Search results for: trauma management

Authors: Yaou Zhang

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Background: Relatively little scholarly attention has been paid to the production of Benjamin Britten’s chamber opera The Turn of the Screw. As one of Britten’s most remarkable operas. The story of the libretto was from Henry James’s novella of the same name. The novella was created in 1898 and one of the primary questions addressed to people in the story is “how real the ghosts are,” which leads the story to a huge ambiguity in readers’ minds. Aims: This research focuses on the experience of seeing the opera on stage over several decades. This study of opera productions over time not only provides insight into how stage performances can alter audience members' perceptions of the opera in the present but also reveals a landscape of shifting aesthetics and receptions. Methods: To examine the hypotheses in interpretation and reception, the qualitative analysis is used to examine the figures of ghosts in different productions across the time from 1954 to 2021 in the UK: by accessing recordings, newspapers, and reviews for the productions that are sourced from online and physical archives. For instance, the field research is conducted on the topic by arranging interviews with the creative team and visiting Opera North in Leeds and Britten-Pears Foundation. The collected data reveals the “hidden identity” in creative teams’ interpretations, social preferences, and rediscover that have previously remained unseen. Results: This research presents an angle of Britten’s Screw by using the third position; it shows how the attention moved from the stage of “do the ghosts really exist” to “traumatised children.” Discussion: Critics and audiences have debated whether the governess hallucinates the ghosts in the opera for decades. While, in recent years, directors of new productions have given themselves the opportunity to go deeper into Britten's musical structure and offer the opera more space to be interpreted, rather than debating if "ghosts actually exist" or "the psychological problems of the governess." One can consider and reflect that the questionable actions of the children are because they are suffering from trauma, whether the trauma comes from the ghosts, the hallucinating governess, or some prior experiences: various interpretations cause one result that children are the recipients of trauma. Arguably, the role of the supernatural is neither simply one of the elements of a ghost story nor simply one of the parts of the ambiguity between the supernatural and the hallucination of the governess; rather, the ghosts and the hallucinating governess can exist at the same time - the combination of the supernatural’s and the governess’s behaviours on stage generates a sharper and more serious angle that draws our attention to the traumatized children.

Keywords: benjamin britten, chamber opera, production, reception, staging, the turn of the screw

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Authors: Amalia Zuhra

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Indonesia is very rich with its natural resources. Natural resource management becomes a challenge for Indonesia. Improper management will make the natural resources run out and future generations will not be able to enjoy the natural wealth. A good rule of law and proper implementation determines the success of the management of a country's natural resources. This paper examines the need to redefine problems and challenges in the management of natural resources in Indonesia in the context of law. The purpose of this article is to overview the latest issues and challenges in natural resource management and to redefine legal provisions related to environmental management and human rights protection so that the management of natural resources in the present and future will be more sustainable. This paper finds that sustainable management of natural resources is absolutely essential. The aspect of environmental protection and human rights must be elaborated more deeply so that the management of natural resources can be done maximally without harming not only people but also the environment.

Keywords: international environmental law, human rights law, natural resource management, sustainable development

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Authors: Kassem Saleh

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An alarming number of software projects fail to deliver the required functionalities within the provided budget and timeframe and with the required qualities. Some of the main reasons for this problem include bad stakeholder management, poor communications and informal change management. Informal processes to identify, engage and control stakeholders lead to these reasons. Recently, to emphasize its importance, the Project Management Institute (PMI) updated the Project Management Body of Knowledge (PMBoK) to explicitly include the stakeholder management knowledge area. This knowledge area consists of four processes to identify stakeholders, plan stakeholder management, and manage and control stakeholder engagement. The use of appropriate techniques for stakeholder management in software projects will definitely lead to higher quality and successful software. In this paper, we describe some of the proven techniques that can be used during the execution of the four processes for stakeholder management. Development of collaboration tools for automating these processes are recommended and need to be integrated in available software project management tools.

Keywords: project management, stakeholder management, software development, project management body of knowledge

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Authors: Grace Rademacher

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Trauma” of the Kingdom of Hungary and the “Lost Cause” of the American Confederacy. Applying Nicole Maurantonio’s articulation of “confederate exceptionalism” and Svetlana Boym’s definition of “restorative nostalgia”, this article argues that, via memorialization and public discourse, both far right bodies flood their constituencies with narratives of nostalgia and martyrdom to sow existential anxieties about past and prophetic victimhood, all under the guise of protecting or restoring heritage. Linking this practice to gamification and conspiracy theorizing and following the work of Patrick Jagoda, this article identifies such industries of nostalgia as means by which the far right in both nations can partake in the “immanent and improvisational process of problem making.” Reified through monuments and references to the Trianon Trauma and the American confederacy, political actors “problem make” by alleging that they are victims of the West or the Left, subject to the cruel whims of liberalism and denial of historical legitimacy. In both nations, relying on their victimhood, pundits and politicians can appeal to white supremacists and distract citizens from legitimate active conflicts, such as wars or democratic rollbacks, redirecting them to fictional, mythical attacks on Hungarian or American society and civilization. This article will examine memorials and monuments as “lieux de memoire” and identify the purposeful similarities between the discourse of public figures and politicians such as María Schmidt, János Lázár, and Viktor Orbán, with that of Donald Trump and pundits such as Tucker Carlson.

Keywords: nationalism, political memory, white supremacy, trianon

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Authors: Tuji Mohammed Sani

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Back ground: An open tibial fracture is an injury where the fractured bone directly communicates with the outside environment. Due to the specific anatomical features of the tibia (limited soft tissue coverage), more than quarter of its fractures are classified as open, representing the most common open long-bone injuries. Open tibial fractures frequently cause significant bone comminution, periosteal stripping, soft tissue loss, contamination and are prone to bacterial entry with biofilm formation, which increases the risk of deep bone infection. Objective: The main objective of the study was to determine Prevalence of infection and its associated factors in surgically treated open tibial fracture in Addis Ababa Burn Emergency and Trauma (AaBET) center. Method: A facility based retrospective cross-sectional study was conducted among patient treated for open tibial fracture at AaBET center from September 2018 to September 2021. The data was collected from patient’s chart using structured data collection form, and Data was entered and analyzed using SPSS version 26. Bivariable and multiple binary logistic regression were fitted. Multicollinearity was checked among candidate variables using variance inflation factor and tolerance, which were less than 5 and greater than 0.2, respectively. Model adequacy were tested using Hosmer-Lemeshow goodness of fitness test (P=0.711). AOR at 95% CI was reported, and P-value < 0.05 was considered statistically significant. Result: This study found that 33.9% of the study participants had an infection. Initial IV antibiotic time (AOR=2.924, 95% CI:1.160- 7.370) and time of wound closure from injury (AOR=3.524, 95% CI: 1.798-6.908), injury to admission time (AOR=2.895, 95% CI: 1.402 – 5.977). and definitive fixation method (AOR=0.244, 95% CI: 0.113 – 0.4508) were the factors found to have a statistically significant association with the occurrence of infection. Conclusion: The rate of infection in open tibial fractures indicates that there is a need to improve the management of open tibial fracture treated at AaBET center. Time from injury to admission, time from injury to first debridement, wound closure time, and initial Intra Venous antibiotic time from the injury are an important factor that can be readily amended to improve the infection rate. Whether wound closed before seven days or not were more important factor associated with occurrences of infection.

Keywords: infection, open tibia, fracture, magnitude

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Authors: Chi-Chang Lin, Jiun-Yan Chiu

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Periodontal disease, oral cancer relating trauma is the prominent factor devastating bone tissue that is crucial to reestablishing in clinical. As we know, common symptom, osteoporosis, and infection limiting the ability of the bone tissue to recover cause difficulty before implantation therapy. Regeneration of bone tissue is the fundamental therapy before surgical processes. To promote the growth of bone tissue, many commercial products still have sophisticated problems that need to overcome. Regrettably, there is no available material which is apparently preferable for releasing and controlling of loading dosage, or mitigating inflammation. In our study, a hydrogel-based composite membrane has been prepared by using Gellan gum (GG), gamma-polyglutamic acid (γ-PGA) and glycerol with simple sol-gel method. GG is a natural material that is massively adopted in cartilage. Unfortunately, the strength of pure GG film is a manifest weakness especially under simulating body fluidic conditions. We utilize another biocompatible material, γ-PGA as cross-linker which can form tri-dimension structure that enhancing the strength. Our result indicated the strength of pure GG membrane can be obviously improved by cross-linked with γ-PGA (0.5, 0.6, 0.7, 0.8, 0.9, 1.0 w/v%). Besides, blending with glycerol (0, 1.0, 2.0, 3.0 w/v%) can significantly improve membrane toughness that corresponds to practical use. The innovative composited hydrogel made of GG, γ-PGA, and glycerol is attested with neat results including elongation and biocompatibility that take the advantage of extension covering major trauma. Recommendations are made for treatment to build up the foundation of bone tissue that would help patients to escape from the suffering and shorten the amount of time in recovery.

Keywords: bone tissue, gellan gum, regeneration, toughness

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Authors: Eakarat Boonreang

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The past two decades, Thailand faced the natural disasters, for instance, Gay typhoon in 1989, tsunami in 2004, and huge flood in 2011. The disaster management in Thailand was improved both structure and mechanism for cope with the natural disaster since 2007. However, the natural disaster management in Thailand has various problems, for examples, cooperation between related an organizations have not unity, inadequate resources, the natural disaster management of public sectors not proactive, people has not awareness the risk of the natural disaster, and communities did not participate in the natural disaster management. Objective of this study is to find the methods for capacity building in the natural disaster management of Thailand. The concept and information about the capacity building and the natural disaster management of Thailand were reviewed and analyzed by classifying and organizing data. The result found that the methods for capacity building in the natural disaster management of Thailand should be consist of 1)link operation and information in the natural disaster management between nation, province, local and community levels, 2)enhance competency and resources of public sectors which relate to the natural disaster management, 3)establish proactive natural disaster management both planning and implementation, 4)decentralize the natural disaster management to local government organizations, 5)construct public awareness in the natural disaster management to community, 6)support Community Based Disaster Risk Management (CBDRM) seriously, and 7)emphasis on participation in the natural disaster management of all stakeholders.

Keywords: capacity building, Community Based Disaster Risk Management (CBDRM), Natural Disaster Management, Thailand

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Authors: Jocelyn Cohen

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This paper identifies a powerful synchronicity of two traditions of life-story writing in the autobiographies of ritual abuse (RA) survivors, the Christian conversion narrative and the memoir of healing from childhood sexual trauma. Using methodologies from literary studies, history, and psychology, a close reading of three RA memoirs sheds light on a taboo and deeply suspect form of violence. Treatment of RA survivors and the unique role of psychotherapists, in particular, deserve far greater attention from multi-disciplinary scholars. Each story reflects salient characteristics of the Christian conversion narrative, a genre which originated in the US in the early 19th century with the serendipitous confluence of the simultaneous emergence of print culture and the basic structures of evangelicalism during the Second Great Awakening. The impulse of writing is thus to give testimony against the sin they witnessed and endured as young children during ritual violence perpetrated within the church. Importantly, RA is seen as an inherent if obscure aspect of Christian discourse itself, not in opposition to it, and not as an aberration. In RA's memoir, healing comes in part from the Christian narrative praxis of personal redemption, framed as prevailing in a war between good and evil. In other words, storytelling itself affects the healing, much as it does by means of each writer’s 'talking cure,' in the relationship with a psychotherapist who guides her through a repair of the life-story through the excavation of traumatic memories and their integration into the writer’s psyche. Integrating literary techniques into the psychotherapeutic relationship, therapists leverage the deep linguistic structures that clients possess as a resource to aid in their healing.

Keywords: memoir, psychotherapy, religion, trauma

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Authors: Mouhoubi Nedjima, Sassi Boudemagh Souad

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In this article, and through the modernization project of metropolis of Constantine (PMMC) experience in Algeria, discussed to highlight the importance of management in an urban project at various levels: strategic and operational. The statement we attended to reach is to evaluate the modernization project of metropolis of Constantine in the light of management and prove the relation between a good urban management and the success of an urban project.

Keywords: urban project, strategic management, operational management, the modernization project of constantine

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Authors: Adekunle Olakunle Felix

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Research will be based on the financial management importance within organization and its important role in non-economic and economic activities that provide us the useful information about the efficient procurement and utilization of finance in a profitable manner. Due to industrialization, financial management become a vital part of business and it is very important for the business concern that with a good financial management to earn maximum profit.

Keywords: management, business, profitability, organization, financial, efficiency

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Authors: Barbara Papp

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Purpose: This article aims to rethink the relationship between the trauma and the choice of professions. By studying a homogenous sample of respondents, it seeks answers to the following question: how did personal losses that were caused by historical upheavals motivate people to enter the helping professions. By becoming helping professionals, the respondents of the survey sought to handle both historical representation and self-representation. How did psychotherapists working in the second half of the 20th century (Kádár-era in Hungary) shape their course of life? How did their family members respond to their choice of career? What forces supported or hindered them? How did they become professional helpers? Methodology: When interviewing 40 psychotherapists, the interviewer used the oral history technique. In-depth interviews were made with a focus on motivation. First, the collected material was examined using traditional content analysis tools: searching for content patterns, applying a word frequency analysis, and identifying the connections between key events and key persons. Second, a narrative psychological content analysis (NarrCat) was made. Findings: Interconnections were established between attachment, family and historical traumas and career choices. The history of the mid-20th-century period was traumatic and full of losses for the families of most of the psychotherapists concerned. Those experiences may have considerably influenced their choice of career. Working as helping therapists, they could get the opportunity to revise their losses. Conclusion: The results revealed core components that play a role in the psychotherapists’ choice of career, and also emphasized the importance of post-traumatic growth.

Keywords: biography, identity, narrative psychological content analysis, psychotherapists, trauma

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Authors: Neeti Rustagi, Naveen Dutt, Arvind Sinha, Mahaveer S. Rhodha, Pankaja R. Raghav

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Background: Pre-hospital trauma care services are in developing stage in fast-urbanizing cities of India including Jodhpur. Training of health professionals in providing necessary pre-hospital trauma care is an essential step in decreasing accident related morbidity and mortality. The current study explores the response of a medical graduate toward helping an accident victim in a pre-hospital setting before patient can be transferred to definitive trauma facility. Methodology: This study examines the perceived competence in predicting response to an accident victim by medical graduates in Jodhpur, Rajasthan. Participants completed measures of attitude, normative influence and perceived behavior control toward providing pre-hospital care to an accident victim. Likert scale was used to measure the participant responses. Preliminary and descriptive analysis were used using SPSS 21.0. Internal consistency of the responses received was measured using Cronbach’s alpha. Results: Almost all medical graduates agreed that road accidents are common in their area (male: 92%; female: 78%). More male medical graduates (28%) reported helping an accident victim as compared to female physicians (9%) in the previous three months. Majority of study participants (96%) reported that providing immediate care to an accident victim is essential to save the life of an individual. Experience of helping an accident victim was considered unpleasant by the majority of female participants (70%) as compared to male participants (36%). A large number of participants believed that their friends (80%) and colleagues (96%) would appreciate them helping an accident victim in a pre-hospital setting. A large number of participants also believed that they possess the necessary skills and competencies (80%) towards helping a roadside accident victim in the pre-hospital care environment. Perceived competence of helping a roadside accident victim until they are transferred to a health facility was reported by less than half of the participants (male: 56%; female: 43%). Conclusion: Medical graduates have necessary attitude, competencies, and intention of helping a roadside accident victim. The societal response towards helping a road side accident victim is also supportive. In spite of positive determinants, a large proportion of medical graduates have perceived lack of competence in helping a roadside accident victim. This is essential to explore further as providing pre-hospital care to a roadside accident victim is an essential step in establishing the continuum of care to an accident victim especially in countries where pre-hospital services are in developing phase.

Keywords: prehospital care, perceived behavior, perceived competence, medical graduates

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Authors: Ismail Halijah, Abdullah Rusli

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Introduction: This systematic literature review aims to identify the Knowledge Management Best Practice components in the Knowledge Management Model for Higher Learning Institutions environment. Study design: Systematic literature review. Methods: A systematic literature re-view of Knowledge Management Best Practice to identify and define the components of Best Practice from the Knowledge Management models was conducted recently. Results: This review of published papers of conference and journals’ articles shows the components of Best Practice in Knowledge Management are basically divided into two aspect which is the soft aspect and the hard aspect. The lacks of combination of these two aspects into an integrated model decelerate Knowledge Management Best Practice to fully throttle. Evidence from the literature shows the lack of integration of this two aspects leads to the immaturity of the Higher Learning Institution (HLI) towards the implementation of Knowledge Management System. Conclusion: The first steps of identifying the attributes to measure the Knowledge Management Best Practice components from the models in the literature will led to the definition of the Knowledge Management Best Practice component for the higher learning environment.

Keywords: knowledge management, knowledge management system, knowledge management best practice, knowledge management higher learning institution

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Authors: Mahmoud A. Amin, Essam Taman, Ahmed Omran, Mahmoud Shawky, Ahmed Mekawy, Abdallah M. Kotkat, Saber Younes, Nehad N. Ghonemy, Amin Saad, Ezz-Aleslam, Abdullah M. Elosh

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Introduction: TMJ is a one-of-a-kind, complicated synovial joint that helps with masticatory function by allowing the mandible to open and close the mouth. True ankylosis is a situation in which condylar movement is limited by a mechanical defect in the joint, whereas false ankylosis is a condition in which there is a restriction in mandibular movement due to muscular spasm myositis ossificans, and coronoid process hyperplasia. Ankylosis is characterized by the inability to open the mouth due to fusion of the TMJ condyle to the base of the skull as a result of trauma, infection, or systemic diseases such as rheumatoid arthritis (the most common) and psoraisis. Ankylosis causes facial asymmetry and affects the patient psychologically as well as speech, difficult mastication, poor oral hygiene, malocclusion, and other factors. TMJ is a technically challenging joint; hence TMJ ankylosis management is complicated. Case presentation: this case is a male patient 25 years old reported to our maxillofacial clinic in Damietta faculty of medicine, Al-Azhar University with the inability to open the mouth at all, with a history of difficulty of mouth breathing and eating foods, there was a history of falling from height at 2006, and the patient underwent corrective surgery before with no improvement because the ankylosis was relapsed short period after the previous operations with that done out of our hospital inter-incisor distant ZERO so, this condition need mandatory management. Clinical examination and radiological investigations were done after complete approval from the patient and his brother; tracheostomy was done for our patient before the operation. The patient entered the operation in our hospital and drastic improvement in mouth opening was noticed, helping to restore the physical psychological health of the patient.

Keywords: temporomandibular joint, TMJ, Ankylosis, mouth opening, physiotherapy, condylar plate

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Authors: Claire Stafford, John Lewis, Ashley Stripling

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The aim of this study is to examine the relationship between both the independent effects and intersection between COVID-19 and the Black Lives Matter (BLM) movement simultaneously to investigate how the two events have coincided with impacting race-based traumatic stress in Black Americans. Four groups will be surveyed: Black Americans who participated in BLM-related activism, Black Americans who did not participate in BLM-related activism, White Americans who participated in BLM-related activism, and White Americans who did not participate in BLM-related activism. Participants are between the ages of 30 and 50. All participants will be administered a Brief Trauma Questionnaire with an additional question asking whether or not they have ever tested positive for COVID-19. Based on prior findings, it is expected that Black Americans will have significantly higher levels of COVID-19 contraction, with Black Americans who participated in BLM-related activism having the highest levels of contractions. Additionally, Black Americans who participated in BLM-related activism will likely have the highest self-reported rates of traumatic experiences due to the compounding effect of both the pandemic and the BLM movement. With the development of the COVID-19 pandemic, stark racial disparities between Black and White Americans have become more defined. Compared to White Americans, Black Americans have more COVID-19-related cases and hospitalizations. Researchers must investigate and attempt to mitigate these disparities while simultaneously critically questioning the structure of our national health care system and how it serves our marginalized communities. Further, a critical gaze must be directed at the geopolitical climate of the United States in order to holistically look at how both the COVID-19 pandemic and the Black Lives Matter (BLM) movement have interacted and impacted race-based stress and trauma in African Americans.

Keywords: COVID-19, black lives matter movement, race-based traumatic stress, activism

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Authors: Uttam Neupane, Narendra Budha, Subash Kumar Bhattarai

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Material management is an essential part in construction project management. There are a number of material management problems in the Nepalese construction industry, which contribute to an inefficient material management system. Ineffective material management can cause waste of time and money thus increasing the problem of time and cost overrun. An assessment of material management system with gap and solution was carried out on 20 construction projects implemented by the Federal Level Project Implementation Unit (FPIU); Kaski district of Nepal. To improve the material management process, the respondents have provided possible solutions to overcome the gaps seen in the current material management process. The possible solutions are preparation of material schedule in line with the construction schedule for material requirement planning, verifications of material and locating of source, purchasing of the required material in advance before commencement of work, classifying the materials, and managing the inventory based on their usage value and eliminating and reduction in wastages during the overall material management process.

Keywords: material management, construction site, inventory, construction project

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Authors: Heba Abdelmotaal, Magdy Abdel-Kader

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Purpose: This study explores whether a firm’s effective political risk management is preventing real and accrual earnings management . Design/methodology/approach: Based on a sample of 130 firms operating in Egypt during the period 2008-2013, two hypotheses are tested using the panel data regression models. Findings: The empirical findings indicate a significant relation between real and accrual earnings management and political risk. Originality/value: This paper provides a statistically evidence on the effects of the political risk management failure on the mangers’ engagement in the real and accrual earnings management practices, and its impact on the firm’s performance.

Keywords: political risk, risk management failure, real activities manipulation, accrual earnings management

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Authors: Supattra Kanchanopast

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The purpose of this research is to develop and design a management information system for 7 eleven shop in Bangkok. The system was designed and developed to meet users’ requirements via the internet network by use of application software such as My SQL for database management, Apache HTTP Server for Web Server and PHP Hypertext Preprocessor for an interface between web server, database and users. The system was designed into two subsystems as the main system, or system for head office, and the branch system for branch shops. These consisted of three parts which are classified by user management as shop management, inventory management and Point of Sale (POS) management. The implementation of the MIS for the mini-mart shop, can lessen the amount of paperwork and reduce repeating tasks so it may decrease the capital of the business and support an extension of branches in the future as well.

Keywords: convenience store, the management information system, inventory management, 7 eleven shop

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Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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Authors: Mohammad Reza Ostad Ali Naghi Kashani

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Nowadays, the amounts of companies which tend to have an Enterprise Resource Planning (ERP) application are increasing. Although ERP projects are expensive, time consuming, and complex, there are some successful experiences. These days, developing countries are striving to implement ERP projects successfully; however, there are many obstacles. Therefore, these projects would be failed or partially failed. This paper concerns the implementation of a successful ERP implementation, IFS, in Iran at Dana Geophysics Company (DGC). After a short review of ERP and ERP market in Iran, we propose a three phases deployment methodology (phase 1: Preparation and Business Process Management (BPM) phase 2: implementation and phase 3: testing, golive-1 (pilot) and golive-2 (final)). Then, we present five guidelines (Project Management, Change Management, Business Process Management (BPM), Training& Knowledge Management, and Technical Management), which were chose as work streams. In this case study we present lessons learned in Project management and Business process Management.

Keywords: business process management, critical success factors, ERP, project management

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Authors: Lajeesh Jabbar, Shibu T. Varghese

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Being under pain is a very distressing factor that it prolongs the healing of any kind of trauma and add to the post traumatic stressful state. Alleviating the pain from acute traumatic conditions like fracture, degloving injury etc will help in faster recovery and also decrease the incidence of post traumatic stress disorder. Most of the emergency departments in INDIA are using IV opioid analgesics to relieve the patient from pain in cases of acute traumatic injuries. None of the Emergency Departments practice regional blocks in the country. In this study, we are comparing the efficacy of Regional Blocks in relieving the pain in lower limb fractures versus the use of IV analgesics for the same in the emergency department. The site of study is Malabar Institute Of Medical Sciences in Calicut in Kerala in India and is a place which receives approximately 10-20 traumatic fracture cases per day. The fracture sites used for the study purpose are femur fracture and phalangeal fractures.

Keywords: regional blocks, IV analgesia, acute traumatic pain, femur fractures, phalanx fractures

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Authors: Vitool Suksankavanich

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This preliminary research aimed to explore the development of wastewater management of Bang Pu Sub- District Municipality, Samutprakan Province, in order to establish appropriate model for effective wastewater management that fit to the context of the area. The research posed three questions: [i] to what extent the promotion of social responsibility awareness built among the local community resulted in effectiveness of the local wastewater management; [ii] did the waste disposal management of Bang Pu Industrial Estate contribute to the overall environmental quality of Bang Pu Sub- District Municipality; and [iii] did the relationship between the community and the industrial factories have any effect on the wastewater management. The in- depth interview revealed main obstacles occurred in the process of wastewater management in the area. The fieldwork also contributed to a product of an appropriate model of effective wastewater management.

Keywords: legitimacy theory, stakeholder theory, social responsibility, wastewater management

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Authors: Lou Gargouri

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This paper examines how Fanny Cabon's solo performance, Gardiennes (2018) strategically crafts empathetic witnessing through the artist's vocal and physical embodiment of her female ancestors' testimonies, dramatizing the cyclical inheritance of reproductive trauma across generations. Drawing on affect theory and the concept of ethical co-presence, we argue that Cabon's raw voicing of illegal abortions, miscarriages, and abuse through her shape-shifting presence generates an intimate energy loop with the audience. This affective resonance catalyzes recognition of historical injustices, consecrating each singular experience while building collective solidarity. Central to Cabon's political efficacy is her transparent self-revelation through intimate impersonation, which fosters identification with diverse characters as interconnected subjects rather than objectified others. Her solo form transforms the isolation often associated with women's marginalization into radical inclusion, repositioning them from victims to empowered survivors. Comparative analysis with other contemporary works addressing abortion rights illuminates how Gardiennes subverts the traditional medical and clerical gazes that have long governed women's bodies. Ultimately, we contend Gardiennes models the potential of solo performance to harness empathy as a subversive political force. Cabon's theatrical alchemy circulates the effects of injustice through the ethical co-presence of performer and spectator, forging intersubjective connections that reframe marginalized groups traditionally objectified within dominant structures of patriarchal power. In dramatizing how the act of witnessing another's trauma can generate solidarity and galvanize resistance, Cabon's work demonstrates the role of embodied performance in catalyzing social change through the recuperation of women's voices and lived experiences. This paper thus aims to contribute to the emerging field of feminist solo performance criticism by illuminating how Cabon's innovative dramaturgy bridges the personal and the political. Her strategic mobilization of intimacy, identification, and co-presence offers a model for how the affective dynamics of autobiographical performance can be harnessed to confront gendered oppression and imagine more equitable futures. Gardiennes invites us to consider how the circulation of empathy through ethical spectatorship can foster the collective alliances necessary for advancing the unfinished project of women's liberation.

Keywords: gender and sexuality studies, solo performance, trauma studies, affect theory

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Authors: Mingbao Chen, Mingli Zhao

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The coastal zone is the intersection of land and sea system, and also is the connecting zone of the two economic systems of land and sea. In the world, all countries attach great importance to the coastal zone management and the coastal zone economy. In China, the government has developed a number of related coastal management policies and institutional, such as marine functional zoning, main function zoning, integrated coastal zone management, to ensure the sustainable utilization of the coastal zone and promote the development of coastal economic. However, in practice, the effect is not satisfactory. This paper analyses the coastal areas of coastal zone management on coastal economic growth contribution based on coastal areas economic development data with the 2007-2015 in China, which uses the method of the evaluation index system of coastal zone management institutional efficiency. The results show that the coastal zone management institutional objectives are not clear, and the institutional has high repeatability. At the same time, over management of coastal zone leads to low economic efficiency because the government management boundary is blurred.

Keywords: institutional overlap, over management, coastal zone management, coastal zone economy

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Authors: Fernanda Varella Borges, Silvio Burrattino Melhado

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Motivated by the importance of public infrastructure projects in the civil construction chain, this research shows the study of project management methods and the infrastructure projects’ characteristics. The research aims at the objective of improving management efficiency by proposing guidelines for the application of project management methods in infrastructure projects. Through literature review and case studies, the research analyses two major infrastructure projects underway in Brazil, identifying the critical points for achieving its success. As a result, the proposed guidelines indicate that special attention should be given to the management of stakeholders, focusing on their knowledge and experience, their different interests, the efficient management of their communication, and their behavior in the day-by-day project management process.

Keywords: construction, infrastructure, project management, public projects

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Authors: Saimir Heta, Kastriot Haxhirexha, Virtut Velmishi, Nevila Alliu, Ilma Robo

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Background: Testicular rotation can occur at any age. The possibility to save the testicle is the fastest possible surgical intervention which is indicated by the presence of acute pain even at rest. The time element is more important to diagnose and proceed further with surgical intervention. Testicular damage is a consequence which mainly depends on the moment of onset of symptoms, at the time when the symptoms are diagnosed, the earliest action to be performed is surgical intervention. Sometimes medical tests are needed to confirm a diagnosis, or to help identify another cause for symptoms; for example, the urine test, that is used to check for infection, associated with the scrotal ultrasound test. Control of blood flow to the longitudinal supply vessels of the testicles is indicated. The sign that indicates testicular rotation is a reduction in blood flow. This is the element which is distinguished from ultrasound examination. Surgery may be needed to determine if the patient’s symptoms are caused by the rotation of the testis or any other condition. Discussion: As a surgical intervention of the emergency, the torsion of the test depends very much on the duration of the torsion, as the success in the life of the testicle depends on the fastest surgical intervention. From the previous clinic, it is noted that in any case presented to the pediatric patient diagnosed with testicular rotation, there is always a link with personal history that the patient refers to the presence of a previous episode of testicular trauma. Literature supports this fact very logically. Conclusions: Salvation without testicular atrophy depends closely on establishing the diagnosis of testicular rotation as soon as possible. Following the logic above, it can be said that the diagnosis for rotation should be performed as soon as possible, to avoid consequences that will not be favorable for the patient.

Keywords: acute scrotum, test torsion, newborns, clinical presentation

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Authors: Adam Aboalkaz, Rana Shamoon, Duncan Meikle, James Lewis

Abstract:

Background and aims: In orthopaedic theatres, radiological screening during operations is a commonly used and useful technique to visualise and guide the operating surgeon. Within any theatre using ionising radiation, it is imperative that the use of protective equipment and the wearing of a dosimeter at all times. 1. To assess compliance with use of protective equipment during orthopaedic procedures involving ionising radiation. 2. To assess the radiation risk knowledge of staff members regularly present in an orthopaedic theatre of a national major trauma centre, in accordance to the ionising radiation regulation (2000) guidelines. Method: We conducted an Observational study of 21 operations at the University Hospital of Wales, which is a major trauma centre, recording the compliance with use of protective equipment (lead aprons and thyroid shields) and dosimeters. The observations were performed sporadically over a two week period to ensure that all staff in monitored operating theatres were not aware of the ongoing study, as to avoid bias. A questionnaire testing the knowledge of trainees and staff within the orthopaedic department was given following completion of the initial phase of the study, with 19 responses. The questions were based on knowledge of ionising radiation exposure and monitoring. The questions also tested the general staff knowledge of what equipment should be worn and where to locate such equipment. Results: This study found that only 25% of staff members were wearing thyroid protectors when less than 1 meter from the radiation source and only 50% were wearing appropriate lead aprons whilst in this same vicinity. The study also showed that 0% of all staff members used a dosimeter whilst in an area of radiation exposure. From the distributed questionnaires, only 40% of staff understood where to stand whilst radiation was being used, and only 25% of staff knew where to find protective equipment. Conclusion: Overall our audit showed poor compliance with regards to the National and local policies, due to lack of awareness of the policy and lack of basic ionising radiation exposure knowledge. It was evident from the observational study and questionnaire that staff were not fully aware of what equipment should be worn, where to find such equipment and did not appreciate that the distance from the ionising radiation source altered its exposure effect. This lack of knowledge may affect the staff health and safety after long term exposure. Changes to clinical practice: From the outcome of this study, we managed to drastically increase awareness of ionising radiation within the orthopaedic department. A mandatory teaching session on the safety of ionising radiation has been incorporated into the orthopaedic induction week for all staff. The dosimeters have been moved to a visible location within the trauma operating theatre and all staff made aware of where to find protective equipment.

Keywords: audit, ionising radiation, observational study, protection

Procedia PDF Downloads 236

Authors: L. Sun, O. Bloom, K. Anderson

Abstract:

The medial and lateral sural artery perforator flaps (MSAP and LSAP, respectively) are two recently described flaps that are less commonly used in lower limb trauma reconstructive surgeries compared to flaps such as the anterolateral thigh (ALT) flap or the gastrocnemius flap. The LSAP flap has several theoretical benefits over the MSAP, including the ability to be sensate and being more easily manoeuvred into position as a local flap for coverage of lateral knee or leg defects. It is less commonly used in part due to a lack of documented studies of the anatomical reliability of the perforator, and an unquantified average length of the pedicle used for microsurgical anastomosis (if used as a free flap) or flap rotation (if used as a pedicled flap). It has been shown to have significantly lower donor site morbidity compared to other flaps such as the ALT, due to the decreased need for intramuscular dissection and resulting in less muscle loss at the donor site. 11 cadaveric lower limbs were dissected, with a mean of 1.6 perforators per leg, with an average pedicle length of 45mm to the sural artery and 70mm to the popliteal artery. While the majority of perforating arteries lay close to the midline (average of 19mm lateral to the midline), there were patients whose artery was significantly lateral and would have been likely injured by the initial incision during an operation. Adding to the literature base of documented LSAP dissections provides a greater understanding of the anatomical basis of these perforator flaps, and the authors hope this will establish them as a more commonly used and discussed option when managing complicated lower limb trauma requiring soft tissue reconstruction.

Keywords: cadaveric, dissection, lateral, perforator flap, sural artery, surface anatomy

Procedia PDF Downloads 134

Authors: Courtley Pharaoh, D. J. Visser

Abstract:

University management is often caught between competing interests from stakeholders like students, trustees, donors, government and the community it serves. This study aimed to identify what management competencies are required by executive management members of universities of technology to effectively manage a university of technology in South Africa from the perspective of the executive management members. This exploratory study will make use of a qualitative methodology to establish what management competencies are deemed as important to manage a university of technology in South Africa from the executive management perspective. Due to the consequences of the COVID-19 Pandemic, the study made use of online face-to-face interviews to ascertain from executive management members of universities of technology what the required management competencies needed by executive management members of universities of technology to effectively manage a University of Technology in South Africa. Qualitative Content Analysis was used to analyse the data collected. The findings of the study identified a total of 26 management competencies which were categorised into three groupings or themes. This study identified a list of required management competencies needed by executive management members of universities of technology to effectively manage a university of technology in South Africa, as per the lived experience of executive management members. The researcher recommends further studies at traditional and comprehensive universities and compares the results of those future studies with the results of this study. A comprehensive list of management competencies could then be identified, which could assist with the compilation of job descriptions of executive management members of universities in South Africa.

Keywords: university of technology, management competencies, executive management, executive management members, important

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Authors: Kittipong Tissayakorn, Fumio Akagi, Yu Song

Abstract:

Logistics is the integrated management of all of the activities required to move products through the supply chain. For a typical product, this supply chain extends from a raw material source through the production and distribution system to the point of consumption and the associated reverse logistics. The logistical activities are comprised of freight transport, storage, inventory management, materials handling and all related information processing. This paper analyzes the green management system of logistics enterprise for Thailand and advances the concept of Green Logistics, which should be held by the public. In addition, it proposes that the government should strengthen its supervision and support for green logistics, and companies should construct self-disciplined green logistics management systems and corresponding processes, a reverse logistics management system and a modern green logistics information collection and management system.

Keywords: logistics, green logistics, management system, ecological economics

Procedia PDF Downloads 370