Search results for: overall satisfaction

Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Huang Wei-Chi, Li Wei, Yu Tien-Chieh

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Medication adherence is crucial for treatment success. Adherence problem is common in patients with polypharmacy, especially in the geriatric population who are vulnerable to multiple chronic conditions but averagely less knowledgeable about diseases and medications. In order to help patients take medications appropriately and enhance the understanding of diseases or medications, a Line official account named e-Pharmacist was designed. The line is a popular freeware app with the highest penetration rate (95.7%) in Taiwan. The interface of e-Pharmacist is user-friendly for easy-to-read and convenient operating. Differ from other medication adherence apps, users just added e-Pharmacist as a LINE friend without installing any more apps and the drug lists were automatically downloaded from the personal electronic medical records with security permission. Over and above medication reminder, several additional capabilities were set up and engaged in the platform of e-Pharmacist including prescription refill reservation, laboratory examination consultation, medical appointment registration, and “Daily Health Log” where patients can record and track data of blood pressure/blood sugar and daily meals for self-health management as well as can share the important information to clinical professionals when seeking medical help. Additionally, a Line chatbot was utilized to provide tailored medicine information for the individual user. From July 2020 to March 2022, around 3000 patients added e-pharmacist as Line friends. Every day more than 1500 patients receive messages from e-pharmacist to notify them to take medicine. Thanks to the e-pharmacist alert system and Chatbot, the low-compliance patients (defined by Program on Adherence to Medication, PAM) significantly dropped from 36% to 6%, whereas the high-compliance patients dramatically increased from 13% to 77%. The user satisfaction is 98%. In brief, an e-pharmacist is not only a medication reminder but also a tailored personal assistant with value-added service for health management.

Keywords: e-pharmacist, self-health management, medication reminder, value-added service

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Authors: Farah Syazwani Hilmy Zaki

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Background: Compared to adult cardiopulmonary resuscitation (CPR), high-quality research and evidence on pediatric CPR remain relatively scarce. This knowledge gap hinders the development of optimal guidelines and best practices for resuscitating children. Objectives: To explore pediatric intensive care unit (PICU) CPR current practices in PICU of Institut Jantung Negara (IJN) Malaysia. Method: The research employed a qualitative approach, utilising case study research design. The data collection process involved in-depth interviews and reviewing the Resuscitation Feedback Form. Purposive sampling was used to select two cases consisting of 14 participants. The study participants comprised a cardiologist, one anaesthetist, and twelve nurses. The data collected were transcribed and entered into NVivo software to facilitate theme development. Subsequently, thematic analysis was conducted to analyse the data. Findings: The study yielded key findings regarding the enhancement of PICU CPR practices. These findings are categorised into four themes, namely routine procedures, resuscitation techniques, team dynamics, and individual contributions. Establishment of cohesive team is crucial in facilitating the effectiveness of resuscitation. According to participants, lack of confidence, skills and knowledge presents significant obstacles to effective PICU CPR. Conclusion: The findings of this study indicate that the participants express satisfaction with the current practices of PICU CPR. However, the research also highlights the need for enhancements in various areas, including routine procedures, resuscitation techniques, as well as team and individual factors. Furthermore, it was suggested that additional training be conducted on the resuscitation process to enhance the preparedness of the medical team.

Keywords: cardiopulmonary resuscitation, feedback, nurses, pediatric intensive care unit

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Authors: G. H. B. Dilhari, A. A. D. T. Saparamadu

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The coir is one of the by-products of the coconut and the coir industry can be identified as one of the traditional industries in Sri Lanka. Sri Lanka is one of the prominent countries for the coir production. Due to the labour insensitiveness, the labourers are the significant factor in the coir production process. The study has analyzed the determinants and its impact on income of the household level coir yarn labourers. The study was conducted in the Kumarakanda Grama Niladhari division, Galle, Sri Lanka. Simple random sampling was used to generate the sample of 100 household level coir yarn labourers and structured questionnaire, personal interviews and discussion were performed to gather the required data. The obtained data were statistically analyzed by using Statistical Package for Social Science (SPSS) software. Mann-Whitney U and Kruskal-Wallis test were carried out. The findings revealed that the household level coir yarn industry is dominated by the female workers and fewer amounts of workers have engaged this industry as the main occupation. In addition to that, elderly participation of the industry is greater than younger participation and most of them engaged as an extra income source. Level of education, the methods of engagement, satisfaction, labour’s children employment in the coir industry, support from the government, method of government support, working hours per day, employed as a main job, no of completed units per day, suffering any job related diseases and type of the diseases were related with income level of household level coir yarn labourers. The recommendations were formulated in respect to these problems including technological transformation for coir yarn production, strengthening of the raw material base and regulating the raw material supply, introduction of new technologies, markets and training programs, the establishment of the labourers association, the initiation of micro credit schemes, better consideration about the job oriented diseases.

Keywords: coir, coir yarn labourers, income, Galle

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Authors: Stanley Fore, Sharon Chipeperekwa

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The start of the 2011 academic year in South Africa saw a number of Institutions of Higher Learning introducing online registration for their students. The efficiency and effectiveness of Information Systems are increasingly becoming a necessity and not an option for many organizations. An information system should be able to allow end users to access information easily and navigate with ease. The selected University of Technology (UoT) in this research is one of the largest public institution of higher learning in the Western Cape Province and boasts of an enrolment of more than 30000 students per academic year. An observation was made that, during registration students’ stand in long queues waiting to register or for assistance to register. The system tends to ‘freeze’ whilst students are registering and students are in most cases unfamiliar with the system interface. They constantly have to enquire what to do next when going through online registration process. A mixed method approach will be adopted which comprises of quantitative and qualitative approaches. The study uses constructs of the updated DeLone and McLean IS success model (2003) to analyse and explain the student’s perceptions of the online registration system. The research was undertaken to establish the student’s perceptions of the online registration system. This research seeks to identify and analyse the challenges and success factors of introducing an online registration system whilst highlighting the extent to which this system has been able to solve the numerous problems associated with the manual era. The study will assist management and those responsible for managing the current system to determine how well the system is working or not working to achieve user satisfaction. It will also assist them going forward on what to consider before, during and after implementation of an information system. Respondents will be informed of the objectives of the research, and their consent to participate will be sought. Ethical considerations that will be applied to this study include; informed consent and protection from harm, right to privacy and involvement of the research.

Keywords: online registration, information systems, University of Technology, end-users

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Authors: Roger-Claude Liwanga

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This article reflects on the normative aspects of the jurisprudence on the protection of human rights in times of war that the International Court of Justice (ICJ) developed in 2005 in the Case Concerning Armed Activities on the Territory of the Congo (Democratic Republic of Congo v. Uganda). The article focuses on theories raised in connection with the Democratic Republic of Congo (DRC)'s claim of the violation of human rights of its populations by Uganda as opposed to the violation of its territorial integrity claims. The article begins with a re-visitation of the doctrine of state extraterritorial responsibility for violations of human rights by suggesting that a state's accountability for the breach of its international obligations is not territorially confined but rather transcends the State's national borders. The article highlights the criteria of assessing the State's extraterritorial responsibility, including the circumstances: (1) where the concerned State has effective control over the territory of another State in the context of belligerent occupation, and (2) when the unlawful actions committed by the State's organs on the occupied territory can be attributable to that State. The article also analyzes the ICJ's opinions articulated in DRC v. Uganda with reference to the relationship between human rights law and humanitarian law, and it contends that the ICJ had revised the traditional interaction between these two bodies of law to the extent that human rights law can no longer be excluded from applying in times of war as both branches are complementary rather than exclusive. The article correspondingly looks at the issue of reparations for victims of human rights violations. It posits that reparations for victims of human rights violations should be integral (including restitution, compensation, rehabilitation, satisfaction, and guarantees of non-repetition). Yet, the article concludes by emphasizing that reparations for victims were not integral in DRC v. Uganda because: (1) the ICJ failed to set a reasonable timeframe for the negotiations between the DRC and Uganda on the amount of compensation, resulting in Uganda paying no financial reparation to the DRC since 2005; and (2) the ICJ did not request Uganda to domestically prosecute the perpetrators of human rights abuses.

Keywords: human rights law, humanitarian law, civilian protection, extraterritorial responsibility

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Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

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Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

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Authors: M. F. Wu, F. T. Cheng, C. S. Wu, M. C. Tan

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It is a critical time to upgrade technology and increase value added with manufacturing skills developing and management strategies that will highly satisfy the customers need in the precision machinery global market. In recent years, the supply side, each precision machinery manufacturers in each country are facing the pressures of price reducing from the demand side voices that pushes the high-end precision machinery manufacturers adopts low-cost and high-quality strategy to retrieve the market. Because of the trend of the global market, the manufacturers must take price reducing strategies and upgrade technology of low-end machinery for differentiations to consolidate the market. By using six key success factors (KSFs), customer perceived value, customer satisfaction, customer service, product design, product effectiveness and machine structure quality are causal conditions to explore the impact of competitive advantage of the enterprise, such as overall profitability and product pricing power. This research uses key success paths (KSPs) approach and f/s QCA software to explore various combinations of causal relationships, so as to fully understand the performance level of KSFs and business objectives in order to achieve competitive advantage. In this study, the combination of a causal relationships, are called Key Success Paths (KSPs). The key success paths guide the enterprise to achieve the specific outcomes of business. The findings of this study indicate that there are thirteen KSPs to achieve the overall profitability, sixteen KSPs to achieve the product pricing power and seventeen KSPs to achieve both overall profitability and pricing power of the enterprise. The KSPs provide the directions of resources integration and allocation, improve utilization efficiency of limited resources to realize the continuous vision of the enterprise.

Keywords: precision machinery industry, key success factors (KSFs), key success paths (KSPs), overall profitability, product pricing power, competitive advantages

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Authors: Asmaa Hamdy, Israa Nassar, Tarek Aly

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Introduction: Femoral fractures are the most common presentation in the Emergency Department (ED), and they can present as isolated injuries or as part of a polytrauma situation. To provide optimum pain management care to these patients, practitioners must be well prepared and current with utilizing modern evidence-based knowledge and practices. Management of pain associated with fracture femur in the emergency department has a critical role in the satisfaction of patients and preventing further complications. This study aimed to evaluate the analgesic efficacy of ultrasound-guided femoral nerve block compared with intravenous fentanyl in fractures of the femur in patients presented to the Emergency Department. Patients and Methods: Fifty patients with femur fractures were divided into two groups: Group A: In this group (twenty-five patients) were given intravenous fentanyl 2 micro-grams/kg and re-assessed for pain by Visual Analogue Score (VAS). Group B: In this group (twenty-five patients) underwent ultrasonography-guided femoral nerve block and were re-assessed for pain by VAS. Results: VAS score on the movement of the fractured limb between group A and group B at a 10-minute post-intervention period shows P= 0.043, and hence the difference is significant. VAS score on the movement of the fractured limb between group A and group B during a 10-minute post-intervention period showed a significant difference. Seventeen patients in group A had major PID with a percentage of 63% VS 10 patients in group B with a percentage of 37%. conclusion: both femoral nerve block and intravenous fentanyl are effective in relieving pain in patients with femur fractures. But femoral nerve block provides better and more intense analgesia and major pain intensity difference in less time. Moreover, the use of FNB had fewer side effects and more Hemodynamics stability compared to opioids.

Keywords: femur fracture, nerve block, fentanyl, ultrasound guided

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Authors: Kinga Zebrowska, Maria Falis, Katarzyna Kosinska-Kaczynska, Bartosz Godek, Olga Plaza, Katarzyna Kwiatkowska

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Introduction: According to the ministerial decree of 16 August 2018, each woman in Poland during childbirth has the right to the pharmacological and non-pharmacological labour pain management (LPM). Aim: The aim of the study was to assess the knowledge of Polish mothers about pharmacological and non-pharmacological LPM, to investigate which methods they chose and their satisfaction with chosen ones. Material And Methods: A prospective cross-sectional study was performed among women who gave birth between 2015 and 2018. The self-composed questionnaire was distributed via the Internet in October 2018. Results: 13.727 women participated in the study. 75% have learned about LPM from the Internet. 68% of them did not gain any information on LPM from doctors during their prenatal appointments Safety of the newborn (46%), midwife’s advice (40%) and the chance of the immediate pain relief (39%) were the most important issues while choosing LPM. Respondents used a wide range of non-pharmacological methods, such as the assistance of partner during labour (81%), physical activity (58%), immersion in water (37%), relaxation techniques (15%) and others. 11% of mothers did not use any of the LPM methods. 52% of women declared that they wanted to use the pharmacological anaesthesia, while 49% had it performed (28% epidural, 16% inhaled anaesthesia, 5% parenteral opioids). Pharmacological methods were unavailable due to lack of anaesthesiologist in the maternity ward (41%) or inaccessibility of the chosen methods in the hospital (31%) and too advanced labour (43%). 48% of respondents did not decide to use pharmacological methods, because the pain was bearable (29%), anxiety of child’s health (17%), or belief that the pain is natural and it should not be avoided (16%). 83% of respondents believed that epidural analgesia has no influence on the time needed to gain a full cervix dilatation and 81% of them claimed that serious spinal cord injury is a common side effect of epidural. 51% believed that epidural increases the risk of caesarean section. Conclusions: The knowledge about the methods of LPM is not satisfactory. We should focus on well- maintained education guided by doctors, midwives, and media.

Keywords: childbirth, labour pain management, maternity experiences, obstetrics

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Authors: Yangyang Zhang

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Martin Eden tells about the tragedy of the protagonist Martin Eden’s suicide after his disillusion about American dream. The author Jack London presents various spatial routines of Martin Eden and reveals the involvement of space in realizing American dream: on the one hand, the Berkeley and Oakland cities contribute to Martin’s material success, making his American dream practical, and on the other hand, the two cities involve in the oppression of bourgeoisie ideology to Martin, promoting the domestic imperialization of bourgeoisie ideology represented by American dream. Molded by bourgeoisie ideology in the city, Martin constructed the oriental South Sea, revealing the oversea imperialization of bourgeoisie ideology behind American dream. By exploring the social, historical and political aspects of space, Martin Eden tries to demonstrate the mere material success and imperialism represented by American dream, revealing the fact of the involvement of American dreamin ideological oppression. When Jack London wrote Martin Eden, he had become a famous writer and realized his personal "American dream". He integrated his struggle experience into the protagonist Martin Eden, and also put his critique of the nature of "American dream" in the novel. The concept of the "American Dream" made the United States the land of dreams, and it also made many Americans believe that through personal struggle, they could climb the social ladder. Under the context of rapid growth in economy in the late 19 th century, American dream was reduced to the satisfaction on a material level. When material wealth was fulfilled, many people felt shattered for a variety of reasons, and such a phenomenon was reflected in the literature of disillusionment in 19th-century America.Martin Eden is such a work about disillusion, in which the geographical space becomes the witness of the realization and disillusionment of the protagonist Martin's "American dream". By analyzing the spatial narrative in Martin Eden, this paper reveals that the "American dream" only represents material success for individuals and the imperialization of capitalist ideology, and exposes the ideological nature of the "American Dream".

Keywords: Martin Eden, space, American dream, ideology of imperialism

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Authors: Elena V. Lysenko

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Motivating as the leading function of a modern Human Resources Management involves issues of increasing the effectiveness of the organization in a broader context. During the formation of motivational systems, the top-management of organization should pay equal attention to both external motivation (incentive system) and internal (self-motivation). The balance of internal and external motivation harmonizes the relations between employers and employees, increases the level of job satisfaction by the organization staff, which in turn leads the organization to success and ensures the organization`s profitability and competitiveness in the market environment. The article is devoted to the study of personnel motivation system in the small metal trade company, which is located in Yekaterinburg, Russian Federation. The study took place during November-December, 2016 ordered by the Company Director to analyze the motivational potential of work (managerial aspect of motivation) and motivation of personnel (personnel aspect of motivation) with the purpose to construct a system of employees’ motivation. The research tools included 6 specially selected tests of motivation, which are: “Motivation profile of your job”, “Constructive motivational attitudes”, Tests about Motivation of achievements (1st variant: Test by А.Mehrabian by the theory of D.С.McClelland and 2nd variant: Test about leading needs according with the theory of D.С.MacClelland), Tests by T.Elers (1st variant: “Determination of the motivation towards success or to avoid failure” and 2nd variant: “Trends to achieve results or to avoid failure”). The results of the study showed only one, but fundamental problem of the whole organization: high level of both motivational potential in work and self-motivation, especially in terms of achievement motivation, but serious lack of productivity. According the results which study showed this problem is derived from insufficient staff competence. The research suggests basic guidelines in order to build the new personnel motivation system for this Company, which is planned to be developed in the nearest future.

Keywords: incentive system, motivation of achievements, motivation system, self-motivation

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Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer

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Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.

Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors

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Authors: Sara Najiazarpour, Mahsa Najiazarpour

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There are many problems in contracting projects and their performance. At each project stage and due to different reasons, these problems affect cost, time and overall project quality. Hence, in order to increase the efficiency and performance in all levels of the chain and with supply chain management approach, there will be a coordination from the beginning of a project (contractor selection) to the end of project (handover of project). Contractor selection is the foremost part of construction projects which in this multi-criteria decision-making, the best contractor is determined by expert judgment, different variables and their priorities. In this paper for selecting the best contractor, numerous criteria were collected by asking from adept experts and then among them, 16 criteria with highest frequency were considered for questionnaire. This questionnaire was distributed between experts. Cronbach's alpha coefficient was obtained as 72%. Then based on Borda's function 12 important criteria was selected which was categorized in four main criteria and related sub-criteria as follow: Environmental factors and physical equipment: procurement and materials (supplier), company's machines, contractor’s proposed cost estimate - financial capacity: bank turnover and company's assets, the income of tax declaration in last year, Ability to compensate for losses or delays - past performance- records and technical expertise: experts and key personnel, the past technical backgrounds and experiences, employer satisfaction of previous contracts, the number of similar projects was done - standards: rank and field of expertise which company is qualified for and its validity, availability and number of permitted projects done. Then with PROMTHEE method, the criteria were normalized and monitored, finally the best alternative was selected. In this research, qualitative criteria of each company is became a quantitative criteria. Finally, information of some companies was evaluated and the best contractor was selected based on all criteria and their priorities.

Keywords: contractor evaluation and selection, project development, supply chain management, PROMTHEE method

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Authors: Biniam Bahiru Tufa, Hana Delil Tesfaye, Seife Demisse Legesse, Manaye Tamire

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The healthcare industry is witnessing a digital transformation, with artificial intelligence (AI) offering potential solutions for challenges in health supply chain management (HSCM). However, the adoption of AI in this field remains limited. This research aimed to assess the knowledge, attitude, and practice of AI among students and employees in the health supply chain sector in Ethiopia. Using an explanatory case study research design with a concurrent mixed approach, quantitative and qualitative data were collected simultaneously. The study included 153 participants comprising students and employed health supply chain professionals working in various sectors. The majority had a pharmacy background, and one-third of the participants were male. Most respondents were under 35 years old, and around 68.6% had less than 10 years of experience. The findings revealed that 94.1% of participants had prior knowledge of AI, but only 35.3% were aware of its application in the supply chain. Moreover, the majority indicated that their training curriculum did not cover AI in health supply chain management. Participants generally held positive attitudes toward the necessity of AI for improving efficiency, effectiveness, and cost savings in the supply chain. However, many expressed concerns about its impact on job security and satisfaction, considering it as a burden Graduate students demonstrated higher knowledge of AI compared to employed staff, while graduate students also exhibited a more positive attitude toward AI. The study indicated low previous utilization and potential future utilization of AI in the health supply chain, suggesting untapped opportunities for improvement. Overall, while supply chain experts and graduate students lacked sufficient understanding of AI and its significance, they expressed favorable views regarding its implementation in the sector. The study recommends that the Ethiopian government and international organizations consider introducing AI in the undergraduate pharmacy curriculum and promote its integration into the health supply chain field.

Keywords: knowledge, attitude, practice, supply chain, articifial intellegence

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Authors: Cheng Sim Quah, Sandra Phek Lin Sim

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This study examined how individuals in their respective teams contributed to innovation performance besides defining the term of innovation in their own respective views. This study also identified factors that motivated University staff to contribute to the innovation products. In addition, it examined whether there is a significant relationship between professional training level and the length of service among university staff towards innovation and to what extent do the two variables contributed towards innovative products. The significance of this study is that it revealed the strengths and weaknesses of the university staff when contributing to innovation performance. Stratified-random sampling was employed to determine the samples representing the population of lecturers in the study, involving 123 lecturers in one of the local universities in Malaysia. The method employed to analyze the data is through categorizing into themes for the open-ended questions besides using descriptive and inferential statistics for the quantitative data. This study revealed that two types of definition for the term “innovation” exist among the university staff, namely, creation of new product or new approach to do things as well as value-added creative way to upgrade or improve existing process and service to be more efficient. This study found that the most prominent factor that propel them towards innovation is to improve the product in order to benefit users, followed by self-satisfaction and recognition. This implies that the staff in the organization viewed the creation of innovative products as a process of growth to fulfill the needs of others and also to realize their personal potential. This study also found that there was only a significant relationship between the professional training level and the length of service of 4-6 years among the university staff. The rest of the groups based on the length of service showed that there was no significant relationship with the professional training level towards innovation. Moreover, results of the study on directional measures depicted that the relationship for the length of service of 4 - 6 years with professional training level among the university staff is quite weak. This implies that good organization management lies on the shoulders of the key leaders who enlighten the path to be followed by the staff.

Keywords: innovation, length of service, performance, professional training level, motivation

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Authors: Farzaneh Askari, Jila Ganji, Sedigheh Hasani Moghadam

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Background and Aim: Endometriosis has been reported as one of the most common chronic gynecological conditions characterized by physical and psychological complications. Given that the impact of this disease on marital relationships and quality of life is multidimensional, the present review study aimed to reflect on the effect of psychosomatic aspects of endometriosis on marital relationships and quality of life. Materials and Methods: A narrative review methodology using keywords determined by the Medical Subject Headings (MeSH) thesaurus was adopted in this study. For this purpose, the databases of ScienceDirect, Scientific Information Database (SID), Google Scholar, and PubMed were searched by means of key terms including endometriosis, marital relationships, physical complications, psychological complications, and quality of life in English and Persian from 2005 to 2020. At the end of the search, 38 articles were retrieved, and ultimately a total number of 16 studies were recruited for this review. Results: A review of the selected articles demonstrated that endometriosis could affect marital relationships and quality of life among couples featuring in three different categories, i.e. “category I: physical health dimension” (chronic pelvic pain, dysmenorrhea, cramps but not period, reduction and loss of fertility), “category II: sexual health dimension” (no sexual intercourse, dyspareunia, lack of sexual satisfaction), and “category III: psychosocial health dimension” (negative self-esteem, low energy, sense of loneliness, depression, social isolation, insufficient sleep, marital distress, divorce and marriage breakdown, inability to work and socialize). Conclusion: In general, it is suggested to pay particular attention to psychosomatic aspects of marital problems in patients affected with endometriosis. Accordingly, implementing educational and counseling strategies to minimize the complications of this disease can provide the grounds for improving marital relationships and maintaining the quality of life in these patients.

Keywords: Endometriosis, marital relationships, psychosomatic complications, quality of life

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Authors: Li-hsing Shih, Tzu-hsun Yen

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Because of the long-term commitment to net zero carbon emission, utility companies include more renewable energy supply, which generates electricity with time and weather restrictions. This leads to time-of-use electricity pricing to reflect the actual cost of energy supply. From an end-user point of view, better residential energy management is needed to incorporate the time-of-use prices and assist end users in scheduling their daily use of electricity. This study uses bi-criteria optimization methods to schedule daily energy consumption by minimizing the electricity cost and maximizing the comfort of end users. Different from most previous research, this study schedules users’ activities rather than household appliances to have better measures of users’ comfort/satisfaction. The relation between each activity and the use of different appliances could be defined by users. The comfort level is at the highest when the time and duration of an activity completely meet the user’s expectation, and the comfort level decreases when the time and duration do not meet expectations. A questionnaire survey was conducted to collect data for establishing regression models that describe users’ comfort levels when the execution time and duration of activities are different from user expectations. Six regression models representing the comfort levels for six types of activities were established using the responses to the questionnaire survey. A computer program is developed to evaluate electricity cost and the comfort level for each feasible schedule and then find the non-dominated schedules. The Epsilon constraint method is used to find the optimal schedule out of the non-dominated schedules. A hypothetical case is presented to demonstrate the effectiveness of the proposed approach and the computer program. Using the program, users can obtain the optimal schedule of daily energy consumption by inputting the intended time and duration of activities and the given time-of-use electricity prices.

Keywords: bi-criteria optimization, energy consumption, time-of-use price, scheduling

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Authors: Naeemeh Silvari

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The tourism industry is important for different nations in two ways. Apart from economic benefits, it provides a basis for getting acquainted with the culture of different regions of the world. Depending on the capacities and contexts of their geography, countries try to attract more people to their country in different ways. Health tourism has been an important branch of the tourism industry in recent years, and many countries around the world are trying to make progress in this field and attract many tourists from around the world. Iran, like many developing countries in the Middle East and East Asia, is trying to improve and develop tourist attractions in the field of health. Due to the cheapness of providing medical services to tourists, many people have traveled to Iran for medical and health care. However, there is a long way to go before recognizing and reaching the desired position in this field. Due to the direct relationship between tourism and culture, the negative attitude towards the context of Iran has caused foreign travelers not to choose this country as their tourist destination. In this article, we tried to study the change in their attitude towards Iran by using semi-structured interviews of foreign travelers who traveled to Iran for treatment and medical services. The text of the interviews was coded and analyzed by MAX QDA software. Many of the people in the sample were from Middle Eastern and Arabic-speaking countries. Influenced by the media, they felt rejected by the Iranians before the trip. During their stay in Iran and in connection with the health care staff, in the first stage, they pointed out that many of their anxieties about the kind of treatment of Iranians have been allayed. In addition to the satisfaction with the medical services provided, they considered the atmosphere of Iranians' interaction with foreign travelers to be relatively appropriate, and some stated that Iran would be the destination of their leisure trip in the future. At the end of the research, policymakers were suggested that in order to resolve cultural contradictions rooted in values, they should first be recognized and seek to use other opportunities to resolve contradictions and form interactions with other cultures.

Keywords: cultural conflict, health tourism, cultural prejudice, advertising and media

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Authors: Andrea Vega-Tinoco, Ana I. Gil-Lacruz, Marta Gil-Lacruz

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The main objective of this research is to acknowledge whether civic participation affects the well-being of the elderly, thus being a key activity of active aging. It is also of interest to recognize any differences among genders, generational cohorts or country of residence. If a positive relationship is found between civic participation and well-being, the actions that promote this participation will benefit the quality of life of senior citizens. Otherwise, independent action must be taken in the improvement of social and human capital. The sample consists of approximately 50.000 individuals from the European Social Survey (2002-2016). Only individuals born before 1965 in 15 European countries were considered. The sample was distributed according to gender, year of birth, country, level of studies and ESS wave to form pseudo-panel data cohorts, leaving a total of 1.318 observations. The data were analyzed through a Cross-Lagged Model using Fixed-Effects. A bidirectional association is observed between the civic participation and well-being variables. However, participating in the past seems to have a higher impact on today’s health, happiness and life satisfaction than the other way around. Furthermore, 26% of the respondents expressed to be satisfied with their life, 27% to be happy and 57% to have good health. On the other hand, 49% have participated civically in the last year, being the most common activities: signing petitions, boycotting products and volunteer work in non-political organizations. A slight trend of BabyBoomers and men towards greater participation can be observed, as well as a higher impact of this participation on their well-being. In addition, international differences exhibit a stronger relation for Nordic, East European and Mediterranean countries. The given results support the hypothesis that civic participation is a promoter of well-being for the elderly. This paper positively highlights the activity of involving in political and non-political organizations, as well as wearing badges. At any rate, almost all forms of civic participation show a positive relationship with well-being and should therefore be promoted, although differences between countries must be taken into consideration.

Keywords: active aging, civic participation, Europe, well-being

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Authors: Adel A. Ghobbar

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The airline industry is continuously challenging how to safely increase the service life of the aircraft with limited maintenance budgets. Operators are looking for the most qualified maintenance providers of aircraft components, offering the finest customer service. Component owner and maintenance provider is offering an Abacus agreement (Aircraft Component Leasing) to increase the efficiency and productivity of the customer service. To increase the customer service, the current focus on No Fault Found (NFF) units must change into the focus on Early Failure (EF) units. Since the effect of EF units has a significant impact on customer satisfaction, this needs to increase the reliability of EF units at minimal cost, which leads to the goal of this paper. By identifying the reliability of early failure (EF) units with regards to No Fault Found (NFF) units, in particular, the root cause analysis with an integrated cost analysis of EF units with the use of a failure mode analysis tool and a cost model, there will be a set of EF maintenance improvements. The data used for the investigation of the EF units will be obtained from the Pentagon system, an Enterprise Resource Planning (ERP) system used by Fokker Services. The Pentagon system monitors components, which needs to be repaired from Fokker aircraft owners, Abacus exchange pool, and commercial customers. The data will be selected on several criteria’s: time span, failure rate, and cost driver. When the selected data has been acquired, the failure mode and root cause analysis of EF units are initiated. The failure analysis approach tool was implemented, resulting in the proposed failure solution of EF. This will lead to specific EF maintenance improvements, which can be set-up to decrease the EF units and, as a result of this, increasing the reliability. The investigated EFs, between the time period over ten years, showed to have a significant reliability impact of 32% on the total of 23339 unscheduled failures. Since the EFs encloses almost one-third of the entire population.

Keywords: supportability, no fault found, FMEA, early failure, availability, operational reliability, predictive model

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Authors: Mapatsakon Sarapat, Mongkol Ketwongsa, Somchat Sonasang, Preecha Yupapin

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The designed and performed preliminary tests on a space-time control circuit using a two-level system circuit with a 4-5 cm diameter microstrip for realistic teleportation have been demonstrated. It begins by calculating the parameters that allow a circuit that uses the alternative current (AC) at a specified frequency as the input signal. A method that causes electrons to move along the circuit perimeter starting at the speed of light, which found satisfaction based on the wave-particle duality. It is able to establish the supersonic speed (faster than light) for the electron cloud in the middle of the circuit, creating a timeline and propulsive force as well. The timeline is formed by the stretching and shrinking time cancellation in the relativistic regime, in which the absolute time has vanished. In fact, both black holes and white holes are created from time signals at the beginning, where the speed of electrons travels close to the speed of light. They entangle together like a capsule until they reach the point where they collapse and cancel each other out, which is controlled by the frequency of the circuit. Therefore, we can apply this method to large-scale circuits such as potassium, from which the same method can be applied to form the system to teleport living things. In fact, the black hole is a hibernation system environment that allows living things to live and travel to the destination of teleportation, which can be controlled from position and time relative to the speed of light. When the capsule reaches its destination, it increases the frequency of the black holes and white holes canceling each other out to a balanced environment. Therefore, life can safely teleport to the destination. Therefore, there must be the same system at the origin and destination, which could be a network. Moreover, it can also be applied to space travel as well. The design system will be tested on a small system using a microstrip circuit system that we can create in the laboratory on a limited budget that can be used in both wired and wireless systems.

Keywords: quantum teleportation, black-white hole, time, timeline, relativistic electronics

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Authors: Nurul Azmawati Mohamed, Zarini Ismail, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, K. Omar

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Choosing a career is one of the most important decisions in our life. A right career leads a person to grow with that career and achieve success through the decision. Thus, career suitability assessment is important to help individuals to understand how a variety of personal attributes can impact their potential success and satisfaction with different career options and work environments. Some career needs specific personality trait that relates to attributes of job requirements and commitments. For medicine, being caring, approachable, inquisitive, able to listen and understand patients’ pain, anxiety and sorrow are important. The aim of this study was to evaluate the career suitability of pre-clinical students. This was a cross sectional study conducted among pre-clinical medical students in Universiti Sains Islam Malaysia. 'Sidek Career Interest Inventory’ was used to assess the students’ suitability for the course. This instrument had been validated locally to suit the local social and cultural context. It assessed the students’ personality trait based on Holland’s theory and their interests. For students to pursue in the medical course, two main personality trait are believed to be essential namely investigative and social trait personalities. Some of the characteristics of investigative trait are analytical, rational, intellectual and curious, while the characteristics of social trait personality include empathy, friendly, understanding and accommodating. The score for each personality trait were categorized as low (0-3.99), moderate (4-6.99) and high (7-10). A total of 81 pre-clinical medical students were included in this study. About two third (93.8%) of them were female and all of them are from 20 to 21 of age. Approximately, half of the students (47.5%) scored high and another 46.3% scored moderate for investigative trait. For social trait, only 13.8% scored high while 31.3% scored moderate. Only 12.5% (10) students had high scores for both investigative and social traits. Most of the pre-clinical medical students scored high in the investigative sections, however their social values were inadequate (low scores). For them to become good medical doctors, they should be good in both investigative and social skills to enhance their suitability for this career. Therefore, there is a need to nurture these medical students with appropriate social values and soft skills.

Keywords: career suitability, career interest, medical students, personality trait

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Authors: Michael Zaidman, Naum Simanovsky

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Introduction. Symptomatic tarsal coalition with rigid flat foot often demands operative solution. An isolated coalition resection does not guarantee pain relief; correction of co-existing foot deformity may be required. The objective of the study was to analyze the results of combination of tarsal coalition resection and arthroereisis. Patients and methods. We retrospectively reviewed medical records and radiographs of children operatively treated in our institution for symptomatic calcaneonavicular or talocalcaneal coalition between the years 2019 and 2022. Eight patients (twelve feet), 4 boys and 4 girls with mean age 11.2 years, were included in the study. In six patients (10 feet) calcaneonavicular coalition was diagnosed, two patients (two feet) sustained talonavicular coalition. To quantify degrees of foot deformity, we used calcaneal pitch angle, lateral talar-first metatarsal (Meary's) angle, and talonavicular coverage angle. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results. The mean follow-up was 28 month. The preoperative mean talonavicular coverage angle was 17,75º as compared with postoperative mean angle of 5.4º. The calcaneal pitch angle improved from mean 6,8º to 16,4º. The mean preoperative Meary’s angle of -11.3º improved to mean 2.8º. The preoperative mean AOFAS score improved from 54.7 to 93.1 points post-operatively. In nine of twelve feet, overall clinical outcome judged by AOFAS scale was excellent (90-100 points), in three feet was good (80-90 points). Six patients (ten feet) obviously improved their subtalar range of motion. Conclusion. For symptomatic stiff or rigid flat feet associated with tarsal coalition, the combination of coalition resection and arthroereisis leads to normalization of radiographic parameters, clinical and functional improvement with good patient’s satisfaction and likely to be more effective than the isolated procedures.

Keywords: rigid flat foot, tarsal coalition resection, arthroereisis, outcome

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Authors: Isabel Carrero, Raquel Redondo, Carmen Valor

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An unclosed issue in sustainable consumption (SC) literature is the relationship between SC and well-being. This paper seeks to address three limitations in past research. First, well-being has been measured as a single-faceted construct. However, other authors have defended the need to broaden the well-being construct since it goes beyond the emotional experiences and life satisfaction. By examining the relationship between SC and the multifaceted construct of psychological well-being, past contradictory results may be reconciled. To illustrate, past studies have shown that sustainable consumers experience negative emotions when they become aware of the harm that human beings inflict on the planet but they realize they have limited power to solving the problem or when they find limited alternatives or useful information to make sustainable decisions. Thus, these experiences may negatively affect the dimension of well-being 'environmental mastery'. However, as past studies have demonstrated that sustainable consumers feel meaningful, their assessment of the dimension 'purpose in life' would be positive. Thus, we need to understand how SC impinge on the different facets of psychological well-being, in order to better understand the relationship between SC and well-being. Another limitation of past research is that most studies failed to distinguish among different pro-environmental actions under SC (i.e., boycotting, buycotting) among others. For instance, activists have been found to experience higher levels of well-being and sense of meaning than less committed sustainable consumers but also burnt-out and social rejection, which should affect negatively the dimension of 'positive relations'. Finally, the influence of gender has been overlooked in the literature of SC and well-being when it has been identified consistently as a moderator variable in SC. Therefore, this study aims to (1) investigate the effect of SC on the six facets of psychological well-being, (2) distinguish between conventional SC behaviors vs. activism to examine whether these behaviors influence psychological well-being differently (3) and test gender as a moderator variable. It does so by surveying 861 individuals. This paper contributes to existing literature by showing that the relationship between well-being and SC is more intricate than it has been presented in previous literature, as it depends on the facet, the type of behavior carried out and gender.

Keywords: activism, gender, psychological well-being, structural equation modelling, sustainable consumption

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Authors: Jared Cheves, Amanda DeChent, Joyce Pan

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Total knee replacements (TKAs) are one of the most common but painful surgical procedures performed in the United States. Currently, the gold standard for postoperative pain management is the utilization of opioids. However, in the wake of the opioid epidemic, the healthcare system is attempting to reduce opioid consumption by trialing innovative opioid sparing analgesic techniques such as continuous peripheral nerve blocks (CPNB) and continuous periarticular infiltration (CPAI). The alleviation of pain, particularly during the first 72 hours postoperatively, is of utmost importance due to its association with delayed recovery, impaired rehabilitation, immunosuppression, the development of chronic pain, the development of rebound pain, and decreased patient satisfaction. While both CPNB and CPAI are being used today, there is limited evidence comparing the two to the current standard of care or to each other. An extensive literature review was performed to explore the safety profiles and effectiveness of CPNB and CPAI in reducing reported pain scores and decreasing opioid consumption. The literature revealed the usage of CPNB contributed to lower pain scores and decreased opioid use when compared to opioid-only control groups. Additionally, CPAI did not improve pain scores or decrease opioid consumption when combined with a multimodal analgesic (MMA) regimen. When comparing CPNB and CPAI to each other, neither unanimously lowered pain scores to a greater degree, but the literature indicates that CPNB decreased opioid consumption more than CPAI. More research is needed to further cement the efficacy of CPNB and CPAI as standard components of MMA in TKA procedures. In addition, future research can also focus on novel catheter-free applications to reduce the complications of continuous catheter analgesics.

Keywords: total knee arthroplasty, continuous peripheral nerve blocks, continuous periarticular infiltration, opioid, multimodal analgesia

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Authors: Elson Szeto

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Over the past 15 years, digital technology has ubiquitously penetrated societies around the world. New values of e-learning are emerging in the preparation of future talents, while e-learning is a key driver of widening participation and knowledge transfer in Chinese higher education. As a vibrant, Chinese society in Asia, Hong Kong’s new generation university students, perhaps the digital natives, have been learning with e-learning since their basic education. They can acquire new knowledge with the use of different forms of e-learning as a generic competence. These students who embrace this competence further their study journeys in higher education. This project reviews the Government’s policy of Information Technology in Education which has largely put forward since 1998. So far, primary to secondary education has embraced advantages of e-learning capability to advance the learning of different subject knowledge. Yet, e-learning capacity in higher education is yet to be fully examined in Hong Kong. The study reported in this paper is a pilot investigation into e-learning capacity in Chinese higher education in the region. By conducting a qualitative case study of Hong Kong, the investigation focuses on (1) the institutional ICT settings in general; (2) the pedagogic responses to e-learning in specific; and (3) the university students’ satisfaction of e-learning. It is imperative to revisit the e-learning capacity for promoting effective learning amongst university students, supporting new knowledge acquisition and embracing new opportunities in the 21st century. As a pilot case study, data will be collected from individual interviews with the e-learning management team members of a university, teachers who use e-learning for teaching and students who attend courses comprised of e-learning components. The findings show the e-learning capacity of the university and the key components of leveraging e-learning capability as a university-wide learning settings. The findings will inform institutions’ senior management, enabling them to effectively enhance institutional e-learning capacity for effective learning and teaching and new knowledge acquisition. Policymakers will be aware of new potentials of e-learning for the preparation of future talents in this society at large.

Keywords: capability, e-learning, higher education, student learning

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Authors: Adèle Hotte-Meunier, Lisa Sarraf, Alan Bougeard, Félicia Bernier, Chloé Voyer, Jiaxuan Deng, Stéphanie El Asmar, Alina Stamate, Marc Corbière, Patrizia Villotti, Geneviève Sauvé

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Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with psychosocial, educational and occupational functioning. Although often conceptualized as a developmental disorder of childhood, 65% of children with ADHD continue to meet full or partial diagnostic criteria for ADHD in adulthood and an estimated 4% of the workforce has a diagnosis of ADHD. Methods: A systematic review was conducted to understand the experiences of people living with ADHD in the workplace. Articles reporting employment outcomes for people living with were identified by a search in eight databases on four separate occasions from June 27, 2022, to June 21, 2023. A risk of bias assessment for each study was performed using the Mixed Methods Appraisal Tool (MMAT). Results: A total of 79 studies were included in this systematic review (nADHD: 68, 216). Results were synthesized into three broad overarching categories: challenges, strengths and adaptations at work. Further, nine themes were included: ADHD symptoms at work, workplace performance, job satisfaction, interpersonal relationships at work, maladaptive work thoughts and behaviors, personal strengths, embracing ADHD, person-environment fit and accommodations and support. Sex differences were highlighted as a tenth subtheme. ADHD confers both strengths and limitations related to employment. Discussion: Workers with ADHD can not only adapt but thrive in employment with the right person-environment fit, accommodations and support. Many challenges related to ADHD can be managed or remodeled as assets in a workplace environment that fosters acceptance, flexible working practices and openness to neurodiversity.

Keywords: neurodivergence, occupation, workplace, person-environment fit

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Authors: Zahra Alqahtani

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The use of e-learning technologies is gaining momentum in all educational institutions of the world, including Saudi universities. In the e-learning context, there is a growing need and concern among Saudi universities to improve and enhance quality assurance for e-learning systems. Practicing quality assurance activities and applying quality standards in e-learning in Saudi universities is thought to reduce the negative viewpoints of some stakeholders and ensure stakeholders’ satisfaction and needs. As a contribution to improving the quality of e-learning method in Saudi universities, the main purpose of this study is to explore and investigate strategies for the development of quality assurance in e-learning in one university in Saudi Arabia, which is considered a good reference university using the best and ongoing practices in e-learning systems among Saudi universities. In order to ensure the quality of its e-learning methods, Saudi university has adopted Quality Matters Standards as a controlling guide for the quality of its blended and full e-course electronic courses. Furthermore, quality assurance can be further improved if a variety of perspectives are taken into consideration from the comprehensive viewpoints of faculty members, administrative staff, and students.This qualitative research involved the use of different types of interviews, as well as documents that contain data related to e-learning methods in the Saudi university environment. This exploratory case study was undertaken, from the perspectives of various participants, to understand the phenomenon of quality assurance using an inductive technique.The results revealed six main supportive factors that assist in ensuring the quality of e-learning in the Saudi university environment. Essentially, these factors are institutional support, faculty member support, evaluation of faculty, quality of e-course design, technology support, and student support, which together have a remarkable positive effect on quality, forming intrinsic columns connected by bricks leading to quality e-learning. Quality Matters standards are considered to have a strong impact on improving faculty members' skills and on the development of high-quality blended and full e-courses.

Keywords: E-learning, quality assurance, quality matters standards, KKU-supportive factors

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Authors: Wisam Ismail, Brendan Wooler, Penelope McManus

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Introduction: The public perception of implants has been damaged in the wake of recent negative publicity and increasingly we are finding patients wanting to avoid them. Planned lipo-modelling to enhance the volume of a Latissimus dorsi flap is a viable alternative to silicone implants and maintains a Totally Autologous Technique (TAT). Here we demonstrate that when compared to an Implant Assisted Technique (IAT), a TAT offers patients many benefits that offset the requirement of more operations initially, with reduced short and long term complications, reduced symmetrisation surgery and reduced revision rates. Methods. Data was collected prospectively over 7 years. The minimum follows up was 3 years. The technique was generally standardized in the hand of one surgeon. All flaps were extended LD flaps (ELD). Lipo-modelling was performed using standard techniques. Outcome measures were unplanned secondary procedures, complication rates, and contralateral symmetrisation surgery rates. Key Results Were: Lower complication rates in the TAT group (18.5% vs. 33.3%), despite higher radiotherapy rates (TAT=49%, IAT=36.8%), TAT was associated with lower subsequent symmetrisation rates (30.6% vs. 50.9%), IAT had a relative risk of 3.1 for subsequent unplanned procedure, Autologous patients required an average of 1.76 sessions of lipo-modelling, Conclusions: Using lipo-modelling to enable totally autologous LD reconstruction offers significant advantages over an implant assisted technique. We have shown a lower subsequent unplanned procedure rate, lower revision surgery, and less contralateral symmetrisation surgery. We anticipate that a TAT will be supported by patient satisfaction surveys and long-term patient-reported cosmetic outcome data and intended to study this.

Keywords: breast, Latissimus dorsi, lipomodelling, reconstruction

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