Search results for: patient management

Authors: P. Řehoř, D. Holátová, V. Doležalová

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Paper deals with analysis of strategic management methods in non-profit making organization in the Czech Republic. Strategic management represents an aggregate of methods and approaches that can be applied for managing organizations - in this article the organizations which associate owners and keepers of non-state forest properties. Authors use these methods of strategic management: analysis of stakeholders, SWOT analysis and questionnaire inquiries. The questionnaire was distributed electronically via e-mail. In October 2013 we obtained data from a total of 84 questionnaires. Based on the results the authors recommend the using of confrontation strategy which improves the competitiveness of non-profit making organizations.

Keywords: strategic management, non-profit making organization, strategy analysis, SWOT analysis, strategy, competitiveness

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Authors: Mohammad Ehson Rangiha, Bill Karakostas

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Social Business Process Management (SBPM) promises to overcome limitations of traditional BPM by allowing flexible process design and enactment through the involvement of users from a social community. This paper proposes a meta-model and architecture for socially driven business process management systems. It discusses the main facets of the architecture such as goal-based role assignment that combines social recommendations with user profile, and process recommendation, through a real example of a charity organization.

Keywords: business process management, goal-based modelling, process recommendation social collaboration, social BPM

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Authors: Mitra Ghiasi, Roghayeh Ghorbani Bousari

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Nowadays, the aim of the organizations is to gain sustainable competitive. So, developing their intellectual capital, encouraging innovation, increasing suitable performance can be done by knowledge management. Knowledge turns into science if knowledge is used to improve decision making, decision quality and make effective decisions. The current research intends to investigate the relationship between cybernetics and knowledge management from the perspective of users who are members of electronic discussion groups (ALA, ALIA). The research methodology is survey method, and it is a type of correlation research. Cybernetics and knowledge management questionnaires used for collecting data. The questionnaire that was designed in electronic format, distributed among two electronic discussion groups during 30 days and completed by 100 members of each electronic discussion groups. The finding of this research showed that although cybernetics has an impact on knowledge management, there is no significant difference between the ALA and ALIA user's view regard to effect of cybernetics on knowledge management. The results also indicated that this conceptual model is consistent with the data collected from the sample.

Keywords: ALA discussion group, ALIA discussion group, cybernetics, knowledge management

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Authors: Anna Demian, Levi Howard, L. Ng, Leslie Simon, Mark Dragon, A. Desai, Timothy Devlantes, W. David Freeman

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Introduction: Out-of-hospital cardiac arrest (OHCA) can carry a high mortality. For survivors, the most common complication is hypoxic-ischemic brain injury (HIBI). Rarely, lumbosacral spinal cord and/or other spinal cord artery ischemia can occur due to anatomic variation and variable mean arterial pressure after the return of spontaneous circulation. We present a case of an OHCA survivor who later woke up with bilateral leg weakness with preserved sensation (ASIA grade B, L2 level). Methods: We describe a clinical, radiographic, and laboratory presentation, as well as a National Library of Medicine (NLM) search engine methodology, characterizing incidence/prevalence of this entity is discussed. A 70-year-old male, a longtime smoker, and alcohol user, suddenly collapsed at a bar surrounded by friends. He had complained of chest pain before collapsing. 911 was called. EMS arrived, and the patient was in pulseless electrical activity (PEA), cardiopulmonary resuscitation (CPR) was initiated, and the patient was intubated, and a LUCAS device was applied for continuous, high-quality CPR in the field by EMS. In the ED, central lines were placed, and thrombolysis was administered for a suspected Pulmonary Embolism (PE). It was a prolonged code that lasted 90 minutes. The code continued with the eventual return of spontaneous circulation. The patient was placed on an epinephrine and norepinephrine drip to maintain blood pressure. ECHO was performed and showed a “D-shaped” ventricle worrisome for PE as well as an ejection fraction around 30%. A CT with PE protocol was performed and confirmed bilateral PE. Results: The patient woke up 24 hours later, following commands, and was extubated. He was found paraplegic below L2 with preserved sensation, with hypotonia and areflexia consistent with “spinal shock” or anterior spinal cord syndrome. MRI thoracic and lumbar spine showed a conus medullaris level spinal cord infarction. The patient was given IV steroids upon initial discovery of cord infarct. NLM search using “cardiac arrest” and “spinal cord infarction” revealed 57 results, with only 8 review articles. Risk factors include age, atherosclerotic disease, and intraaortic balloon pump placement. AoA (Artery of Adamkiewicz) anatomic variation along with existing atherosclerotic factors and low perfusion were also known risk factors. Conclusion: Acute paraplegia from anterior spinal cord infarction of the AoA territory after cardiac arrest is rare. Larger prospective, multicenter trials are needed to examine potential interventions of hypothermia, lumbar drains, which are sometimes used in aortic surgery to reduce ischemia and/or other neuroprotectants.

Keywords: cardiac arrest, spinal cord infarction, artery of Adamkiewicz, paraplegia

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Authors: Mensah-Akoto Julius, Kenichi Matsui

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This paper examines the impact of COVID-19 on waste management workers in Ghana. A questionnaire survey was conducted among 60 waste management workers in Accra metropolis, the capital region of Ghana, to understand the impact of the COVID-19 pandemic on waste generation, workers’ safety in collecting solid waste, and service delivery. To find out correlations between the pandemic and safety of waste management workers, a regression analysis was used. Regarding waste generation, the results show the pandemic led to the highest annual per capita solid waste generation, or 3,390 tons, in 2020. Regarding the safety of workers, the regression analysis shows a significant and inverse association between COVID-19 and waste management services. This means that contaminated wastes may infect field workers with COVID-19 due to their direct exposure. A rise in new infection cases would have a negative impact on the safety and service delivery of the workers. The result also shows that an increase in economic activities negatively impacts waste management workers. The analysis, however, finds no statistical relationship between workers’ service deliveries and employees’ salaries. The study then discusses how municipal waste management authorities can ensure safe and effective waste collection during the pandemic.

Keywords: Covid-19, waste management worker, waste collection, Ghana

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Authors: Thusitha Mabotuwana, Christopher S. Hall

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Radiologists routinely make follow-up imaging recommendations, usually based on established clinical practice guidelines, such as the Fleischner Society guidelines for managing lung nodules. In order to ensure optimal care, it is important to make guideline-compliant recommendations, and also for patients to follow-up on these imaging recommendations in a timely manner. However, determining such compliance rates after a specific finding has been observed usually requires many time-consuming manual steps. To address some of these limitations with current approaches, in this paper we discuss a methodology to automatically detect finding-specific follow-up recommendations from radiology reports and create a visualization for relevant subsequent exams showing the modality transitions. Nearly 5% of patients who had a lung related follow-up recommendation continued to have at least eight subsequent outpatient CT exams during a seven year period following the recommendation. Radiologist and section chiefs can use the proposed tool to better understand how a specific patient population is being managed, identify possible deviations from established guideline recommendations and have a patient-specific graphical representation of the imaging pathways for an abstract view of the overall treatment path thus far.

Keywords: follow-up recommendations, follow-up tracking, care pathways, imaging pathway visualization

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Authors: Tesfaye Mengistu

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This thesis aims to investigate the effectiveness of Reinforcement Learning (RL) for Autonomous Energy Management solutions. The study explores the potential of Model Free RL approaches, such as Monte Carlo RL and Q-learning, to improve energy management by autonomously adjusting energy management strategies to maximize efficiency. The research investigates the implementation of RL algorithms for optimizing energy consumption in a single-agent environment. The focus is on developing a framework for the implementation of RL algorithms, highlighting the importance of RL for enabling autonomous systems to adapt quickly to changing conditions and make decisions based on previous experiences. Moreover, the paper proposes RL as a novel energy management solution to address nations' CO2 emission goals. Reinforcement learning algorithms are well-suited to solving problems with sequential decision-making patterns and can provide accurate and immediate outputs to ease the planning and decision-making process. This research provides insights into the challenges and opportunities of using RL for energy management solutions and recommends further studies to explore its full potential. In conclusion, this study provides valuable insights into how RL can be used to improve the efficiency of energy management systems and supports the use of RL as a promising approach for developing autonomous energy management solutions in residential buildings.

Keywords: artificial intelligence, reinforcement learning, monte carlo, energy management, CO2 emission

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Authors: Nuruddin Mohammod Zahangir, Syed Tanvir Ahmady, Firoz Ahmed, Mainul Kabir, Tamjid Mohammad Najmus Sakib Khan, Nazmul Hossain, Niaz Ahmed, Madhava Janardhan Naik

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The management of combined Coronary Artery Disease and Peripheral Vascular Disease is a challenge and brings with it numerous clinical dilemmas.The 56 year old gentleman presented to our department with significant triple vessel disease with occluded lower end of aorta just before bifurcation and bilateral superficial femoral arteries. Operation was done on 11.03.14. The The Left Internal Mammary Artery (LIMA) and the Right Internal Mammary Artery (RIMA) were harvested in skeletonized manner. The free RIMA was then anastomosed with LIMA to make LIMA-RIMA Y. Cardio Pulmonary Bypass was then established and coronary artery bypass grafts performed. LIMA was anastomosed to the Left Anterior Descending artery. RIMA was anastomosed to Posterior Descending Artery, 1st and 2nd Obtuse Marginal arteries in a sequential manner. Abdomen was opened by midline incision. The infrarenal aorta exposed and was found to be severely diseased. A Vascular Clamp was applied infrarenally, aortotomy done and limited endarterectomy performed. An end-to-side anastomosis was done with upper end of PTFE synthetic Y-graft (14/7 mm) to the infarenal Aorta and the Clamp released. Good flow noted in both limbs of the graft. Patient was then slowly weaned off from Cardio Pulmonary Bypass without difficulty. The distal two limbs of the Y graft were passed to the groin through retroperitoneal tunnels and anastomosed end-to-side with the common femoral arteries. Saphenous vein was interposed between common femoral and popliteal arteries bilaterally through subfascial tunnels in both thigh. On 12th postoperative day he was discharged from hospital in good general condition. Follow up after 3 months of operation the patient is doing good and free of chest pain and claudication pain.

Keywords: total arterial, coronary revascularization, aorto-bifemoral bypass, bifemoro-bipopliteal bypass

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Authors: Ruqayya Naheed Khan, Romaisa Shamim, Awais Amjad Malik, Awais Naeem, Amina Iqbal Khan, Asad Parvaiz

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Objective: Patients undergoing axillary lymph node dissection (ALND) for metastatic lymph nodes in our hospital usually have drains placed in their axilla for a period of 6-10 days. We evaluated the post-op course of patients who underwent breast conservation surgery (BCS) along with ALND. Methods: A prospective cohort study was conducted at Shaukat Khanam Memorial Cancer Hospital from April 2017 to August 2017 including all lymph node positive breast cancer patients undergoing BCS with ALND. Patients were divided into two groups. Group A had no axillary drain while in Group B a drain was placed in axilla. Results: A total of 76 patients were included. 41 patients were included in group A and 35 patients in Group B. Median number of LNs dissected in group A was 17 and in group B was 15 (p value 0.443). Median operative time in group A was 84 min and in group B was 79 min (p value 0.223). Median hospital stay in both groups was 1 day (p value 0.78). At 2 weeks all patients in group A developed seroma as compared to none in group B (p value < 0.001). 3 of these patients in group A required aspiration of seroma due to pressure effects. Rest were managed conservatively. At 6 weeks only 50% patients had a seroma radiologically in Group A as compared to 33% in group B (p value 0.023). No intervention was required in any patients at week 6. QOL at 2 weeks was much better in Group A (7/41 patients had unsatisfactory response) as compared to group B (10/31 had unsatisfactory response). Results were statistically significant (p value 0.045). However, there wasn’t much difference in QOL at 6 weeks. Only 1 patient in group A had an unsatisfactory response. Average pain score at 2 weeks was similar in both groups (4.2 v/s 4.1 p value 0.73). Infection was seen in 1 patient in each group at 2 weeks (p value 0.668) and in only 1 patient in group A at 6 weeks (p value 0.067). Conclusion: We conclude from our study that there isn’t much difference in drain and no drain group in terms of wound infection and pain scores. No drain group is however associated with a better QOL in early post-op period.

Keywords: axillary drainage, axillary lymph node dissection, breast cancer, no drain in axilla

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Authors: Zanib Nafees, Amir Razaghizad, Ibtisam Mahmoud, Abhinav Sharma, Renzo Cecere

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More than one million surgeries are performed each year in Canada, resulting in more than 100,000 associated serious adverse events (SAEs) per year. These are defined as unintended injuries or complications that adversely affect the well-being of patients. In recent years, there has been a proliferation of digital health interventions that have the potential to assist, monitor, and educate patients—facilitating self-care following post-operative discharge. Among digital health, interventions are interactive-voice response technologies (IVRs), which have been shown to be highly effective in certain medical settings. Although numerous IVR-based interventions have been developed, their effectiveness and utility remain unclear, notably in post-operative settings. To the best of our knowledge, no systematic or scoping reviews have evaluated this topic to date. Thus, the objective of this scoping review protocol is to systematically map and explore the literature and evidence describing and examining IVR tools, implementation, evaluation, outcome, and experience for post-operative patients. The focus will be primarily on the evaluation of baseline performance status, clinical assessment, treatment outcomes, and patient management, including self-management and self-monitoring. The objective of this scoping review is to assess the extent of the literature to direct future research efforts by identifying gaps and limitations in the literature and to highlight relevant determinants of positive outcomes in the emerging field of IVR monitoring for health outcomes in post-operative patients.

Keywords: digital healthcare technologies, post-surgery, interactive voice technology, interactive voice response

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Authors: Chairun Wiedyaningsih, Sri Suryawati, Yati Soenarto, Muhammad Hakimi

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Background: Many drugs used in paediatrics are not commercially available in suitable dosage forms. Therefore, the drugs often prescribed in extemporaneous compounding dosage form. Compounding can pose health risks include poor quality and unsafe products. Studies of compounding dosage form have primarily focused on prescription profiles, reasons of prescribing never be explored. Objectives: The study was conducted to identify factors influencing physicians’ decision to prescribe extemporaneous compounding dosage form for paediatric outpatients. Setting: Daerah Istimewa Yogyakarta (DIY) province, Indonesia. Method: Qualitative semi-structured interviews were conducted with 15 general physicians and 7 paediatricians to identify the reason of prescribing extemporaneous compounding dosage form. The interviews were transcribed and analysed using thematic analysis. Results: Factors underlying prescribing of compounding could be categorized to therapy, healthcare system, patient and past experience. The primary reasons of therapy factors were limited availability of drug compositions, dosages or formulas specific for children. Beliefs in efficacy of the compounding forms were higher when the drugs used primarily to overcome complex cases. Physicians did not concern about compounding form containing several active substances because manufactured syrups may also contain several active substances. Although medicines were available in manufactured syrups, limited institutional budget was healthcare system factor of compounding prescribing. The prescribing factors related to patients include easy to use, efficient and lower price. The prescribing factors related to past experience were physicians’ beliefs to the progress of patient's health status. Conclusions: Compounding was prescribed based on therapy-related factors, healthcare system factors, patient factors and past experience.

Keywords: compounding dosage form, interview, physician, prescription

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Authors: Nasrudin Andi Mappaware, Muh. Wirawan Harahap, Erlin Syahril, Farah Ekawati Mulyadi

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The increasing trend of cesarean sections, especially those performed on self-request without medical indications, presents complex dilemmas related to medical aspects, professionalism, and bioethics. This study aims to investigate the medical, professional, and bioethical considerations surrounding anesthesia in cesarean sections performed on self-request without medical indications. We report the case of a 27-year-old woman, G1P0A0 gravid 38 weeks, admitted to the hospital for a planned cesarean section on request for the reason that she could not tolerate pain and requested on a date that corresponded to the date and month of her mother's birth. Cesarean section on patient request fulfills the principle of autonomy, which states that patients have the right to themselves. However, this medical procedure is still considered no safer and riskier even though medical technology has developed rapidly. Furthermore, anesthesia during cesarean section at self-request without medical indications is a dilemma for anesthesiologists considering the risks and complications of anesthesia for both the fetus and the mother. The trend in increasing the number of cesarean sections is influenced by patient reasons such as not being able to tolerate pain, trust factors, and worry about damage to the birth canal.

Keywords: anesthesia, bioethics, cesarean section, self-request, professionalism

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Authors: H. Hussain, N. H. Mohamad

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Practical experiences have been one of the successful criteria for the Project Management course for the art and design students. There are series of events that the students have to undergo as part of their practical exercises in the learning context for Project Management courses. These series have been divided into few mini programs that involved the whole individual in each group. Therefore, the events have been one of the bench marks for these students. Through the practical experience, the task that has been given to individual has been performed according to the needs of professional practice and ethics.

Keywords: practical experience, project management, art and design students, events, programs

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Authors: Fahad Almehmadi, Abdullah Alrajhi, Bader K. Alaslab, Abdullah A. Al Qurashi, Hattan A. Hassani

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Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) is an uncommon, inheritable cardiac disorder characterized by the progressive substitution of cardiac myocytes by fibro-fatty tissues. This pathologic substitution predisposes patients to ventricular arrhythmias and right ventricular failure. The underlying genetic defect predominantly involves genes encoding for desmosome proteins, particularly plakophilin-2 (PKP2). These aberrations lead to impaired cell adhesion, heightening the susceptibility to fibrofatty scarring under conditions of mechanical stress. Primarily, ARVD/C affects the right ventricle, but it can also compromise the left ventricle, potentially leading to biventricular heart failure. Clinical presentations can vary, spanning from asymptomatic individuals to those experiencing palpitations, syncopal episodes, and, in severe instances, sudden cardiac death. The establishment of a diagnostic criterion specifically tailored for ARVD/C significantly aids in its accurate diagnosis. Nevertheless, the task of early diagnosis is complicated by the disease's frequently asymptomatic initial stages, and the overall rarity of ARVD/C cases reported globally. In some cases, as exemplified by the adult female patient in this report, the disease may advance to terminal stages, rendering therapies like Ventricular Tachycardia (VT) ablation ineffective. This case underlines the necessity for increased awareness and understanding of ARVD/C to aid in its early detection and management. Through such efforts, we aim to decrease morbidity and mortality associated with this challenging cardiac disorder.

Keywords: ARVD/C, cardiology, interventional cardiology, cardiac electrophysiology

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Authors: Madre Paarlber, Alwiena Blignaut

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Background: Medication administration errors remains a global patient safety problem targeted by the WHO (World Health Organization), yet research on this matter is sparce within the South African context. Objective: The aim was to explore and describe nurses’ (medication administrators) perceptions regarding medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province of South Africa, and to determine any relationships between perceived variables concerned with medication safety (safety culture, incidences, causes, reporting of incidences, and reasons for non-reporting). Method: A quantitative research design was used through which self-administered online surveys were sent to 768 nurses (medication administrators) (n=217). The response rate was 28.26%. The survey instrument was synthesised from the Agency of Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture, the Registered Nurse Forecasting (RN4CAST) survey, a survey list prepared from a systematic review aimed at generating a comprehensive list of medication administration error causes and the Medication Administration Error Reporting Survey from Wakefield. Exploratory and confirmatory factor analyses were used to determine the validity and reliability of the survey. Descriptive and inferential statistical data analysis were used to analyse quantitative data. Relationships and correlations were identified between items, subscales and biographic data by using Spearmans’ Rank correlations, T-Tests and ANOVAs (Analysis of Variance). Nurses reported on their perceptions of medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province. Results: Units’ teamwork deemed satisfactory, punitive responses to errors accentuated. “Crisis mode” working, concerns regarding mistake recording and long working hours disclosed as impacting patient safety. Overall medication safety graded mostly positively. Work overload, high patient-nurse ratios, and inadequate staffing implicated as error-inducing. Medication administration errors were reported regularly. Fear and administrative response to errors effected non-report. Non-report of errors’ reasons was affected by non-punitive safety culture. Conclusions: Medication administration safety improvement is contingent on fostering a non-punitive safety culture within units. Anonymous medication error reporting systems and auditing nurses’ workload are recommended in the quest of improved medication safety within Gauteng Province private hospitals.

Keywords: incidence, medication administration errors, medication safety, reporting, safety culture

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Authors: Mohamed Chabi

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The purpose of this study is to determine Whether paper assessment especially in the subject mathematics will ever be completely replaced by online assessment using Learning Management System and Content Management System such as blackboard. In the subject mathematics, the assessment is the exercise of judgment on the quality of students’ work, as a way of supporting student learning and appraising its outcomes. Testing students has moved from the traditional scribbling and sketching on paper towards working online on a screen and keyboard.

Keywords: paper assessment, online assessment, learning management system, content management system, mathematics

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Authors: Munish Saroch, Amit Saini

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Introduction: Many children with congenital malformation of inner ear have undergone cochlear implant (CI) surgery. The results for cochlear implant surgery in these children are very encouraging and provide a ray of hope for these patients. Objective: The main objective of this presentation is to prove that even in Mondini’s deformity Minimal incision cochlear implantation improves cosmesis, reduces post-operative infection and earliest switch on of device. Methods: We report a case of two-year-old child suffering from Mondini’s deformity who underwent CI with minimal incision cochlear implantation (MICI). MICI has been developed with the aims of reducing the impact of surgery on the patient without any preoperative shaving of hairs. Results: Patient after surgery with MICI showed better looking postauricular scar, low post-operative morbidity in comparison to conventional wider access approach and hence earliest switch on of device (1st post operative day). Conclusion: We are of opinion that MICI is safe and successful in Mondini’s deformity.

Keywords: CI, Cochlear Implant, MICI, Minimal Incision Cochlear Implantation, HL, Hearing Loss, HRCT, High Resolution Computer Tomography, MRI, Magnetic resonance imaging, SCI, Standard cochlear implantation

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Authors: Asfa Hussain, Chee Tang, Mien Nguyen

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

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

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Authors: A. T. Omarova, G. N. Nakipova

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This article discusses the principles of object-oriented human capital development using the technology program. Also the article includes priorities of the strategy of industrial-innovative development of Kazakhstan in conditions of integration activity into the world community. The article shows the tasks of human resource management in the implementation of industrial and innovation development, particularities of Kazakhstan's theory of management staff, as well as due to the specificity of the Kazakhstan authorities. In the article, we have considered the factors which are affecting the people in the organization and also have considered mechanisms of HRM within organization in the conditions of innovative development in Kazakhstan.

Keywords: programming, management of human resources, innovation, investment, innovation process, HRD model, innovative development, integration, management, transformation, economic potential, competitiveness

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Authors: Anupuma Raina, Ajay P. Balayan, Prateek Pandya, Pankaj Shrivastava, Uma Kanga, Tulika Seth

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DNA fingerprinting analysis aids in personal identification for forensic purposes and has always been a driving motivation for law enforcement agencies in almost all countries since its inception. The introduction of DNA markers (Y-STR) has allowed for greater precision and higher discriminatory power in forensic testing. A criminal/ person committing crime after bone marrow transplantation is a rare situation but not an impossible one. Keeping such a situation in mind, a study was carried out to find out the best biological sample to be used for personal identification, especially in forensic situation. We choose a female patient (recipient) and a male donor. The pre transplant sample (blood) and post transplant samples (blood, buccal swab, hair roots) were collected from the recipient (patient). The same were compared with the blood sample of the donor using DNA FP technique. Post transplant samples were collected at different interval of time (15, 30, 60, and 90 days). The study was carried out using Y-STR kit at 23 loci. The results determined discusses the phenomenon of chimerism and its impact on Y-STR. Hair sample was found the most suitable sample which had no donor DNA profiling up to 90 days.

Keywords: bone marrow transplantation, chimerism, DNA profiling, Y-STR

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Authors: Haruna Abdu Usman, J. Mohammed Umar, U. M. Bashir

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Solid waste management continued to be the biggest threat to the sustainability of urban centers of developing countries. Most streets corners of these urban centers are characterized by heaps of uncollected wastes at drains, public spaces and road sides destroying the aesthetic qualities and environmental ecosystems of these cities. Also, harboring disease vectors and rodents putting the health of the populace at risk, thus posing a serious challenge to the municipalities who are in most cases responsible for the solid waste management in these cities. The typical or commonest method adapted by these agencies in dealing with the solid waste management is the conventional approach; focusing mainly on waste collection ,treatment(composting and incineration)and disposal giving little consideration to the 3RS, of waste reduce, re-used and recycled. The resultant consequence being huge budget spending in solid waste management as high as 80% but little collection rate as low as 50%. This paper attempt to analyze the impacts and effects of the conventional solid waste management practices on the stakeholders in solid waste management; the municipal authorities, the communities, formal and informal waste managers, the NGOs and CBOs and suggests appropriate measures that would lessen the effects.

Keywords: conventional waste management, solid waste, waste stakeholders, developing countries

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Authors: Mohammad Soliman, Mohamed A. Abou-Shouk

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Knowledge management focuses on the development, storage, retrieval, and dissemination of information and expertise. It has become an important tool to improve performance in tourism enterprises. This includes improving decision-making, developing customer services, and increasing sales and profits. Knowledge management adoption depends on human, organizational and technological factors. This study aims to explore the concept of knowledge management in travel agents in Egypt. It explores the requirements of adoption and its impact on performance in these agencies. The study targets Category A travel agents in Egypt. The population of the study encompasses Category A travel agents having online presence. An online questionnaire is used to collect data from managers of travel agents. This study is useful for travel agents who are in urgent need to restructure their intermediary role and support their survival in the global travel market. The study sheds light on the requirements of adoption and the expected impact on performance. This could help travel agents identify their situation and the determine the extent to which they are ready to adopt knowledge management. This study is contributing to knowledge by providing insights from the tourism sector in a developing country where the concept of knowledge management is still in its infancy stages.

Keywords: knowledge management, knowledge management adoption, performance, travel agents

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Authors: Yeliz Ekinci, Melis Koyuncu

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Successful planning of solid waste management systems requires successful prediction of the amount of solid waste generated in an area. Waste management planning can protect the environment and human health, hence it is tremendously important for countries. The lack of information in waste generation can cause many environmental and health problems. Turkey is a country that plans to join European Union, hence, solid waste management is one of the most significant criteria that should be handled in order to be a part of this community. Solid waste management system requires a good forecast of solid waste generation. Thus, this study aims to forecast solid waste generation in Turkey. Artificial Neural Network and Linear Regression models will be used for this aim. Many models will be run and the best one will be selected based on some predetermined performance measures.

Keywords: forecast, solid waste generation, solid waste management, Turkey

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Authors: Diana Ruth Caga-Anan

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Classroom management is a critical skill but the styles are constantly evolving. It is constantly under pressure particularly in the college education level due to diversity in student profiles, modes of delivery, and marketization of higher education. This study sought to analyze the extent of implementation of classroom management practices (CMPs) of the college instructors of the Hotel, Restaurant, and Institution Management of a premier university in the Philippines. It was also determined if their length of teaching affects their classroom management style. A questionnaire with sixteen 'evidenced-based' CMPs grouped into five critical features of classroom management, adopted from the literature search of Simonsen et al. (2008), was administered to 4 instructor-respondents and to their 88 students. Weighted mean scores of each of the CMPs revealed that there were differences between the instructors’ self-scores and their students’ ratings on their implementation of CMPs. The critical feature of classroom management 'actively engage students in observable ways' got the highest mean score, corresponding to 'always' from the instructors’ self-rating and 'frequently' from their students’ ratings. However, 'use a continuum of strategies to respond to inappropriate behaviors' got the lowest scores from both the instructors and their students corresponding only to 'occasionally'. Analysis of variance showed that the only CMP affected by the length of teaching is the practice of 'prompting students to respond'. Based on the findings, some recommendations for the instructors to improve on the critical feature where they scored low are discussed and suggestions are included for future research.

Keywords: classroom management, CMPs, critical features, evidence-based classroom management practices

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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: Byung Keun Yang, Jae Eun Ku, Young Seon Joo, Je Sung You, Sung Phil Chung, Hahn Shick Lee

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The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication. PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs. 11 days) in case of delayed extracorporeal therapy. Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.

Keywords: carnitine, overdose, poisoning, renal dialysis, valproic acid

Procedia PDF Downloads 361

Authors: Ilir Rexhepi, Naim Ismajli

Abstract:

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

Procedia PDF Downloads 273

Authors: I. S. Gandhi, D. N. Patel, M. Johnson, A. R. Hirsch

Abstract:

Although distortion of taste perception following a cerebrovascular event may seem to be a frivolous consequence of a classic stroke presentation, altered taste perception places patients at an increased risk for malnutrition, weight loss, and depression, all of which negatively impact the quality of life. Impaired taste perception can result from a wide variety of cerebrovascular lesions to various locations, including pons, insular cortices, and ventral posteromedial nucleus of the thalamus. Wallenberg syndrome, also known as a lateral medullary syndrome, has been described to impact taste; however, specific sweet to bitter taste dysgeusia from a territory infarction is an infrequent event; as such, a case is presented. One year prior to presentation, this 64-year-old right-handed woman, suffered a right posterior inferior cerebellar artery aneurysm rupture with resultant infarction, culminating in a ventriculoperitoneal shunt placement. One and half months after this event, she noticed the gradual onset of lack of ability to taste sweet, to eventually all sweet food tasting bitter. Since the onset of her chemosensory problems, the patient has lost 60-pounds. Upon gustatory testing, the patient's taste threshold showed ageusia to sucrose and hydrochloric acid, while normogeusia to sodium chloride, urea, and phenylthiocarbamide. The gustatory cortex is made in part by the right insular cortex as well as the right anterior operculum, which are primarily involved in the sensory taste modalities. In this model, sweet is localized in the posterior-most along with the rostral aspect of the right insular cortex, notably adjacent to the region responsible for bitter taste. The sweet to bitter dysgeusia in our patient suggests the presence of a lesion in this localization. Although the primary lesion in this patient was located in the right medulla of the brainstem, neurodegeneration in the rostal and posterior-most aspect, of the right insular cortex may have occurred due to diaschisis. Diaschisis has been described as neurophysiological changes that occur in remote regions to a focal brain lesion. Although hydrocephalus and vasospasm due to aneurysmal rupture may explain the distal foci of impairment, the gradual onset of dysgeusia is more indicative of diaschisis. The perception of sweet, now tasting bitter, suggests that in the absence of sweet taste reception, the intrinsic bitter taste of food is now being stimulated rather than sweet. In the evaluation and treatment of taste parageusia secondary to cerebrovascular injury, prophylactic neuroprotective measures may be worthwhile. Further investigation is warranted.

Keywords: diaschisis, dysgeusia, stroke, taste

Procedia PDF Downloads 176

Authors: Muhammad Umair Ahmed, Aftab Shoukat

Abstract:

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

Procedia PDF Downloads 85

Authors: Amina Oukennou, Zitouni Beidouri, Otmane Bouksour

Abstract:

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

Procedia PDF Downloads 305