (9.6%), lymphoma (4.6%), and cervical cancer (4.4%). These figures are based on histopathological confirmation at the facility and may not fully represent the broader population due to potential selection biases related to geographic and financial accessibility to the hospital. In contrast, the World Health Organization (WHO) model estimates for cancer prevalence in the DRC show different proportions. According to WHO data, the distribution of cancer types is as follows: cervical cancer (15.9%), prostate cancer (15.3%), breast cancer (14.9%), liver cancer (6.8%), colorectal cancer (5.9%), and other cancers (41.2%) (WHO, 2020). Conclusion: The data indicate a rising cancer prevalence in DRC but highlight significant gaps in clinical, biomedical, and genetic cancer data. The establishment of a population-based cancer registry (PBCR) and a defined cancer management pathway is crucial. The current estimates are limited due to data scarcity and inconsistencies in clinical practices. There is an urgent need for multidisciplinary cancer management, integration of palliative care, and improvement in care quality based on evidence-based measures.

Keywords: cancer, risk factors, DRC, gene-environment interactions, survivors

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Authors: Shreya Mishra, Manosi Chaudhuri, Ajoy K. Dey

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Workplace bullying is a social phenomenon which has proved to be hazardous not only for employees’ well-being but also organizations. Despite being prevalent across geographical boundaries, Indian organizations have failed to acknowledge its vices. This paper aims to understand targets’ perception on what makes bullying nurture in organizations. The paper suggests that person-led Indian work settings give birth to bullying behavior as it lacks professional acumen and systems. An analysis of 13 in-depth interviews of employees from the organized sector suggests that organizations, where decision making lies with single individual, may be a hub of hostile behavior due to the culture which promotes ‘yesmanship’, ‘authoritarianism’ and/or blind belief of leaders on certain set of employees. The study used constructivist grounded theory approach, and the data was analyzed using R Based Qualitative Data Analysis (RQDA) software. Respondents reported that bullying behavior is taken lightly by the management with 'just ignore it' attitude. According to the respondents, the behavior prolong as the perpetrator have a direct approach to the top authority. The study concludes that person-led organizations may create a family-like environment which is favored by employees; however, authoritative leaders are unable to gain the trust of employees. Also, employees who are close to the leader may either be a perpetrator or a target of bullying. It is recommended that leaders in such organizations need to acknowledge the presence of bullying which affects an employees’ commitment towards their job and/or organization. They need to have an assertive check on individuals who hide behind ‘yesman’ attitude. This may help employees feel safe in such work settings.

Keywords: constructivist grounded theory, person-led organization, RQDA, workplace bullying

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Authors: Jeong-Moh John Yahng, Angelika Na

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Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

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Authors: Priyanka Yadav, Umesh Bnasal, Yashvinder Kumar

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The placenta is an important structure that provides oxygen and nutrients to the growing fetus in utero. It is usually thrown away after birth, but it has a therapeutic role in the regeneration of tissue. It is covered by the amniotic membrane, which can be easily separated into the amnion layer and the chorion layer—the amnion layer act as a biofilm for the healing of burn wound and non-healing ulcers. The freshly collected membrane has stem cells, cytokines, growth factors, and anti-inflammatory properties, which act as a biofilm for the healing of wounds. It functions as a barrier and prevents heat and water loss and also protects from bacterial contamination, thus supporting the healing process. The application of Amnion membranes has been successfully used for wound and reconstructive purposes for decades. It is a very cheap and easy process and has shown superior results to allograft and xenograft. However, there are very few case reports of amnion membrane grafting in newborns; we intend to highlight its therapeutic importance in burn injuries in newborns. We present a case of 9 days old male neonate who presented to the neonatal unit of Maulana Azad Medical College with a complaint of fluid-filled blisters and burns wound on the body for six days. He was born outside the hospital at 38 weeks of gestation to a 24-year-old primigravida mother by vaginal delivery. The presentation was cephalic and the amniotic fluid was clear. His birth weight was 2800 gm and APGAR scores were 7 and 8 at 1 and 5 minutes, respectively. His anthropometry was appropriate for gestational age. He developed respiratory distress after birth requiring oxygen support by nasal prongs for three days. On the day of life three, he developed blisters on his body, starting from than face then over the back and perineal region. At a presentation on the day of life nine, he had blisters and necrotic wound on the right side of the face, back, right shoulder and genitalia, affecting 60% of body surface area with full-thickness loss of skin. He was started on intravenous antibiotics and fluid therapy. Pus culture grew Pseudomonas aeuroginosa, for which culture-specific antibiotics were started. Plastic surgery reference was taken and regular wound dressing was done with antiseptics. He had a storming course during the hospital stay. On the day of life 35 when the baby was hemodynamically stable, amnion membrane grafting was done on the wound site; for the grafting, fresh amnion membrane was removed under sterile conditions from the placenta obtained by caesarean section. It was then transported to the plastic surgery unit in half an hour in a sterile fluid where the graft was applied over the infant’s wound. The amnion membrane grafting was done twice in two weeks for covering the whole wound area. After successful uptake of amnion membrane, skin from the thigh region was autografted over the whole wound area by Meek technique in a single setting. The uptake of autograft was excellent and most of the areas were healed. In some areas, there was patchy regeneration of skin so dressing was continued. The infant was discharged after three months of hospital stay and was later followed up in the plastic surgery unit of the hospital.

Keywords: amnion membrane grafting, autograft, meek technique, newborn, regeneration of skin

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Authors: Orapan Thosingha, Tassana Boontong, Prapa Yuttatri, Vilaivan Thongcharoen, Soparn Potaya, Mattika Chaichan, Chanin Chakkrapopyodhin, Khwanthida Phimphakarn, Taddao Nabnean

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This research aimed to explore symptom experiences among Thai adults with chronic illnesses living in an urban community area of Bangkok. The sample was 670 adults with ages ranging from 20-59 years. The majority of them (65.2%) had more than one disease. Hypertension, dyslipidemia, and diabetes were the first three diseases among them. About 58% were female, and 51.1 % stayed with their couples. The studied sample had relatively low socioeconomic status; 33.7% were wage workers, 15.2% were street vendors, and 10.4% were unemployed. About 54 % had family incomes less than 10,000 baht (300 US Dollars) per month, and 41.6% addressed that their incomes were not adequate for daily living. Although the majority of them (63.7%) did not have to pay for hospital visits, they still had to pay for public transportation and could not earn a wage or any income on the hospital visit day. The first three physical symptoms they experienced were knee pain (60.5%) due to being overweight, headache (47.0%), and insomnia (44.6%). About 45% stated that their incomes decreased after having chronic illnesses and 37.2% expressed that having lower incomes affected their living, 34.5% perceived being a burden, and 34.3% regret about depending on others. It can be concluded that adults with low socioeconomic status who experienced chronic illnesses and resided in an urban community area had complex needs. While caring for them, nurses should pay attention not only to a disease-related domain but also to a social-related domain. Reached-out clinics led by professional nurses who are well-prepared for primary medical care and home visit are strongly recommended. National Health Security Office should adopt this policy and develop an action plan to serve the needs of chronically ill adults with low socioeconomic status.

Keywords: chronic illnesses, urban community, socioeconomic status, symptom experiences, low incomes

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Authors: Zeynep Genel

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The concept of reputation in corporate development comes to the fore as one of the most frequently discussed topics in recent years. Many organizations, which make worldwide investments, make effort in order to adapt themselves to the topics within the scope of this concept and to promote the name of the organization through the values that might become prominent. The stakeholder groups are considered as the most important actors determining the reputation. Even, the effect of stakeholders is not evaluated as a direct factor; it is signed as indirect effects of their perception are a very strong on ultimate reputation. It is foreseen that the parallelism between the projected reputation and the perceived c reputation, which is established as a result of communication experiences perceived by the stakeholders, has an important effect on achieving these objectives. In assessing the efficiency of these efforts, the opinions of stakeholders are widely utilized. In other words, the projected reputation, in which the positive and/or negative reflections of corporate communication play effective role, is measured through how the stakeholders perceptively position the organization. From this perspective, it is thought that the interaction and cooperation of corporate communication professionals with different stakeholder groups during the reputation positioning efforts play significant role in achieving the targeted reputation or in sustainability of this value. The governmental stakeholders having intense communication with mass stakeholder groups are within the most effective stakeholder groups of organization. The most important reason of this is that the organizations, regarding which the governmental stakeholders have positive perception, inspire more confidence to the mass stakeholders. At this point, the organizations carrying out joint projects with governmental stakeholders in parallel with sustainable communication approach come to the fore as the organizations having strong reputation, whereas the reputation of organizations, which fall behind in this regard or which cannot establish the efficiency from this aspect, is thought to be perceived as weak. Similarly, the social responsibility campaigns, in which the governmental stakeholders are involved and which play efficient role in strengthening the reputation, are thought to draw more attention. From this perspective, the role and effect of governmental stakeholders on the reputation positioning is discussed in this study. In parallel with this objective, it is aimed to reveal perspectives of seven governmental stakeholders towards the cooperation in reputation positioning. The sample group representing the governmental stakeholders is examined under the lights of results obtained from in-depth interviews with the executives of different ministries. It is asserted that this study, which aims to express the importance of stakeholder participation in corporate reputation positioning especially in Turkey and the effective role of governmental stakeholders in strong reputation, might provide a new perspective on measuring the corporate reputation, as well as establishing an important source to contribute to the studies in both academic and practical domains.

Keywords: collaborative communications, reputation management, stakeholder engagement, ultimate reputation

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Authors: Mihail Nagea, Olivera Lupescu, Nicolae Ciurea, Alexandru Dimitriu, Alina Grosu

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Introduction: As severe open injuries are more and more frequent in modern traumatology, threatening not only the integrity of the affected limb but even the life of the patients, new methods desired to cope with the consequences of these traumas were described. Vacuum therapy is one such method which has been described as enhancing healing in trauma with extensive soft-tissue injuries, included those with septic complications. Material and methods: Authors prospectively analyze 15 patients with severe lower limb trauma with MESS less than 6, with considerable soft tissue loss following initial debridement and fracture fixation. The patients needed serial debridements and vacuum therapy was applied after delayed healing due to initial severity of the trauma, for an average period of 12 days (7 - 23 days).In 7 cases vacuum therapy was applied for septic complications. Results: Within the study group, there were no local complications; secondary debridements were performed for all the patients and vacuum system was re-installed after these debridements. No amputations were needed. Medical records were reviewed in order to compare the outcome of the patients: the hospital stay, anti-microbial therapy, time to healing of the bone and soft tissues (there is no standard group to be compared with) and the result showed considerable improvements in the outcome of the patients. Conclusion: Vacuum therapy improves healing of the soft tissues, including those infected; hospital stay and the number of secondary necessary procedures are reduced. Therefore it is considered a valuable support in treating trauma of the limbs with severe soft tissue injuries.

Keywords: complex injuries, negative pressure, open fractures, wound therapy

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Authors: Mohamed Saeed Ahmed Salman

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The aim of this Current Study is to reveals the impact of Transformational Leadership on Organizational Innovation in Mobile Jordanian Communication Companies, (Zain; Orange; Umniah and Xpress). The study depends on descriptive and analytical mothodize using the practical manner, study sample consists of Head of section and Experts from all Specializations in Mobile Jordanian Communication Companies amounted (120). A major study finding all Transformational Leadership Behaviors was median extent. The innovation adoption and innovation abilities availability was high extent. Besides there is a significant statistical impact of Transformational Leadership Behaviors, (Idealized Influence; Intellectual Stimulation; Individualized Consideration and Empowerment), on Organizational Innovation (innovation adoption & innovation abilities availability). It can be said that organizational creativity is the adoption of new ideas and behaviors that are applied in the organization, whether this is in creating new products or services, or new technology that is used at work. Transformational leadership is a process that occurs when one or more people engage with others in a way that enables leaders and followers to raise each other to higher levels of morals, motivations, and behaviors (desires, needs, ambitions, and followers' core values). An effective leader under transformational leadership is one who has a high ability to communicate, motivate, delegate, and listen to others, and is characterized by great flexibility in solving problems and dealing greatly with variables. The difference between creativity and innovation, in conclusion, innovation, invention, and creativity are three important elements for any institution or organization, and there is a fine line that separates them, which is that creativity works to generate new ideas, while invention makes them tangible, and innovation makes them valuable.

Keywords: leadership, organizational, transformational, creativity

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Authors: Yael Livneh, Shay Tzafrir, Ilan Meshoulam

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Technological startup companies have been recognized as bearing tremendous potential for business and economic success. However, many entrepreneurs who produce promising innovative ideas fail to implement them as successful businesses. A key argument for such failure is the entrepreneurs' lack of competence in adaptation of the relevant level of formality of human resource management (HRM). The purpose of the present research was to examine multiple antecedents and consequences of HRM formality in growing startup companies. A review of the research literature identified two central components of HRM formality: HR control and professionalism. The effect of three contextual predictors was examined. The first was an intra-organizational factor: the development level of the organization. We based on a differentiation between knowledge exploration and knowledge exploitation. At a given time, the organization chooses to focus on a specific mix of these orientations, a choice which requires an appropriate level of HRM formality, in order to efficiently overcome the challenges. It was hypothesized that the mix of orientations of knowledge exploration and knowledge exploitation would predict HRM formality. The second predictor was the personal characteristics the organization's leader. According the idea of blueprint effect of CEO's on HRM, it was hypothesized that the CEO's cognitive style would predict HRM formality. The third contextual predictor was an external organizational factor: the level of investor involvement. By using the agency theory, and based on Transaction Cost Economy, it was hypothesized that the level of investor involvement in general management and HRM would be positively related to the HRM formality. The effect of formality on trust was examined directly and indirectly by the mediation role of procedural justice. The research method included a time-lagged field study. In the first study, data was obtained using three questionnaires, each directed to a different source: CEO, HR position-holder and employees. 43 companies participated in this study. The second study was conducted approximately a year later. Data was recollected using three questionnaires by reapplying the same sample. 41 companies participated in the second study. The organizations samples included technological startup companies. Both studies included 884 respondents. The results indicated consistency between the two studies. HRM formality was predicted by the intra-organizational factor as well as the personal characteristics of the CEO, but not at all by the external organizational context. Specifically, the organizational orientations was the greatest contributor to both components of HRM formality. The cognitive style predicted formality to a lesser extent. The investor's involvement was found not to have any predictive effect on the HRM formality. The results indicated a positive contribution to trust in HRM, mainly via the mediation of procedural justice. This study contributed a new concept for technological startup company development by a mixture of organizational orientation. Practical implications indicated that the level of HRM formality should be matched to that of the company's development. This match should be challenged and adjusted periodically by referring to the organization orientation, relevant HR practices, and HR function characteristics. A relevant matching could enhance further trust and business success.

Keywords: control, formality, human resource management, organizational development, professionalism, technological startup company

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Authors: Harmeet Pal Singh Dhooria, Deepinder Chinna, UPS Sidhu, Alok Jain

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Serious infections caused by gram-negative bacteria are a significant cause of mortality and morbidity in the hospital setting. In acute care facilities like in intensive care units (ICUs), the intensity of antimicrobial use together with a population highly susceptible to infection, creates an environment, which facilitates both emergence and transmission of Extended Spectrum -lactamase (ESBL) producing Enterobacteriaceae species. The study was conducted in the Medical Intensive Care Unit (MICU) and the Pulmonary Critical Care Unit (PCCU) of the Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Out of a total of 1108 samples of urine, blood and respiratory tract secretions received for culture and sensitivity analysis from Medical Intensive Care Unit and Pulmonary Critical Care Unit, a total of 170 isolates of Enterobacteriaceae species were obtained which were then included in our study. Out of these 170 isolates, confirmed ESBL production was seen in 116 (68.24%) cases. E.coli was the most common species isolated (56.47%) followed by Klebsiella (32.94%), Enterobacter (5.88%), Citrobacter (3.53%), Enterobacter (0.59%) and Morganella (0.59%) among the total isolates. The rate of ESBL production was more in Klebsiella (78.57%) as compared to E.coli (60.42%). ESBL producers were found to be significantly more common in patients with prior history of hospitalization, antibiotic use, and prolonged ICU stay. Also significantly increased the prevalence of ESBL related infections was observed in patients with a history of catheterization or central line insertion but not in patients with the history of intubation. Patients who had an underlying malignancy had significantly higher prevalence of ESBL related infections as compared to other co-morbid illnesses. A slightly significant difference in the rate of mortality/LAMA was observed in the ESBL producer versus the non-ESBL producer group. The rate of mortality/LAMA was significantly higher in the ESBL related UTI but not in the ESBL related respiratory tract and bloodstream infections. ESBL producing isolates had significantly higher rates of resistance to Cefepime and Piperacillin/Tazobactum, and to non β-lactum antibiotics like Amikacin and Ciprofloxacin. The level of resistance to Imipenem was lower as compared to other antibiotics. However, it was noted that ESBL producing isolates had higher levels of resistance to Imipenem as compared to non-ESBL producing isolates. Conclusion- The prevalence of ESBL producing organisms was found to be very high (68.24%) among Enterobacteriaceae isolates in our ICU setting as among other ICU care settings around the world.

Keywords: enterobacteriaceae, extended spectrum B-lactamase (ESBL), ICU, antibiotic resistance

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Authors: Nurlaila Effendy

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Companies in Asia face a number of constraints in tight competitiveness in ASEAN Economic Community 2015 and globalization. An economic capitalism system as an integral part of globalization processing brings broad impacts. They need to improve business performance in globalization and ASEAN Economic Community. Organizational development has quite clearly demonstrated that aligning individual’s personal goals with the goals of the organization translates into measurable and sustained performance improvement. Human capital is a key to achieve company performance. Employee Engagement (EE) creates and expresses themselves physically, cognitively and emotionally to achieve company goals and individual goals. One will experience a total involvement when they undertake their jobs and feel a self integration to their job and organization. A leader plays key role in attaining the goals and objectives of a company/organization. Any Manager in a company needs to have leadership competence and global mindset. As one the of positive organizational behavior developments, psychological capital (PsyCap) is assumed to be one of the most important capitals in the global mindset, in addition to intellectual capital and social capital. Textile companies also need to face a number of constraints in tight competitiveness in regional and global. This research involved 42 managers in two textiles and a spinning companies in a group, in Central Java, Indonesia. It is a quantitative research with Partial Least Squares (PLS) studying job resource (Social Support & Organizational Climate) and Personal Resource (4 dimensions of Psychological Capital & Leadership Competence) as prediction of Employee Engagement, also Employee Engagement and leadership competence as prediction of leader’s performance. The performance of a leader is measured by means of achievement on objective strategies in terms of 4 perspectives (financial and non-financial perspectives) in a Balanced Score Card (BSC). It took one year during a business plan of year 2014, from January to December 2014. The result of this research is there is correlation between Job Resource (coefficient value of Social Support is 0.036 & coefficient value of organizational climate is 0.220) and Personal Resource (coefficient value of PsyCap is 0.513 & coefficient value of Leadership Competence is 0.249) with employee engagement. There is correlation between employee engagement (coefficient value is 0.279) and leadership competence (coefficient value is 0.581) with performance.

Keywords: organizational climate, social support, psychological capital leadership competence, employee engagement, performance, integrated textile companies

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Authors: Mine Tanaç Zeren

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The traditional architectural style or the vernacular architecture can be considered modern and permanent in terms of reflecting the community’s lifestyle, reasonable interpretation of the material and the structure, and the building and the environment relationship’s integrity. When vernacular architecture is examined, it is seen that sustainable building design approaches are achieved at the very beginning by adapting to climate conditions. The aim of the sustainable design approach is to maintain to adapt to the characteristics of the topography of the land and to the climatic conditions, minimizing the energy use by the building material and structural elements. Traditional Turkish House, as one of the representatives of the traditional and vernacular architecture in Anatolia, has a sustainable building design approach as well, which can be read both from the space organization, the section, the volume, and the building components and building details. The only effective factor that human beings cannot change and have to adapt their constructions and settlements to is climate. The vernacular settlements of vernacular architecture in Anatolia, “Traditional Turkish Houses,” are generally formed as concentric settlements in desert conditions and climates or separate and dependently formations according to the wind and the sun in moist areas. They obtain the sustainable building design criteria. This paper aims to put forward the sustainable building design approaches of vernacular architecture in Anatolia. There are four main different climatic conditions depending on the regional differentiations in Anatolia. Taking these different climatic and topographic conditions into account, it has been seen that the vernacular housing features shape and differentiate from each other due to the changing conditions. What is differentiating is the space organization, design of the shelter of the building, material, and structural system used. In this paper, the sustainable building design approaches of Anatolian vernacular architecture will be examined within these four different vernacular settlements located in Aegean Region, Marmara Region, Black Sea Region, and Eastern Region. These differentiated features and how these features differentiate in order to maintain the sustainability criteria will be the main discussion part of the paper. The methodology of this paper will briefly define these differentiations and the sustainable design criteria. The sustainable design approaches and these differentiated items will be read through the design criteria of the shelter of the building and the material selection criteria according to climatic conditions. The methods of preventing energy loss will be examined. At the end of this research, it is going to be seen that the houses located in different parts of Anatolia, depending on climate and topographic conditions to be able to adapt to the environment and maintain sustainability, differ from each other in terms of space organization, structural system, and material use, design of the shelter of the building

Keywords: sustainability of vernacular architecture, sustainable design criteria of traditional Turkish houses, Turkish houses, vernacular architecture

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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: Mammar Khames, Mustapha Oumouna

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Brucellosis is one of the most common zoonoses in the world. It represents a serious threat to human health; the existence of brucellosis in Algeria dates back to the beginning of the 19th century. Its transmission to humans is through coccobacilli of the genus Brucella following direct contact with contaminated animals or indirectly through the consumption of their unpasteurized dairy products. The present investigation covers a retrospective study on human brucellosis in the district of Medea over a period from 2011 to 2021 at the level of two public health establishments. In the first place, it is at the level of the Directorate of Public Health and in the infectious department level at Medea Hospital, and at the level of the directorate of agricultural services in the third place. The results showed that during these eleven years of study, 795 cases were collected from the department of health and population, and 141 cases were collected from the infectious department of the district of Medea. A total of 56 cases of bovine brucellosis were obtained from the directorate of agricultural services of the district of Medea. Human brucellosis affects all age groups with different percentages, but the rate has been higher in the 20-44 age group, with a predominance of men. However, the geographic distribution map of the cases shows that the western part of the district was the most affected. A cohort of 141 cases was hospitalized at the infectious service level of Medea Hospital. They were 89 men and 52 women. The most common age reached is [20-44] years. The majority were of rural origin. Two serological reactions were performed for diagnosis: the buffered antigen test and Wright's serodiagnosis. Bovine brucellosis affects all age groups with different percentages, but the rate was higher in the 2-to-4-year age group, with a predominance of females. From these data, we conclude that brucellosis has a strong spread in the region studied.

Keywords: human brucellosis, serology, Medea, Algeria

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Authors: Mohamed H. Kosba, Heba A. Ibrahim, H. Rozita

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Statement of the Problem: The life expectancy for transfusion-dependent thalassemia patients has increased dramatically with iron-chelation therapy and other modern management modalities. In these patients, the most dominant maxillofacial manifestations are protrusion of zygomatic bones and premaxilla due to the hyperplasia of bone marrow. The purpose of this study is to determine the prevalence of malocclusion and orthodontic treatment needs according to the Dental Aesthetic Index (DAI) among Malay transfusion-dependent thalassemia patients. Orientation: This is a cross-sectional study consist of 43 Malay transfusion-dependent thalassemia patients, 22 males, and 19 females with the mean age of 15.9 years old (SD 3.58). The subjects were selected randomly from patients attending Paediatrics and Internal Medicine Clinic at Hospital USM and Hospital Sultana Bahiyah. The subjects were assessed for malocclusion according to Angle’s classification, and orthodontic treatment needs using DAI. The results show that 22 of the subjects (51.1%) have class II malocclusion, 12 subjects (28%) have class І, while 9 subjects (20.9%) have class Ⅲ. The assessment of orthodontic treatment needs to reveal 22 cases (51.1%) fall in the normal/minor needs category, 12 subjects (28%) fall in the severe and very severe category, while 9 subjects (20.9%) fall in the definite category. Conclusion & Significance: Half of Malay transfusion-dependent thalassemia patients have Class Ⅱmalocclusion. About 28% had malocclusion and required orthodontic treatment. This research shows that Malay transfusion-dependent thalassemia may require orthodontic management; earlier intervention to reduce the complexity of the treatment later, suggesting functional appliance as a suitable treatment option for them, a twin block appliance together with headgear to restrict maxillary growth suggested for management. The current protocol implemented by the Malaysian Ministry of Health for the management of these patients seems to be sufficient since the result shows that about 28% require orthodontic treatment need, according to DAI.

Keywords: prevalence, DAI, thalassaemia, angle classification

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Authors: Hsin-Yi Lo, Chia-Yu Hsu

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This article is the nursing experience of a multiple trauma case using Swanson's theory of caring, the nursing period is from May 31 to June 4, 2021, collect data through observation, written talks, interviews, listening, direct care and physical assessment, established cases with health problems such as acute pain, impaired tissue integrity, and anxiety. Nursing process including, evaluate the pain index with the pain assessment scale, assist in acupoint massage, use a corset to fix the wound, and give the patient listening to favorite radio programs to divert attention and relieve pain problems; promote wound healing and avoid infection by assessing wound condition and exudation, changing dressings with aseptic technique, and providing appropriate dressings; encourage patients to express their feelings, provide companionship, and assist in self-care and participation in treatment plans, to enable the case to overcome the anxiety caused by being admitted to the intensive care unit for the first time and not knowing about the disease, and assist the case to overcome the injury caused by the accident and return to normal life. There is no video equipment in the intensive care unit during the nursing period. In response to the problem that family visits cannot be opened during the epidemic, it is a limitation this time. It is recommended that the hospital take this into consideration in the future. In the post-epidemic era, it can reduce the risk of various infections for patients and family members. Traveling between home and hospital, improving the quality of high-quality and technological care.

Keywords: swanson's theory of caring, multiple trauma, anxiety, nursing experience

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Authors: Adem Öğüt, M. Tahir Demirsel

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Rapid changes and developments today, besides the opportunities and facilities they offer to the organization, may also be a source of danger and difficulties due to the uncertainty. In order to take advantage of opportunities and to take the necessary measures against possible uncertainties, organizations must always follow the changes and developments that occur in the business environment and develop flexible structures and strategies for the alternative cases. Perceived environmental uncertainty is an outcome of managers’ perceptions of the combined complexity, instability and unpredictability in the organizational environment. An environment that is perceived to be complex, changing rapidly, and difficult to predict creates high levels of uncertainty about the appropriate organizational responses to external circumstances. In an uncertain and complex environment, organizations experiencing cutthroat competition may be successful by developing their corporate entrepreneurial ability. Corporate entrepreneurship is a process that includes many elements such as innovation, creating new business, renewal, risk-taking and being predictive. Successful corporate entrepreneurship is a critical factor which has a significant contribution to gain a sustainable competitive advantage, to renew the organization and to adapt the environment. In this context, the objective of this study is to investigate the effect of perceived environmental uncertainty of managers on corporate entrepreneurship performance. The research was conducted on 222 business executives in one of the major industrial zones of Turkey, Konya Organized Industrial Zone (KOS). According to the results, it has been observed that there is a positive statistically significant relationship between perceived environmental uncertainty and corporate entrepreneurial activities.

Keywords: corporate entrepreneurship, entrepreneurship, industrial zone, perceived environmental uncertainty, uncertainty

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Authors: Malab Sana Balouch, Meenakshi Nayar

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Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.

Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist

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Authors: Ömer Faruk Ada, Türker Baş, M. Yaman Öztek

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In this study, we aim to investigate the skills to be owned by procurement professionals in order to fulfill their developing and changing role completely. Market conditions, competitive pressure, and high financial costs make it more important than ever for organizations to be able to use resources more efficiently. Research shows that procurement expenses consist more than 50 % of the operating expenses. With increasing profit impact of procurement, reviewing the position of the procurement function within the organization has become inevitable. This study is significant as it indicates the necessary skills that procurement professionals must have to keep in step with the transformation of procurement units from transaction oriented to value chain oriented. In this study, the transformation of procurement is investigated from the perspective of procurement professionals and we aim to answer following research questions: • How do procurement professionals perceive their role within the organization? • How has their role changed and what challenges have they had to face? • What portfolio of skills do they believe will enable them to fulfill their role effectively? Literature review consists of the first part of the study by investigating the changing role of procurement from different perspectives. In the second part, we present the results of the in-depth interviews with 15 procurement professionals and we used descriptive analysis as a methodology. In the light of these results, we classified procurement skills under operational, tactical and strategic levels and Procurement Skills Framework has been developed. This study shows the differences in the perception of purchasing by professionals and the organizations. The differences in the perception are considered as an important barrier beyond the procurement transformation. Although having the necessary skills has a significant effect for procurement professionals to fulfill their role completely and keep in step with the transformation of the procurement function, It is not the only factor and the degree of high-level management and organizational support has also a direct impact during this transformation.

Keywords: procuement skills, procurement transformation, strategic procurement, value chain

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

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

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

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Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

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Authors: Merkouche Wassila, Marchand Alain, Renaud Stéphane

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Organizations are facing competitive pressures constraining them to modify their practices and change initial work conditions of employees, however, these modifications have to sustain initial quality of work and engagements toward the workforce. We focus on the importance of promises in the perspective of psychological contract. According to this perspective, employees perceiving a breach of the expected obligations from the employer may become unsatisfied at work and develop organizational withdrawal behaviors. These are negative counterproductive behaviours aiming to damage the organisation according to the principle of reciprocity and social exchange. We present an integrative model of the determinants and manifestations of organizational withdrawal (OW), a set of behaviors allowing the employee to leave his job or avoid his assigned work. OW contains two main components often studied in silos: work withdrawal (delays, absenteeism and other adverse behaviors) and job withdrawal (turnover). We use the systemic micro, meso and macro sociological approach designing the individual at the heart of a system containing individual, organizational, and environmental determinants. Under the influence of these different factors, the individual assesses the type of behavior to adopt. We provide better lighting for understanding OW using both psychological contract approach through the perception of its respect by the organization and job embeddedness approach which explains why the employee does not leave the organization and then remains in his post while practicing negative and counterproductive behaviors such as OW. We study specifically cynicism as a type of OW as it is a dimension of burnout. We focus on the antecedents of cynicism to try to prevent it in the workplace.

Keywords: burnout, cynicism, job embeddedness, organizational withdrawal, psychological contract

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

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The ERP is integrating all data from various departments within the company into one data base. One department inputs the data and many other departments can access and use the data through the connected information system. As many manufacturing companies in Indonesia implement the ERP technology, many adjustments are to be made to align with the business process in the companies, especially the management policy and the competitive advantages. For companies that are successful in the initial implementation, they still have to maintain the process so that the initial success can develop along with the changing of business processes of the company. For companies which have already implemented the ERP successfully, they are still in need to maintain the system so that it can match up with the business development and changes. The continued success of the extended ERP implementation aims to achieve efficient and effective performance for the company. This research is distributing 100 questionnaires to manufacturing companies in East Java, Indonesia, which have implemented and have going live ERP for over five years. There are 90 returned questionnaires with ten disqualified questionnaires because they are from companies that implement ERP less than five years. There are only 80 questionnaires used as the data, with the response rate of 80%. Based on the data results and analysis with PLS (Partial Least Square), it is obtained that the organization commitment brings impacts to the user’s effectiveness and provides the adequate IT infrastructure. The user’s effectiveness brings impacts to the adequate IT infrastructure. The information quality of the company increases the implementation of the extended ERP in manufacturing companies in East Java, Indonesia.

Keywords: organization commitment, adequate IT infrastructure, information quality, extended ERP implementation

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Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

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Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

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Authors: Nadama Kumar, P. Parthiban, T. Niranjan

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In the present paper, we propose an incorporated approach for 3PL supplier choice that suits the distinctive strategic needs of the outsourcing organization in southern part of India. Four fundamental criteria have been used in particular Performance, IT, Service and Intangible. These are additionally subdivided into fifteen sub-criteria. The proposed strategy coordinates Structural Equation Modeling (SEM) and Non-additive Fuzzy Integral strategies. The presentation of fluffiness manages the unclearness of human judgments. The SEM approach has been used to approve the determination criteria for the proposed show though the Non-additive Fuzzy Integral approach uses the SEM display contribution to assess a supplier choice score. The case organization has a exclusive vertically integrated assembly that comprises of several companies focusing on a slight array of the value chain. To confirm manufacturing and logistics proficiency, it significantly relies on 3PL suppliers to attain supply chain superiority. However, 3PL supplier selection is an intricate decision-making procedure relating multiple selection criteria. The goal of this work is to recognize the crucial 3PL selection criteria by using the non-additive fuzzy integral approach. Unlike the outmoded multi criterion decision-making (MCDM) methods which frequently undertake independence among criteria and additive importance weights, the nonadditive fuzzy integral is an effective method to resolve the dependency among criteria, vague information, and vital fuzziness of human judgment. In this work, we validate an empirical case that engages the nonadditive fuzzy integral to assess the importance weight of selection criteria and indicate the most suitable 3PL supplier.

Keywords: 3PL, non-additive fuzzy integral approach, SEM, fuzzy

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Authors: Suchitra Chnadrashekhar

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Earlier looked as a support function in an organization information technology has now become a critical utility to manage their daily operations. Organizations are processing huge amount of data which was unimaginable few decades before. This has opened the opportunity for IT sector to help industries across domains to handle the data in the most intelligent manner. Presence of IT has been a leverage for the Oil & Gas industry to store, manage and process the data in most efficient way possible thus deriving the economic value in their day-to-day operations. Proper synchronization between Operational data system and Information Technology system is the need of the hour. Predictive analytics supports oil and gas companies by addressing the challenge of critical equipment performance, life cycle, integrity, security, and increase their utilization. Predictive analytics go beyond early warning by providing insights into the roots of problems. To reach their full potential, oil and gas companies need to take a holistic or systems approach towards asset optimization and thus have the functional information at all levels of the organization in order to make the right decisions. This paper discusses how the use of predictive analysis in oil and gas industry is redefining the dynamics of this sector. Also, the paper will be supported by real time data and evaluation of the data for a given oil production asset on an application tool, SAS. The reason for using SAS as an application for our analysis is that SAS provides an analytics-based framework to improve uptimes, performance and availability of crucial assets while reducing the amount of unscheduled maintenance, thus minimizing maintenance-related costs and operation disruptions. With state-of-the-art analytics and reporting, we can predict maintenance problems before they happen and determine root causes in order to update processes for future prevention.

Keywords: hydrocarbon, information technology, SAS, predictive analytics

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Authors: Abiola Olukemi Ogunyemi

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Many organizations would like to gain customer loyalty, and to achieve this they invest in customer management systems which help them to learn and anticipate the customers’ needs, get feedback from them and serve them. One of the most elementary ways to achieve customer loyalty is for employees to be able to empathize with their customers, and to be able to feel what they feel when the company betrays their trust, which usually otherwise shown in patronage and loyalty. Unfortunately, the staff and management of organizations do not always realize the negative impact of treating customers badly, because they do not stop to think how these customers feel. If they did, they would be more careful and more respectful of these people who are human beings just like they are. They would be wiser, since this would ultimately make them more profitable businesses. This paper looks at thirteen descriptions of situations in which customers felt treated badly by organizations they trusted, and focuses on the feelings of these customers. If the organization (made of people) could empathize with the customer, then customer service would be surely enhanced. It is expected that these stories, real experiences narrated by young professionals working in Nigeria, can awaken greater empathy for consumers within organizations. Thus, they may help the organization to learn empathy and to incorporate it into their foundational principles for ethical behavior. The paper’s contents contribute to a heightened appreciation of empathy as an organizing mechanism by showing how putting one in the consumer’s shoes can help managers to understand how he or she feels. This will lead organizations to be even more innovative in finding ways to meet their customers’ needs and to deserve and win their loyalty. It addresses an issue that cuts across cultures, and therefore can be quite thought-provoking for every business owner or for team leads within organizations. By trying to stimulate empathy across the seller-buyer divide, it necessarily contributes to a deeper understanding of empathy as a building block for a sustainable society.

Keywords: customer service, empathy, ethical behavior, respectfulness

Procedia PDF Downloads 259