Search results for: hospital management

Authors: A. Baloglu, A. Çınar

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Different tools and technologies were implemented for Crisis Response and Management (CRM) which is generally using available network infrastructure for information exchange. Depending on type of disaster or crisis, network infrastructure could be affected and it could not be able to provide reliable connectivity. Thus any tool or technology that depends on the connectivity could not be able to fulfill its functionalities. As a solution, a new message exchange framework has been developed. Framework provides offline/online information exchange platform for CRM Information Systems (CRMIS) and it uses XML compression and packet prioritization algorithms and is based on open source web technologies. By introducing offline capabilities to the web technologies, framework will be able to perform message exchange on unreliable networks. The experiments done on the simulation environment provide promising results on low bandwidth networks (56kbps and 28.8 kbps) with up to 50% packet loss and the solution is to successfully transfer all the information on these low quality networks where the traditional 2 and 3 tier applications failed.

Keywords: crisis response and management, XML messaging, web services, XML compression, mining

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Authors: Mohammad Alawairdhi

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Customer Relationship Management (CRM) started gaining attention as late as the 1990s, and since then efforts are ongoing to define the domain’s precise specifications. There is yet no single agreed upon definition. However, a predominant majority perceives CRM as a mechanism for enhancing interaction with customers, thereby strengthening the relationship between a business and its clients. From the perspective of Information Technology (IT) companies, CRM systems can be viewed as facilitating software products or services to automate the marketing, selling and servicing functions of an organization. In this paper, we have proposed a Bluetooth enabled CRM system for small- and medium-scale organizations. In the proposed system, Bluetooth technology works as an automatic identification token in addition to its common use as a communication channel. The system comprises a server side accompanied by a user-interface support for both client and server sides. The system has been tested in two environments and users have expressed ease of use, convenience and understandability as major advantages of the proposed solution.

Keywords: customer relationship management, CRM, bluetooth, automatic identification token

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Authors: Sanjida Ahmed Sinthia

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Bangladesh is one of the poorest countries in the world. There are several reasons for this insufficiency and uncontrolled population growth is one of the prime reasons. Others include low economic progress, imbalanced resource management, unemployment and underemployment, urban migration and natural catastrophes etc. As a result, the rate of urban poor is increasing inevitably in every sphere of urban cities in Bangladesh and Dhaka is the most affected one. Besides there is scarcity of urban land, housing, urban infrastructure and amenities which create pressure on urban cities and mostly encroach the open space, wetlands that causes environmental degradation. Government has no or limited control over these due to poor government policy and management, political pressure and lack of resource management. Unfortunately, over centralization and bureaucracy creates unnecessary delay and interruptions in any government initiations. There is also no coordination between government and private sector developer to solve the problem of urban Poor. To understand the problem of these huge populations this paper analyzes one of the single largest slum areas in Dhaka, Korail Slum. The study focuses on socio demographic analysis, morphological pattern and role of different actors responsible for the improvements of the area and recommended some possible steps for determining the potential outcomes.

Keywords: demographic analysis, environmental degradation, government policy, housing and land management policy

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Authors: Reuben Kinyuru Njuguna, Martin Mabuya Njuguna

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Digital platforms, such as The Internet, and the advent of digital marketing strategies, have led to many changes in the marketing of goods and services. These have resulted in improved service quality, enhanced customer relations, productivity gains, marketing transaction cost reductions, improved customer service and flexibility in fulfilling customers’ changing needs and lifestyles. Consequently, the purpose of this study was to determine the effect of digital marketing practices on the financial performance of mobile network operators in the telecommunications industry in Kenya. The objectives of the study were to establish how digital customer relationship management strategies on performance of mobile network operators in Kenya. The study used an explanatory cross-sectional survey research design, while the target population was made up of from the 4 major mobile network operators in Kenya, namely Safaricom Limited, Airtel Networks Kenya Limited, Finserve Africa Limited and Telkom Kenya Limited. Sampling strategy was stratified sampling with a sample size of 97 respondents. Digital customer relationship strategies were seen to influence firm performance, through enhancing convenience, building trust, encouraging growth in market share through creating sustainable relationships, building commitment with customers, enhancing customer retention and customer satisfaction. Digital customer relationship management were seen to maximize gross profits by increasing customer satisfaction, loyalty and retention. The study recommended upscaling the use of digital customer relationship management strategies to further enhance firm performance, given their great potential in this regard.

Keywords: customer relationship management, customer service delivery, performance, customer satisfaction

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Authors: Faith Eweluegim Enahoro-Ofagbe

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Worldwide, every nation is experiencing the effects of global warming. In developing countries, due to the heavy reliance on agriculture for socioeconomic growth and security, among other things, these countries are more affected by climate change, particularly with the availability of water. Floods, droughts, rising temperatures, saltwater intrusion, groundwater depletion, and other severe environmental alterations are all brought on by climatic change. Life depends on water, a vital resource; these ecological changes affect all water use, including agriculture and household water use. Therefore adequate and adaptive water usage strategies for sustainability are essential in developing countries. Therefore, this paper investigates Nigeria's challenges due to climate change and adaptive techniques that have evolved in response to such issues to ensure water management and sustainability for irrigation and provide quality water to residents. Questionnaires were distributed to respondents in the study area, central Nigeria, for quantitative evaluation of sustainable water resource management techniques. Physicochemical analysis was done, collecting soil and water samples from several locations under investigation. Findings show that farmers use different methods, ranging from intelligent technologies to traditional strategies for water resource management. Also, farmers need to learn better water resource management techniques for sustainability. Since more residents obtain their water from privately held sources, the government should enforce legislation to ensure that private borehole construction businesses treat water sources of poor quality before the general public uses them.

Keywords: developing countries, irrigation, strategies, sustainability, water resource management, water usage

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Authors: Farzam Chakherlouy, Amirmehdi Dokhanchi

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Nowadays organizations have to identify, evaluate and manage intangible assets which enable them to provide maximum requirements to achieve their goals and strategies. Organizations also have to try to promote and improve these kinds of assets continuously. It seems necessary to implement developed strategies in today’s competitive world where all the organizations and companies spend great amounts of expenses for developing their own strategies. In fact, after determining strategies to be implemented, the management process is not completed and it will not have any effect on the success and existence of the organization until these strategies are implemented. The objective of this article is to define the intellectual capital and it components and studying the impact of intellectual capital on the implementation of strategy based upon the Bozbura model. Three dimensions of human capital, relational capital, and the structural capital. According to the test’s results, the correlation between the intellectual capital and three components of strategic implementation (leadership, human resource management, and culture) has not been approved yet. According to results of Friedman’s test in relation with the intellectual capital, the maximum inadequacy of this company is in the field of human capital (with an average of 3.59) and the minimum inadequacy is in the field of the relational capital (customer) with an average of 2.83. Besides, according to Friedman test in relation with implementation of the strategy, the maximum inadequacy relates to the culture of the organization and the corporate control with averages of 2.60 and 3.45 respectively. In addition, they demonstrate a good performance in scopes of human resources management and financial resources management strategies.

Keywords: Bozbura model, intellectual capital, strategic management, implementation of strategy, Modiran Ideh Pardaz company

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Authors: Awole Seid, Yosef Zenebe, Hadgu Gerensea, Kebede Haile Misgina

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Background: Clinical competence is one of the ultimate goals of nursing education. Clinical skills are more than successfully performing tasks; it incorporates client assessment, identification of deficits and the ability to critically think to provide solutions. Assessment of clinical competence, particularly identifying gaps that need improvement and determining the educational needs of nursing students have great importance in nursing education. Thus this study aims determining clinical self-efficacy of final year school of nursing students in three universities of Tigray Region. Methods: A cross-sectional study was conducted on 224 final year school of nursing students from department of nursing, psychiatric nursing, and midwifery on three universities of Tigray region. Anonymous self-administered questionnaire was administered to generate data collected on June, 2017. The data were analyzed using SPSS version 20. The result is described using tables and charts as required. Logistic regression was employed to test associations. Result: The mean age of students was 22.94 + 1.44. Generally, 21% of students have been graduated in the department in which they are not interested. The study demonstrated 28.6% had poor and 71.4% had good perceived clinical self-efficacy. Beside this, 43.8% of psychiatric nursing and 32.6% of comprehensive nursing students have poor clinical self-efficacy. Among the four domains, 39.3% and 37.9% have poor clinical self- efficacy with regard to ‘Professional development’ and ‘Management of care’. Place of the institution [AOR=3.480 (1.333 - 9.088), p=0.011], interest during department selection [AOR=2.202 (1.045 - 4.642), p=.038], and theory-practice gap [AOR=0.224 (0.110 - 0.457), p=0.000] were significantly associated with perceived clinical self-efficacy. Conclusion: The magnitude of students with poor clinically self efficacy was high. Place of institution, theory-practice gap, students interest to the discipline were the significant predictors of clinical self-efficacy. Students from youngest universities have good clinical self-efficacy. During department selection, student’s interest should be respected. The universities and other stakeholders should improve the capacity of surrounding affiliate teaching hospitals to set and improve care standards in order to narrow the theory-practice gap. School faculties should provide trainings to hospital staffs and monitor standards of clinical procedures.

Keywords: clinical self-efficacy, nursing students, Tigray, northern Ethiopia

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Authors: Maria Giovanna Pacifico

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Maintenance, in Italy, is not yet a consolidated practice despite the benefits that could come from. Among the main reasons, there are the lack of financial resources and personnel in the public administration and a general lack of knowledge about how to activate and to manage a prevented and programmed maintenance. The experimentation suggests that users and tourists could be involved in the maintenance process from the knowledge phase to the monitoring ones by using mobile devices. The goal is to increase the quality of Facility Management for cultural heritage, prioritizing usage needs, and limiting interference between the key stakeholders. The method simplifies the consolidated procedures for the Information Systems, avoiding a loss in terms of quality and amount of information by focusing on the users' requirements: management economy, user safety, accessibility, and by receiving feedback information to define a framework that will lead to predictive maintenance. This proposal was designed to be tested in the Archaeological Park of Pompeii on the state property asset.

Keywords: asset maintenance, key stakeholders, Pompeii, user requirement

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Authors: G. Ramya

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Value engineering is a systematic approach, widely used to optimize the design or process or product in the designing stage. It used to achieve the client's obligation by increasing the functionality and attain the targeted cost in the cost planning. Value engineering effectiveness and benefits decrease along with the progress of the project since the change in the scope of the work and design will account for more cost all along the lifecycle of the project. Integrating the value engineering with other project management activities will promote cost minimization, client satisfaction, and ensure early completion of the project in time. Previous research studies suggested that value engineering can integrate with other project delivery activities, but research studies unable to frame a model that collaborates the project management activities with the job plan of value engineering approach. I analyzed various project management activities and their synergy between each other. The project management activities and processes like a)risk analysis b)lifecycle cost analysis c)lean construction d)facility management e)Building information modelling f)Contract administration, collaborated, and project delivery model planned along with the RIBA plan of work. The key outcome of the research is a value-driven project delivery model, which will succeed in dealing with the economic impact, constraints and conflicts arise due to the COVID-19 outbreak in the Indian construction sector. Benefits associated with the structured framework is construction project delivery that ensures early contractor involvement, mutual risk sharing, and reviving the project with a cost overrun and delay back on track ,are discussed. Keywords: Value-driven project delivery model, Integration, RIBA plan of work Themes: Design Economics

Keywords: value-driven project delivery model, Integration, RIBA

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Authors: F. Gökgöz, M. E. Atmaca

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Electricity has an indispensable role in human daily life, technological development and economy. It is a special product or service that should be instantaneously generated and consumed. Sources of the world are limited so that effective and efficient use of them is very important not only for human life and environment but also for technological and economic development. Competitive electricity market is one of the important way that provides suitable platform for effective and efficient use of electricity. Besides benefits, it brings along some risks that should be carefully managed by a market player like Electricity Generation Company. Risk management is an essential part in market players’ decision making. In this paper, risk management through diversification is applied with the help of Value at Risk methods for case studies. Performance of optimal electricity sale solutions are measured and the portfolio performance has been evaluated via Sharpe-Ratio, and compared with conventional approach. Biennial historical electricity price data of Turkish Day Ahead Market are used to demonstrate the approach.

Keywords: electricity market, portfolio optimization, risk management, value at risk

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Authors: Rigved Chandrashekhar Nimkhedkar, Rajat Agrawal, Vinay Sharma

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Architects need help with a demand for an expanded skill set to effectively navigate a landscape of evolving opportunities and challenges in the dynamic realm of the architectural profession. This literature and survey-based study investigates the reasons behind architects’ choices of careers, as well as the effects of the evolving architectural scenario. The traditional role of architects in construction projects evolves as they explore diverse career motivations, face financial constraints due to an oversupply of professionals, and experience specialisation and upskilling trends. Architects inherently derive numerous value chains as more and more disciplines have been introduced into the design-construction-operation supply chain. This insight emphasizes the importance of integrating management and entrepreneurial education into architectural education rather than keeping them separate entities. The study reveals the complex nature of the entrepreneurially challenging architectural profession, including cash flow management, market competition, environmental sustainability, and innovation opportunities. Loyal to their professional identity, architects express dissatisfaction while envisioning a future in which they play a more significant role in shaping reputable brands and contributing to education. The study emphasizes the importance of dovetailing management and entrepreneurial education in architecture education in preparing graduates for the industry’s changing nature, emphasising the need for real-world skills. This research contributes insights into the architectural profession’s transformative trajectory, emphasising adaptability, upskilling, and educational enhancements as critical success factors.

Keywords: architects, career path, education, management, specialisation

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Authors: Godfrey Katende, Lillian Nakimera

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The process of caregiving may cause emotional distress in form of anxiety and depression among family carers of cancer patients. Little is known about the prevalence anxiety and depression among family carers of cancer patients in Uganda. This cross-sectional study aimed to determine the prevalence of anxiety and depression among family carers of cancer patients and related factors associated with abnormal levels of anxiety and depression. A total of 119 family carers from Uganda Cancer Institute (UCI) were assessed by the Hospital Anxiety and Depression Scale (HADS) standardized questionnaire. The prevalence of anxiety and depression among family carers was high (45% and 26 % respectively); (2) abnormal levels of anxiety (ALA) and depression (ALD) was significantly associated with being a relative carer. Incorporating evidence based psychological therapies targeting family carers into usual care of cancer patients is imperative.

Keywords: anxiety, cancer, carer, cross-sectional design, depression, Uganda

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Authors: Ratri Werdiningtyas, Yongping Wei, Andrew Western

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The status quo of social-ecological systems is the results of not only natural processes but also the accumulated consequence of policies applied in the past. Often water management objectives are challenging and are only achieved to a limited degree on the ground. In choosing water management approaches, it is important to account for current conditions and important differences due to varied histories. Since the mid-nineteenth century, Victorian water management has evolved through a series of policy regime shifts. The main goal of this research to explore and identify the stages of the evolution of the water policy instruments as practiced in Victoria from 1890-2016. This comparative historical analysis has identified four stages in Victorian policy instrument development. In the first stage, the creation of policy instruments aimed to match the demand and supply of the resource (reserve condition). The second stage begins after natural system alone failed to balance supply and demand. The focus of the policy instrument shifted to an authority perspective in this stage. Later, the increasing number of actors interested in water led to another change in policy instrument. The third stage focused on the significant role of information from different relevant actors. The fourth and current stage is the most advanced, in that it involved the creation of a policy instrument for synergizing the previous three focal factors: reserve, authority, and information. When considering policy in other jurisdiction, these findings suggest that a key priority should be to reflect on the jurisdictions current position among these four evolutionary stages and try to make improve progressively rather than directly adopting approaches from elsewhere without understanding the current position.

Keywords: policy instrument, policy transformation, socio-ecolgical system, water management

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Authors: Temiloluwa J. Akinyemi, Denis W. Aheto, Wisdom Akpalu

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Capture fisheries in developing countries provide significant animal protein and directly supports the livelihoods of several communities. However, the misperception of biophysical dynamics owing to a lack of adequate scientific data has contributed to the suboptimal management in marine capture fisheries. This is because yield and catch potentials are sensitive to the quality of catch and effort data. Yet, studies on fisheries data collection practices in developing countries are hard to find. This study investigates the data collection methods utilized by fisheries technical officers within the four fishing regions of Ghana. We found that the officers employed data collection and sampling procedures which were not consistent with the technical guidelines curated by FAO. For example, 50 instead of 166 landing sites were sampled, while 290 instead of 372 canoes were sampled. We argue that such sampling errors could result in the over-capitalization of capture fish stocks and significant losses in resource rents.

Keywords: Fisheries data quality, fisheries management, Ghana, Sustainable Fisheries

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Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

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The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

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Authors: Joshua Chew, Vesa Cheng, David Thomson

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Background: Hereditary angioedema (HAE) or C1 esterase deficiency is a relatively rare entity that has a potential for significant anesthetic complications. Methods: A literature review was performed of published cases of surgery in patients with HAE. Results were limited to English language only and cases were examined for management strategies and successful prevention of acute attacks. Results: The literature revealed the successful use of C1 esterase inhibitors as the most common agent in surgical prophylaxis therapy. Other therapeutic targets described included kallikrein inhibitors and bradykinin B2 receptor antagonists. Conclusions: Therapeutic targets that exist for the management of acute attacks in HAE have been successfully employed in the setting of surgery. The data is currently limited and could not be used as a firm evidence base, but the limited outcomes seen are positive and reassuring for the prospective anesthetic management of this potentially fatal condition.

Keywords: anesthesia, C1 esterase deficiency, hereditary angioedema, surgical prophylaxis

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Authors: V. Moser-Siegmeth, M. C. Gambal, M. Jelovcak, B. Prytek, I. Swietalsky, D. Würzl, C. Fida, V. Mühlegger

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Adaptability is the capacity to adjust without great difficulty to changing circumstances. Within our project, we aimed to detect whether older people living within a long-term care hospital lose the ability to adapt. Theoretical concepts are contradictory in their statements. There is also lack of evidence in the literature how the adaptability of older people changes over the time. Following research questions were generated: Are older residents of a long-term care facility able to adapt to changes within their daily routine? How long does it take for older people to adapt? The study was designed as a convergent parallel mixed method intervention study, carried out within a four-month period and took place within seven wards of a long-term care hospital. As a planned intervention, a change of meal-times was established. The inhabitants were surveyed with qualitative interviews and quantitative questionnaires and diaries before, during and after the intervention. In addition, a survey of the nursing staff was carried out in order to detect changes of the people they care for and how long it took them to adapt. Quantitative data was analysed with SPSS, qualitative data with a summarizing content analysis. The average age of the involved residents was 82 years, the average length of stay 45 months. The adaptation to new situations does not cause problems for older residents. 47% of the residents state that their everyday life has not changed by changing the meal times. 24% indicate ‘neither nor’ and only 18% respond that their daily life has changed considerably due to the changeover. The diaries of the residents, which were conducted over the entire period of investigation showed no changes with regard to increased or reduced activity. With regard to sleep quality, assessed with the Pittsburgh sleep quality index, there is little change in sleep behaviour compared to the two survey periods (pre-phase to follow-up phase) in the cross-table. The subjective sleep quality of the residents is not affected. The nursing staff points out that, with good information in advance, changes are not a problem. The ability to adapt to changes does not deteriorate with age or by moving into a long-term care facility. It only takes a few days to get used to new situations. This can be confirmed by the nursing staff. Although there are different determinants like the health status that might make an adjustment to new situations more difficult. In connection with the limitations, the small sample size of the quantitative data collection must be emphasized. Furthermore, the extent to which the quantitative and qualitative sample represents the total population, since only residents without cognitive impairments of selected units participated. The majority of the residents has cognitive impairments. It is important to discuss whether and how well the diary method is suitable for older people to examine their daily structure.

Keywords: adaptability, intervention study, mixed methods, nursing home residents

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Authors: R. Frikha, H. Kamoun

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Background:Chronicmyeloidleukemia (CML), a hematologicaldisease, ischaracterized by t (9; 22) and relatedoncogene BCR-ABL formation. Although Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of CML, resistanceoccurs and possibly médiates by mutation in severalgenesindependently of the bcr-abl1 kinase mechanism. it has been reportedthat JAK2V617F/BCR-ABL double positivitymaybe a potential marker of resistance in CML. Aims: This studywasinvestigated the JAK2V617F mutation in TKI-resistant CML patients. Methods: A retrospectivestudywasconducted in the Hospital University of Sfax, south of Tunisia, including all CML TKI-resistant patients. A Sanger sequencingwasperformedusing a high-fidelity DNA polymerase. Results:Nineresistant CP-CML patients wereenrolled in thisstudy. The JAK2V617F mutation wasdetectedin 3 patients with TKI resistance. Conclusion:Despite the limit of ourstudy, ourfinding highlights the high frequency of JAK2V617F/BCR-ABL double positivity as an important marker of resistance. So; the combination of JAK and TKI inhibitorsmightbe effective and potentiallybeguided by molecular monitoring of minimal residual disease1.

Keywords: chronic myeloid leukemia, tyrosine kinase inhibitors, resistance, JAK2V617F, BCR-ABL

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Authors: Rattakorn Poonsuph

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Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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Authors: Dhruba Khatri

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Despite the short history of community based forest management, the community forestry program of Nepal has produced substantial positive effects to organize the local people at a local level institution called Community Forest User Group and manage the local forest resources in the line of poverty reduction since its inception in 1970s. Moreover, each CFUG has collected a community fund from the sale of forest products and non-forestry sources as well and the fund has played a vital role to improve the livelihood of user households living in and around the forests. The specific study sites were selected based on the criteria of i) community forests having dominancy of Sal forests, and ii) forests having 3-5 years experience of community forest management. The price rates of forest products fixed by the CFUGs and the distribution records were collected from the respective community forests. Nonetheless, the relation between pricing strategy and community fund collection revealed that the small change in price of forest products could greatly affect in community fund collection and carry out of forest management, community development, and income generation activities in the line of poverty reduction at local level.

Keywords: benefit sharing, community forest, equitable, Nepal

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Authors: Nnadi Ezekiel Ejiofor

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The construction industry plays a decisive role in the healthy development of any nation. Not only large but even small construction projects contribute to a country’s economic growth. There is a need for good management to ensure successful delivery and sustainability because of the plethora of risks that have resulted in low-profit margins for contractors, cost and schedule overruns, poor quality delivery, and abandoned projects. This research reviewed Capitalization on Sustainable Risk Management. Questionnaires and oral interviews conducted were utilized as means of data collection. One hundred and ninety-eight (198) large construction firms in Nigeria form the population of this study. 15 (fifteen) companies that emanated from merger and acquisition were used for the study. The instruments used for data collection were a researcher-developed structured questionnaire based on a five-point rating scale, interviews, focus group discussion, and secondary sources (bill of quantities and stock and exchange commission). The instrument was validated by two experts in the field. The reliability of the instrument was established by applying the split-half method. Kendall’s coefficient of concordance was used to test the data, and a degree of agreement was obtained. Data were subjected to descriptive statistics and analyzed using analysis of variance, t-test, and SPSS. The identified impacts of capitalization were an increase in turnover (24.5%), improvement in the image (24.5%), risk reduction (20%), business expansion (17.3%), and geographical spread (13.6%). The study strongly advocates the inclusion of risk management evaluation as part of the construction procurement process.

Keywords: capitalization, project delivery, risks, risk management, sustainability

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Authors: Mimi My Tse

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The prevalence of chronic non-cancer pain is high among community-dwelling older adults. Pain affects physical and psychosocial abilities. Older adults tend to be less mobile and have a high tendency to fall risk. In addition, older adults with pain are depressed, anxious, and not too willing to join social activities. This will make them feel very lonely and social isolation. Instead of giving pain management education and programs to older adults/clients, both older adults and their caregivers, it is sad to find that the majority of existing services are given to older adults only. Given the importance of family members in increasing compliance with health-promoting programs, we proposed to offer pain management programs to both older adults with his/her caregiver as a “dyad.” We used the Health Promotion Model and implemented a dyadic pain management program (DPM). The DPM is an 8-week group-based program. The DPM comprises 4 weeks of center-based, face-to-face activities and 4 weeks of digital-based activities delivered via a WhatsApp group. There were 30 dyads (15 in the experimental group with DPM and 15 in the control group with pain education pamphlets). Upon the completion of DPM, pain intensity and pain interference were significantly lower in the intervention group as compared to the control group. At the same time, physical function showed significant improvement and lower depression scores in the intervention group. In conclusion, the study highlights the potential benefits of involving caregivers in the management of chronic pain for older adults. This approach should be widely promoted in managing chronic pain situations for community-dwelling older adults and their caregivers.

Keywords: pain, older adults, dyadic approach, education

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Authors: Hualter Oliveira Barbosa, Raquel Feitosa do Vale Cunha, Erika Muniz dos Santos, Fernanda Belmira Souza, Fabio Sousa, Luis Henrique Pascareli, Franciney de Oliveira Lima, Ana Cláudia Reis da Silva, Christiane Moreira de Almeida

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Software development is intrinsic human-based knowledge-intensive. Due to globalization, software development has become a complex challenge and we usually face barriers related to knowledge management, team building, costly testing processes, especially in distributed settings. For this reason, several approaches have been proposed to minimize barriers caused by geographic distance. In this paper, we present as we use experimental studies to improve our knowledge management process using the Wiki system. According to the results, it was possible to identify learning preferences from our software projects leader team, organize and improve the learning experience of our Wiki and; facilitate collaboration by newcomers to improve Wiki with new contents available in the Wiki.

Keywords: mobile product, knowledge transfer, knowledge management process, wiki, GSD

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Authors: Marianys Fernandez

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Gastronomic experiences generate a positive impact on the dynamization of the economy when they are managed in a sustainable manner, given that they value the identity of the destination, strengthen cooperation between stakeholders in the sector, contribute to the preservation of gastronomic heritage, and encourage the implementation of competitive and sustainable public policies. Having as its main aim the analysis of sustainable management of gastronomic experiences, this study analyses different elements associated with the promotion of the local economy. For this purpose, a systematic literature review was carried out to identify, select, synthesise, and evaluate the studies that respond to the research objectives in order to select more reliable articles for research and reduce the potential for bias within the review of literature. To obtain reliable, updated and relevant sources for scientific research, the Web of Science and Scopus databases were used, taking into account the following key words: (1) experiential tourism, (2) gastronomy experience, (3) sustainable destination management, (4) sustainable gastronomy, (5) sustainable economy, in which we obtained a final list of 76 articles. The analysis of the literature allowed us to identify the most pertinent elements referring to the objective of the study: (a) need for competitive policies in the gastronomic sector to promote sustainable local economic development, (b) incentive for cooperation between stakeholders in the gastronomic sector, to guarantee the competitiveness of the destination, (c) propose sustainable standards in the gastronomic tourism sector that link the local economy. Gastronomic experiences constitute a dynamic element of the local economy and promote sustainable tourism. We can highlight that sustainability is a mechanism for the preservation of regional identity in the gastronomic sector through the valuation of the attributes of gastronomy, promotion of the local economy, strengthening of strategic alliances between the stakeholders of the gastronomic sector and its relevant contribution to the competitiveness of the destination. The theoretical implications of the study are focused on suggesting planning, management, and policy criteria to promote the sustainable management of gastronomic experiences in order to promote the local economy. In the practical context, research integrates different approaches, tools, and methods to encourage the active participation of local actors in the promotion of the local economy through the sustainable management of gastronomic tourism.

Keywords: experiential tourism, gastronomy experience, sustainable destination management, sustainable economy, sustainable gastronomy

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Authors: Manoj Kumar Reddy Pulim, Lakshmi Muthukrishnan, Geetha Jayapathy, Radhika Raman

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Introduction: In the past two decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure in children. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions, decrease airway injury, and prevent respiratory tract infections. There is a need to determine the clinical profile and parameters which point towards the need for NIV in the pediatric emergency setting. Objectives: i) To study the clinical profile of children who required non invasive ventilation and invasive ventilation, ii) To study the clinical parameters common to children who required non invasive ventilation. Methods: All children between one month to 18 years, who were intubated in the pediatric emergency department and those for whom decision to commence Non Invasive Ventilation was made in Emergency Room were included in the study. Children were transferred to the Paediatric Intensive Care Unit and started on Non Invasive Ventilation as per our hospital policy and followed up in the Paediatric Intensive Care Unit. Clinical profile of all children which included age, gender, diagnosis and indication for intubation were documented. Clinical parameters such as respiratory rate, heart rate, saturation, grunting were documented. Parameters obtained were subject to statistical analysis. Observations: Airway disease (Bronchiolitis 25%, Viral induced wheeze 22%) was a common diagnosis in 32 children who required Non Invasive Ventilation. Neuromuscular disorder was the common diagnosis in 27 children (78%) who were Intubated. 17 children commenced on Non Invasive Ventilation who later needed invasive ventilation had Neuromuscular disease. High frequency nasal cannula was used in 32, and mask ventilation in 17 children. Clinical parameters common to the Non Invasive Ventilation group were age < 1 year (17), tachycardia n = 7 (22%), tachypnea n = 23 (72%) and severe respiratory distress n = 9 (28%), grunt n = 7 (22%), SPO2 (80% to 90%) n = 16. Children in the Non Invasive Ventilation + INTUBATION group were > 3 years (9), had tachycardia 7 (41%), tachypnea 9(53%) with a male predominance n = 9. In statistical comparison among 3 groups,'p' value was significant for pH, saturation, and use of Ionotrope. Conclusion: Invasive ventilation can be avoided in the paediatric Emergency Department in children with airway disease, by commencing Non Invasive Ventilation early. Intubation in the pediatric emergency department has a higher association with neuromuscular disorders.

Keywords: clinical parameters, indications, non invasive ventilation, paediatric emergency room

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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: Berlian Eka Kurnia, Mohamad Very Setiawan, Rahmat Fadhli

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Archives play an important role in organization’s continuity, especially related to the learning activities in the past. Archive management is considered accessible when the archive can be used when needed. University archive can support research activities for institutions, besides, archive management services also have to pay attention to the accessibility that became a barometer of how easy users get the data or information from an archive, use and understand it. This study identifies about the accessibility of archive services at the Universitas Gadjah Mada, with case study method. Universitas Gadjah Mada archives not only provide a service to the academicians, but also for public. Universitas Gadjah Mada archive can be traced online and offline. Online searching archives can be acceessed through an application “SIKS” and offline searching can be accessed by "finding aids" printed. Although Universitas Gadjah Mada Archives has its own procedures to access the archive directly, but they also remain guided by National Archive of Indonesia.

Keywords: archival institution, university archive, archive’s accessibility, archive management

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Authors: Mohammed Buhaya

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Purpose: The purpose of this study is to analyze the decision, implementation process and the outcomes of the introduction of the balanced scorecard in a developing country having particular regard to the impacts of agency and institutional, endogenous and exogenous. Design/methodology/approach: This study builds on a longitudinal explanatory case study, an institutional framework, especially Ter-Bogt and Scapens (2014) framework. Findings: Empirical findings drawn from a telecom company indicate that the dynamics of change of the company are influenced by the interconnection of external institutions and the company's situation and internal institutions encompassing issues of power, politics, and culture. Organizational practice introduced to secure external legitimacy is not always the case. The adoption of the balanced scorecard was the instrumental manner and had revolutionary change. Originality/value: In contrast to much previous research on management accounting practice, the paper analyses the process of change in one of developing country. The study also sheds new light on the power of religion as one of institutional logics and how this logic rises to potential to influence management accounting change among actors and achieving the company’s targets. This paper highlights how the culture and values can play a vital role in making the process of change smoother.

Keywords: balanced scorecard, institutional, management accounting practice, rules, and routines

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Authors: Camille Plant, Katherine McGill, Pek Ang

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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.

Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry

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Authors: Amber Hatch, Eric Wright, Feihong Wang

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Research suggests that attachment in close relationships affects one’s emotional processes, mindfulness, conflict-management behaviors, and interpersonal interactions. Attachment insecurity is often associated with maladaptive social interactions and suboptimal relationship qualities. Past studies have considered how the nature of emotion regulation and mindfulness in teachers may be related to student or classroom outcomes. Still, no research has examined how the relationship between such internal experiences and classroom management outcomes may also be related to teachers’ attachment insecurity. This study examined the interrelationships between teachers’ attachment insecurity, mindfulness tendencies, emotion regulation abilities, and classroom management efficacy as indexed by students’ classroom behavior and teachers’ response effectiveness. Teachers’ attachment insecurity was evaluated using the global ECRS-SF, which measures both attachment anxiety and avoidance. The present study includes a convenient sample of 357 American elementary school teachers who responded to a survey regarding their classroom management efficacy, attachment in/security, dispositional mindfulness, emotion regulation strategies, and difficulties in emotion regulation, primarily assessed via pre-existing instruments. Good construct validity was demonstrated for all scales used in the survey. Sample demographics, including gender (94% female), race (92% White), age (M = 41.9 yrs.), years of teaching experience (M = 15.2 yrs.), and education level were similar to the population from which it was drawn, (i.e., American elementary school teachers). However, white women were slightly overrepresented in our sample. Correlational results suggest that teacher attachment insecurity is associated with poorer classroom management efficacy as indexed by students’ disruptive behavior and teachers’ response effectiveness. Attachment anxiety was a much stronger predictor of adverse student behaviors and ineffective teacher responses to adverse behaviors than attachment avoidance. Mindfulness, emotion regulation abilities, and years of teaching experience predicted positive classroom management outcomes. Attachment insecurity and mindfulness were more strongly related to frequent adverse student behaviors, while emotion regulation abilities were more strongly related to teachers’ response effectiveness. The teaching experience was negatively related to attachment insecurity and positively related to mindfulness and emotion regulation abilities. Although the data were cross-sectional, path analyses revealed that attachment insecurity is directly related to classroom management efficacy. Through two routes, this relationship is further mediated by emotion regulation and mindfulness in teachers. The first route of indirect effect suggests double mediation by teacher’s emotion regulation and then teacher mindfulness in the relationship between teacher attachment insecurity and classroom management efficacy. The second indirect effect suggests mindfulness directly mediated the relationship between attachment insecurity and classroom management efficacy, resulting in improved model fit statistics. However, this indirect effect is much smaller than the double mediation route through emotion regulation and mindfulness in teachers. Given the significant predication of teacher attachment insecurity, mindfulness, and emotion regulation on teachers’ classroom management efficacy both directly and indirectly, the authors recommend improving teachers’ classroom management efficacy via a three-pronged approach aiming at enhancing teachers’ secure attachment and supporting their learning adaptive emotion regulation strategies and mindfulness techniques.

Keywords: Classroom management efficacy, student behavior, teacher attachment, teacher emotion regulation, teacher mindfulness

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