Search results for: General Practice

Authors: Cornelius Femi Popoola

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Nigerian manufacturing industry, particularly the flour producing firms play vital roles in Nigerian economy. This sector’s quality management practice is given a little attention along with organizational factors that hinder successful practice of total quality management which needs to be documented. Honeywell Flour Mills Plc operate in Nigeria with an appreciable number of products that serves this sector of the economy. Internal-external disposition of the company and total quality practice of the company deserve some elucidations. Hence, this study examined the influence of organizational factors on total quality management practice of Nigerian manufacturing industry, using Honeywell Flour Mills Plc as a case study. The study employed the correlational type of descriptive survey research design. The population consisted of 656 staff of Honeywell Flour Mills Plc, out of which 235 members were selected through scientific sampling method developed by Paler-Calmorin and Calmorin. A total of 235 copies of questionnaires titled 'Organisational Factors and Total Quality Management Practices (QF-TQM) Questionnaire' were administered with a response rate of 66 copies returned. The following variables were applied internal organisational factors (IOFs), external organizational factors (EOFs) and total quality management (TQM). Data generated were analysed using frequency distribution and regression analysis at 0.05 level. The findings revealed that IOFs positively and significantly related with TQM (r = .147**, N= 64, P(.000) < .01). Also, EOFs negatively and significantly related with TQM (r = -.117, N= 64, P(.000) < .01). Findings showed that internal and external organizational factors jointly influenced TQM practiced in F₍₂,₆₁₎=22.250; R²=.629; Adj.R²=.603; P(.000) < .05). The study concluded that organizational factors are determinants of TQM practice in Nigerian manufacturing industry. It is recommended that both internal and external organizational factors influencing TQM practices should be considered in the development of TQM strategies.

Keywords: external organizational factors, internal organisational factors, Nigerian manufacturing industry, total quality management

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Authors: Paul Lam, Kevin Wong, Chi Him Chan

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Constant practicing and accurate, immediate feedback are the keys to improving students’ speaking skills. However, traditional oral examination often fails to provide such opportunities to students. The traditional, face-to-face oral assessment is often time consuming – attending the oral needs of one student often leads to the negligence of others. Hence, teachers can only provide limited opportunities and feedback to students. Moreover, students’ incentive to practice is also reduced by their anxiety and shyness in speaking the new language. A mobile app was developed to use artificial intelligence (AI) to provide immediate feedback to students’ speaking performance as an attempt to solve the above-mentioned problems. Firstly, it was thought that online exercises would greatly increase the learning opportunities of students as they can now practice more without the needs of teachers’ presence. Secondly, the automatic feedback provided by the AI would enhance students’ motivation to practice as there is an instant evaluation of their performance. Lastly, students should feel less anxious and shy compared to directly practicing oral in front of teachers. Technically, the program made use of speech-to-text functions to generate feedback to students. To be specific, the software analyzes students’ oral input through certain speech-to-text AI engine and then cleans up the results further to the point that can be compared with the targeted text. The mobile app has invited English teachers for the pilot use and asked for their feedback. Preliminary trials indicated that the approach has limitations. Many of the users’ pronunciation were automatically corrected by the speech recognition function as wise guessing is already integrated into many of such systems. Nevertheless, teachers have confidence that the app can be further improved for accuracy. It has the potential to significantly improve oral drilling by giving students more chances to practice. Moreover, they believe that the success of this mobile app confirms the potential to extend the AI-assisted assessment to other language skills, such as writing, reading, and listening.

Keywords: artificial Intelligence, mobile learning, oral assessment, oral practice, speech-to-text function

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Authors: Manasi V. Shah

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Organizations, in the competitive era, are participating in the competency act. They have discerned that, strategically researched and defined competencies when put up on the shelf, can help in achieving business goals. The research focuses on critical elements of competency-based talent acquisition process from practical vantage, with significant experience in a variety of business settings. The research is exploratory and descriptive in nature. The research conduct and outcome is the hinge on with reference to Indian Industries. It elaborates about the concept, practice and a brief model that human resource practitioner can use for effective talent acquisition process, which in turn would be in alignment with business performance. The research helps to present a prudent understanding of recruiting and selecting apt human capital, that can fit in a given job role and has action oriented competency based assessment approach for measuring the probable success of a job incumbent in a given job role.

Keywords: competency based talent acquisition, competency model, talent acquisition concept, talent acquisition practice

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Authors: Dagmara Wrzecionkowska

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Mass media campaigns against obesity are often designed to impact large audiences. This usually means that their audience is defined based on general demographic characteristics like age, gender, occupation etc., not taking into account psychographics like behavior, motivations, wants, etc. Using psychographics, as the base for the audience segmentation, is a common practice in case of successful campaigns, as it allows developing more relevant messages. It also serves a purpose of identifying key segments, those that generate the best return on investment. For a health campaign, that would be segments that have the best chance of being converted into healthy lifestyle at the lowest cost. This paper presents the limitations of the demographic targeting, based on the findings from the reception study of IMSS anti-obesity TV commercials and proposes mothers as the first level of segmentation, in the process of identifying the key segment for these campaigns.

Keywords: anti-obesity campaigns, mothers, segmentation, targeting

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Authors: Jeong-Moh John Yahng, Angelika Na

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

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

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Authors: P. T. Collett, M. Kershaw

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Introduction: The discussion regarding which method of anesthesia provides better results for lower limb arthroplasty is a continuing debate. Multiple meta-analysis has been performed with no clear consensus. The current recommendation is to use neuraxial anesthesia for lower limb arthroplasty; however, the evidence to support this decision is weak. The Enhanced Recovery After Surgery (ERAS) society has recommended, either technique can be used as part of a multimodal anesthetic regimen. A local study was performed to see if the current anesthetic practice correlates with the current recommendations and to evaluate the efficacy of the different techniques utilized. Method: 90 patients who underwent total hip or total knee replacements at Nevill Hall Hospital between February 2019 to July 2019 were reviewed. Data collected included the anesthetic technique, day one opiate use, pain score, and length of stay. The data was collected from anesthetic charts, and the pain team follows up forms. Analysis: The average of patients undergoing lower limb arthroplasty was 70. Of those 83% (n=75) received a spinal anaesthetic and 17% (n=15) received a general anaesthetic. For patients undergoing knee replacement under general anesthetic the average day, one pain score was 2.29 and 1.94 if a spinal anesthetic was performed. For hip replacements, the scores were 1.87 and 1.8, respectively. There was no statistical significance between these scores. Day 1 opiate usage was significantly higher in knee replacement patients who were given a general anesthetic (45.7mg IV morphine equivalent) vs. those who were operated on under spinal anesthetic (19.7mg). This difference was not noticeable in hip replacement patients. There was no significant difference in length of stay between the two anesthetic techniques. Discussion: There was no significant difference in the day one pain score between the patients who received a general or spinal anesthetic for either knee or hip replacements. The higher pain scores in the knee replacement group overall are consistent with this being a more painful procedure. This is a small patient population, which means any difference between the two groups is unlikely to be representative of a larger population. The pain scale has 4 points, which means it is difficult to identify a significant difference between pain scores. Conclusion: There is currently little standardization between the different anesthetic approaches utilized in Nevill Hall Hospital. This is likely due to the lack of adherence to a standardized anesthetic regimen. In accordance with ERAS recommends a standard anesthetic protocol is a core component. The results of this study and the guidance from the ERAS society will support the implementation of a new health board wide ERAS protocol.

Keywords: anaesthesia, orthopaedics, intensive care, patient centered decision making, treatment escalation

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Authors: Usamah Al-Ali

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We explore the effect of expanding space on the exoticity of the matter supporting a traversable Lorentzian wormhole of zero radial tide whose line element is given by ds2 = dt^2 − a^2(t)[ dr^2/(1 − kr2 −b(r)/r)+ r2dΩ^2 in the context of General Relativity. This task is achieved by deriving the Einstein field equations for anisotropic matter field corresponding to the considered cosmological wormhole metric and performing a classification of their solutions on the basis of a variable equations of state (EoS) of the form p = ω(r)ρ. Explicit forms of the shape function b(r) and the scale factor a(t) arising in the classification are utilized to construct the corresponding energy-momentum tensor where the energy conditions for each case is investigated. While the violation of energy conditions is inevitable in case of static wormholes, the classification we performed leads to interesting solutions in which this violation is either reduced or eliminated.

Keywords: general relativity, Einstein field equations, energy conditions, cosmological wormhole

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Authors: Rahmat Irawan, Mundhir Hanifsyam Harahap, Andar Ristabet Hesda

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As a public sector organization in Indonesia, Directorate General of State Asset Management (DGSAM) which is a unit under the Ministry of Finance of The Republic of Indonesia, has many constraints in managing its employees. While private organizations are able to conduct a human resource management as the best practice, DGSAM is limited by many regulations, especially about punishment and lay off policy for under-performance employees. Therefore, since 2015, DGSAM tries to implement a new and uncommon approach considering employees’ preference to encourage the motivation and performance of employees. DGSAM’s employees may propose the job places, and DGSAM considers them in deciding employees deployment. This study tries to determine the impact of preference-based approach toward employees’ satisfaction and organizational performance. This study uses quantitative approaches by regression analysis to measure the impact of deployment toward satisfaction of deployed employees and performance change of related units in DGSAM. The result of this study shows that preference-based approach significantly improves employees’ satisfaction and performance of related units as well. Based on the results of this study, it can be suggested that the approach is able to be implemented in the wider scope of the Ministry of Finance of The Republic of Indonesia and whole public sector organization in Indonesia. However, this study only focuses on short term measurement, so it is suggested to do further study to analyze the long-term impact.

Keywords: employee deployment, employee satisfaction, human resource management, organizational performance, preference-based approach

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Authors: William Thomas Worster

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This paper will highlight the failure of international adjudication to prevent a state from evading an order of provisional measures by simply issuing a diplomatic assurance to the court. This practice changes the positions of the litigants as equals before a court, prevents the court from inquiring into the reliability of the political pledge as it would with assurances from a state to an individual, and diminishes the court’s ability to control its own proceedings in the face of concerns over sovereignty. Both the European Court of Human Rights (ECtHR) and International Court of Justice (ICJ) will entertain these kinds of unilateral pledges, but they consider them differently when the declaration is made between states or between a state and an individual, and when made directly to the court. In short, diplomatic assurances issued between states or to individuals are usually considered not to be legally binding and are essentially questions of fact, but unilateral assurances issued directly to an international court are questions of law, and usually legally binding. At the same time, orders for provisional measures are now understood also to be legally binding, yet international courts will sometimes permit a state to substitute an assurance in place of an order for provisional measures. This emerging practice has brought the nature of a state as a sovereign capable of creating legal obligations into the forum of adjudication where the parties should have equality of arms and permitted states to create legal obligations that escape inquiry into the reliability of the outcome. While most recent practice has occurred at the ICJ in state-to-state litigation, there is some practice potentially extending the practice to human rights courts. Especially where the litigants are factually unequal – a state and an individual – this practice is problematic since states could more easily overcome factual failings in their pledges and evade the control of the court. Consider, for example, the potential for evading non-refoulement obligations by extending the current diplomatic assurances practice from the state-to-state context to the state-to-court context. The dual nature of assurances, as both legal and factual instruments, should be considered as addressed to distinct questions, each with its own considerations, and that we need to be more demanding about their precise legal and factual effects.

Keywords: unilateral, diplomacy, assurances, undertakings, provisional measures, interim measures

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Authors: Andreas Jede, Frank Teuteberg

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Cloud computing (CC) has already gained overall appreciation in research and practice. Whereas the willingness to integrate cloud services in various IT environments is still unbroken, the previous CC procurement processes run mostly in an unorganized and non-standardized way. In practice, a sufficiently specific, yet applicable business process for the important acquisition phase is often lacking. And research does not appropriately remedy this deficiency yet. Therefore, this paper introduces a field-tested approach for CC procurement. Based on an extensive literature review and augmented by expert interviews, we designed a model that is validated and further refined through an in-depth real-life case study. For the detailed process description, we apply the event-driven process chain notation (EPC). The gained valuable insights into the case study may help CC research to shift to a more socio-technical area. For practice, next to giving useful organizational instructions we will provide extended checklists and lessons learned.

Keywords: cloud procurement process, IT-organization, event-driven process chain, in-depth case study

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Authors: Eman AbuKhousa, Marwan Z. Bataineh

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The 21^st century higher education and globalization challenge new faculty members to build effective professional networks and partnership with industry in order to accelerate their growth and success. This creates the need for community of practice (CoP)-oriented development approaches that focus on cognitive apprenticeship while considering individual predisposition and future career needs. This work adopts data mining, clustering analysis, and social networking technologies to present the CoP-Network as a virtual space that connects together similar career-aspiration individuals who are socially influenced to join and engage in a process for domain-related knowledge and practice acquisitions. The CoP-Network model can be integrated into higher education to extend traditional graduate and professional development programs.

Keywords: clustering analysis, community of practice, data mining, higher education, new faculty challenges, social network, social influence, professional development

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Authors: Maiss Razem

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The construction sector is considered a major consumer of materials that undergoes processes of extraction, processing, transportation, and maintaining when used in buildings. Several metrics have been devised to capture the environmental impact of the materials consumed during construction using lifecycle thinking. Rarely has the materiality of this sector been explored qualitatively and systemically. This paper aims to explore socio-cultural forces that drive the use of certain materials in the Jordanian construction industry, using practice theory as a heuristic method of analysis, more specifically Shove et al. three-element model. By conducting semi-structured interviews with architects, the results unravel contextually embedded routines when determining qualities of three materialities highlighted herein; stone, glass and spatial openness. The study highlights the inadequacy of only using efficiency as a quantitative metric of sustainable materials and argues for the need to link material consumption with socio-economic, cultural, and aesthetic driving forces. The operationalization of practice theory by tracing materials’ lifetimes as they integrate with competencies and meanings captures dynamic engagements through the analyzed routines of actors in the construction practice. This study can offer policymakers better-nuanced representation to green this sector beyond efficiency rhetoric and quantitative metrics.

Keywords: architects' practices, construction materials, Jordan, practice theory

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Authors: I. A. Harris, J. M. Naylor

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Antibiotic guidelines are published in order to reduce the risk of perioperative infection in orthopaedics. We surveyed 20 orthopaedic hospitals in Australia to determine their protocols for antibiotic prophylaxis around joint replacement surgery. We tested the protocols against Australian guidelines. We found that less than half of all protocols adhered to Australian guidelines. This indicates that current practice may lead to increased infection rates and increased antibiotic resistance.

Keywords: antibiotics, practice guidelines, orthopaedic surgery, joint replacement

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Authors: Martina Maria Keitsch

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Critical Design (CD) confronts traditional design practice. Instead of reproducing and reinforcing contemporary perceptions of products and services, CD seeks to challenge them with the goal to stimulate debates and visions on societal innovation. CD methods comprise, among other narratives and design of critical objects. The oral presentation is based on a study that discusses concepts, methods, and applications of CD links CD to traditional design, and identifies CD benefits and challenges for design research and practice. The objective of the study is to introduce CD as an alternative for design researchers and practitioners supplementing commercially oriented design approaches. The study utilizes a literature review on CD concepts and methods based on current publications and online documents and illustrates CD practice with help of selected case studies. Findings of the study indicate that CD contribute, among others, to create new societal roles for designers, foster innovative relationships between designers and users, and encourage creativity through imaginative aesthetics.

Keywords: critical design, postmodern design theories, narratives, rhizome

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Authors: Young Kwon Yang, In Sung Kang, Jung Ha Hwang, Jin Chul Park

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The present study is a foundational study for performance improvements on isolation wards to prevent proliferation of secondary infection of infectious diseases such as SARS, H1N1, and MERS inside hospitals. Accordingly, the present study conducted an analysis of the effect of sealing mechanisms and filling of openings on ensuring air tightness performance in isolation wards as well as simulation on air currents in improved isolation wards. The study method is as follows. First, previous studies on aerial infection type and mechanism were reviewed, and the review results were utilized as basic data of analysis on simulation of air current. Second, national and international legislations and regulations in relation to isolation wards as well as case studies on developed nations were investigated in order to identify the problems in isolation wards in Korea and improvement plans. Third, construction and facility plans were compared and analyzed between general and isolation wards focusing on large general hospitals in Korea, thereby conducting comparison and analysis on the performance and effects of air-tightness of general and isolation wards through CFD simulations. The study results showed that isolation wards had better air-tightness performance than that of general wards.

Keywords: AII Room, air-borne infection, CFD, computational fluid dynamics

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Authors: A. F. G. Van Woezik, L. M. A. Braakman-Jansen, O. A. Kulyk, J. E. W. C. Van Gemert-Pijnen

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Background: Zoonoses pose a serious threat to public health and economies worldwide, especially as antimicrobial resistance grows and newly emerging zoonoses can cause unpredictable outbreaks. In order to prevent and control emerging and re-emerging zoonoses, collaboration between veterinary, human health and public health domains is essential. In reality however, there is a lack of cooperation between these three disciplines and uncertainties exist about their tasks and responsibilities. The objective of this ongoing research project (ZonMw funded, 2014-2018) is to develop an online education and communication One Health platform, “eZoon”, for the general public and professionals working in veterinary, human health and public health domains to support the risk communication of non-alimentary zoonoses in the Netherlands. The main focus is on education and communication in times of outbreak as well as in daily non-outbreak situations. Methods: A participatory development approach was used in which stakeholders from veterinary, human health and public health domains participated. Key stakeholders were identified using business modeling techniques previously used for the design and implementation of antibiotic stewardship interventions and consisted of a literature scan, expert recommendations, and snowball sampling. We used a stakeholder salience approach to rank stakeholders according to their power, legitimacy, and urgency. Semi-structured interviews were conducted with stakeholders (N=20) from all three disciplines to identify current problems in risk communication and stakeholder values for the One Health platform. Interviews were transcribed verbatim and coded inductively by two researchers. Results: The following key values were identified (but were not limited to): (a) need for improved awareness of veterinary and human health of each other’s fields, (b) information exchange between veterinary and human health, in particularly at a regional level; (c) legal regulations need to match with daily practice; (d) professionals and general public need to be addressed separately using tailored language and information; (e) information needs to be of value to professionals (relevant, important, accurate, and have financial or other important consequences if ignored) in order to be picked up; and (f) need for accurate information from trustworthy, centrally organised sources to inform the general public. Conclusion: By applying a participatory development approach, we gained insights from multiple perspectives into the main problems of current risk communication strategies in the Netherlands and stakeholder values. Next, we will continue the iterative development of the One Health platform by presenting key values to stakeholders for validation and ranking, which will guide further development. We will develop a communication platform with a serious game in which professionals at the regional level will be trained in shared decision making in time-critical outbreak situations, a smart Question & Answer (Q&A) system for the general public tailored towards different user profiles, and social media to inform the general public adequately during outbreaks.

Keywords: ehealth, one health, risk communication, stakeholder, zoonosis

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Authors: Yen Ling Liu, Shu-Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Chia-Yu Chen

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Purpose: Nurse anesthetists are confronting extraordinarily high job stress in their daily practice, deriving from the fast-track anesthesia care, risk of perioperative complications, routine rotating shifts, teaching programs and interactions with the surgical team in the operating room. This study investigated the influence of work stress on the burnout and turnover intention of nurse anesthetists in a regional general hospital in Southern Taiwan. Methods: This was a descriptive correlational study carried out in 66 full-time nurse anesthetists. Data was collected from March 2017 to June 2017 by in-person interview, and a self-administered structured questionnaire was completed by the interviewee. Outcome measurements included the Practice Environment Scale of the Nursing Work Index (PES-NWI), Maslach Burnout Inventory (MBI) and nursing staff turnover intention. Numerical data were analyzed by descriptive statistics, independent t test, or one-way ANOVA. Categorical data were compared using the chi-square test (x²). Datasets were computed with Pearson product-moment correlation and linear regression. Data were analyzed by using SPSS 20.0 software. Results: The average score for job burnout was 68.7916.67 (out of 100). The three major components of burnout, including emotional depletion (mean score of 26.32), depersonalization (mean score of 13.65), and personal(mean score of 24.48). These average scores suggested that these nurse anesthetists were at high risk of burnout and inversely correlated with turnover intention (t = -4.048, P < 0.05). Using linear regression model, emotional exhaustion and depersonalization were the two independent factors that predicted turnover intention in the nurse anesthetists (19.1% in total variance). Conclusion/Implications for Practice: The study identifies that the high risk of job burnout in the nurse anesthetists is not simply derived from physical overload, but most likely resulted from the additional emotional and psychological stress. The occurrence of job burnout may affect the quality of nursing work, and also influence family harmony, in turn, may increase the turnover rate. Multimodal approach is warranted to reduce work stress and job burnout in nurse anesthetists to enhance their willingness to contribute in anesthesia care.

Keywords: anesthesia nurses, burnout, job, turnover intention

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Authors: Rob Gesley Capistrano, Jasper James Isaac, Rose Mae Moralda, Therese Anne Peleo, Danica Rillo, Maria Virginia Santillian

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One of the valuable things that shows the intelligence among individuals is the academic background specifically their Grade Weighted Average and the significant result of the Comprehensive Examination. The general objective of the researchers to this study is to determine if there is a significant difference between General Weighted Average and Comprehensive Examination Result of Psychometrician Board Passers and Non-Board Passers. The respondents of this study composed of board passers and non-board passers. The researchers used purposive sampling technique. The result utilized by using T-test Independent Sample to determine the comparison of General Weighted Average and Comprehensive Examination Result of Board Passers and Non Board Passers. At the end, it concluded that the General Weighted Average of Board Passers and Non-Board Passers shows that there is no significant difference, but the average showed a minimal variation. The Comprehensive Examination Result of Board Passers and Non-Board Passers result revealed that there is a significant difference. The performance of comprehensive examination that will test the overall knowledge of an individual and will determine whose more proficient will likely to have a higher score. The result of the comprehensive examination had an impact in the passing performance of board examination.

Keywords: board passers, comprehensive examination result, grade weighted average, non board passers

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Authors: Binh Thanh Ta, Elizabeth Sturgiss

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Central to patient-centered care is the idea of treating a patient as a person and understanding their perspectives regarding their health conditions and care preferences. Surprisingly, little is known about how GPs can understand their patients’ perspectives. This paper addresses the challenge of understanding patient perspectives in behavior change consultations by adopting Conversation Analysis (CA), which is an empirical research approach that allows both researchers and the audience to examine patients’ perspectives as displayed in GP-patient interaction. To understand people’s perspectives, CA researchers do not rely on what they say but instead on how they demonstrate their endogenous orientations to social norms when they interact with each other. Underlying CA is the notion that social interaction is orderly by all means. (It is important to note that social orders should not be treated as exogenous sets of rules that predetermine human behaviors. Rather social orders are constructed and oriented by social members through their interactional practices. Also, note that these interactional practices are the resources shared by all social members). As CA offers tools to uncover the orderliness of interactional practices, it not only allows us to understand the perspective of a particular patient in a particular medical encounter but, more importantly, enables us to recognise the shared interactional practice for signifying a particular perspective. Drawing on the 10 video-recorded consultations on behavior change in primary care, we have discovered the orderliness of patient laughter when reporting health behaviors, which signifies their orientation to the problematic nature of the reported behaviors. Among 24 cases where patients reported their health behaviors, we found 19 cases in which they laughed while speaking. In the five cases where patients did not laugh, we found that they explicitly framed their behavior as unproblematic. This finding echoes the CA body research on laughter, which suggests that laughter produced by first speakers (as opposed to laughing in response to what has been said earlier) normally indicates some sort of problems oriented to the self (e.g. self-tease, self-depreciation, etc.). This finding points to the significance of understanding when and why patients laugh; such understanding would assist GPs to recognise whether patients treat their behavior as problematic or not, thereby producing responses sensitive to patient perspectives.

Keywords: patient centered care, laughter, conversation analysis, primary care, behaviour change consultations

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Authors: Bjørn Salskov, Nicolaj Bang, Charlotte Falko

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Future labour markets demand employees that can carry out a non-linear task which is still not possible for computers. This means that employees must have well-developed soft-skills to perform at high levels in such a work environment. One of these soft-skills is presenting a message effectively. To be able to present a message effectively, one needs to practice this. To practice effectively, the trainee needs feedback on the current performance. Here VR environments can be used as a practice tool because it gives the trainee a sense of presence and reality. VR environments are becoming a cost-effective training method since it does not demand the presence of an expert to provide this feedback. The research article analysed in this study suggests that VR environment can be used and are able to provide the necessary feedback to the trainee which in turn will help the trainee become better at the task. The research analysed in this review does, however, show that there is a need for a study with larger sample size and a study which runs over a longer period.

Keywords: training, presentation, presentation skills, VR training, VR as a training tool, VR and presentation

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Authors: Mohammad T. Uddin, Aurup R. Dhar

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The study was conducted to assess the impact of conservation agriculture practice on farmers’ socioeconomic condition and soil environmental quality in Bangladesh. A total of 450 (i.e., 50 focal, 150 proximal and 250 control) farmers from five districts were selected for this study. Descriptive statistics like sum, averages, percentages, etc. were calculated to evaluate the socioeconomic data. Using Enyedi’s crop productivity index, it was found that the crop productivity of focal, proximal and control farmers was increased by 0.9, 1.2 and 1.3 percent, respectively. The result of DID (Difference-in-difference) analysis indicated that the impact of conservation agriculture practice on farmers’ average annual income was significant. Multidimensional poverty index (MPI) indicates that poverty in terms of deprivation of health, education and living standards was decreased; and a remarkable improvement in farmers’ socioeconomic status was found after adopting conservation agriculture practice. Most of the focal and proximal farmers stated about increased soil environmental condition where majority of control farmers stated about constant environmental condition in this regard. The Probit model reveals that minimum tillage operation, permanent organic soil cover, and application of compost and vermicompost were found significant factors affecting soil environmental quality under conservation agriculture. Input support, motivation, training programmes and extension services are recommended to implement in order to raise the awareness and enrich the knowledge of the farmers on conservation agriculture practice.

Keywords: conservation agriculture, crop productivity, socioeconomic status, soil environment quality

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Authors: Kailash C. Madan

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We study the steady state behaviour of a batch arrival single server queue in which the first service with general service times is compulsory and the second service with general service times is optional. We term such a two phase service as generalized Coxian-2 service. Just after completion of a service the server must take a vacation of random length of time with general vacation times. We obtain steady state probability generating functions for the queue size as well as the steady state mean queue size at a random epoch of time in explicit and closed forms. Some particular cases of interest including some known results have been derived.

Keywords: batch arrivals, compound Poisson process, generalized Coxian-2 service, steady state

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Authors: Hilde Heim

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The textile industry is known for its swift adoption of innovations in fashion technology (Fash-Tech). The industry is also known for its harmful effects on the environment. Opportunely, Fash-Tech is expected to facilitate the turn towards more sustainable practice. However, although several technologies have the potential for advancing sustainable practice, many industry players, whether large or small, are confused and misinformed about Fash-Tech adoption, application, and impact. Through a visual poster presentation, this project aims to map global fashion innovations along the supply chain from fibre production to waste management, thus providing a clearer picture of numbers, scale, and adoption. While the project aims to identify Fash-Tech effectiveness in reaching sustainability goals, it also identifies areas of congestion as well as insufficiency in the accessibility of Fash-Tech. This project intends to help inform future decisions in business, investment, and policy for the advancement of sustainable practice.

Keywords: fashion technology, sustainability, supply chain, enterprise management

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Authors: T. Vandeyar

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The purpose of this study is to explore how Government policy on ICT influences teaching and learning in South African schools. An instrumental case study using backward mapping principles as a strategy of inquiry was used. Utilizing a social constructivist lens and guided by a theoretical framework of a sociocultural approach to policy analysis, this exploratory qualitative research study set out to investigate how teachers appropriate government policy on ICT in South African schools. Three major findings emanated from this study. First, although teachers were ignorant of the national e-education policy their professionalism and agency were key in formulating and implementing an e-education policy in practice. Second, teachers repositioned themselves not as recipients or reactors of the e-education policy but as social and cultural actors of policy appropriation and formulation. Third, the lack of systemic support to teachers catalyzed improved school and teacher collaborations, teachers became drivers of ICT integration through collaboration, innovation, institutional practice and institutional leadership.

Keywords: ICT, teachers as change agents, practice as policy, teacher's beliefs, teacher's attitudes

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Authors: Jacquelene Swanepoel, J. C. Visagie, H. M. Linde

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Purpose: The aim of this article is to investigate the psychosocial risk environment influencing employee behaviour, and subsequently the trust relationship between employer and employee. Design/methodology/approach: The unique nature and commonness of negative acts, such as unsafe behaviour, human errors, poor performance and negligence, also referred to as unsafe practice, are explored. A literature review is formulated to investigate the nature of negative acts or unsafe behaviour. The findings of this study are used to draw comparisons between unsafe behaviour/misconduct and accidents in the workplace and finally conclude how it should be addressed from a labour relations point of view. Findings: The results indicate comparisons between unsafe practice/misconduct and occupational injuries and accidents, as a result of system flaws, human error or psychosocial risk.

Keywords: occupational risks, unsafe practice, misconduct, organisational safety culture, ergonomics, management commitment and leadership, labour relations

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Authors: Augustar Omoze Ehighalua, Itotenaan Henry Ogiri

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As a mono-product economy, Nigeria relies largely on oil revenues for its foreign exchange earnings and the exploration activities of firms operating in the Niger Delta region have left in its wake tales of environmental degradation, poverty and misery. This, no doubt, have created corporate social responsibility issues in the region. The focus of this research is the critical evaluation of the ethical response to Corporate Social Responsibility (CSR) practice by firms operating in Nigeria Delta Swamplands. While CSR is becoming more popular in developed society with effective practice guidelines and reporting benchmark, there is a relatively low level of awareness and selective applicability of existing international guidelines to effectively support CSR practice in Nigeria. This study, haven identified the lack of CSR institutional framework attempts to develop an ethically-driven CSR transparency benchmark laced within a regulatory framework based on international best practices. The research adopts a qualitative methodology and makes use of primary data collected through semi-structured interviews conducted across the six core states of the Niger Delta Region. More importantly, the study adopts an inductive, interpretivist philosophical paradigm that reveal deep phenomenological insights into what local communities, civil society and government officials consider as good ethical benchmark for responsible CSR practice by organizations. The institutional theory provides for the main theoretical foundation, complemented by the stakeholder and legitimacy theories. The Nvivo software was used to analyze the data collected. This study shows that ethical responsibility is lacking in CSR practice by firms in the Niger Delta Region of Nigeria. Furthermore, findings of the study indicate key issues of environmental, health and safety, human rights, and labour as fundamental in developing an effective CSR practice guideline for Nigeria. The study has implications for public policy formulation as well as managerial perspective.

Keywords: corporate social responsibility, CSR, ethics, firms, Niger-Delta Swampland, Nigeria

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Authors: Tiffany Gallagher, Sheila Bennett

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Based on data from a larger study, this research is based in a small school district in Ontario, Canada, that has made a transition from self-contained classes for students with exceptionalities to inclusive classroom placements for all students with their age-appropriate peers. The school board aided this transition by hiring Inclusion Coaches with a background in special education to work alongside teachers as partners and inform their inclusive practice. Based on qualitative data from four focus groups conducted with Inclusion Coaches, as well as four blog-style reflections collected at various points over two years, six principles of inclusive practice were identified for coaches. The six principles form a model during transition: pre-requisite, process, precipice, promotion, proof, and promise. These principles are encapsulated in a visual model of a spiraling staircase displaying the conditions that exist prior to coaching, during coaching interactions and considerations for the sustainability of coaching. These six principles are re-iterative and should be re-visited each time a coaching interaction is initiated. Exploring inclusion coaching as a model emulates coaching in other contexts and allows us to examine an established process through a new lens. This research becomes increasingly important as more school boards transition toward inclusive classrooms, The Six ‘P’ Model: Principles of Inclusive Practice for Inclusion Coaches allows for a unique look into a scaffolding model of building educator capacity in an inclusive setting.

Keywords: capacity building, coaching, inclusion, special education

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Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: alcohol screening, AUDIT-C, CAGE, hazardous drinking

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Authors: Tamadher Alfahal

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Faith and art practice in traditional Islam had a profound rapport that is lost today. From practicing the principles of faith throughout everyday life, art was found as an expressive tool for Islamic revelation, worship, and the contemplative remembrance of God. Today, this rapport between Islamic art and spirituality has diminished; and the cosmological and metaphysical ideas that were the core of creative practices lost their imminence in people's lives. Hence, the cultural and religious practice of Islamic societies became separate from the creative production. In an attempt to revisit this rapport, it is sought to investigate the possibility of creating a set of principles for contemporary Islamic art and design through collaborative practice-led research. The research will aim to regenerate the potentials of Islamic philosophy for creative expressions, particularly in design studies. The outcomes will be manifested through different mediums such as: reflexive mind maps and visuals by the researcher, and various methods of participatory art practice aim to validate the philosophical concepts as design principles as a way to disseminate knowledge. This paper will focus on showcasing the key findings and the research approach for generating philosophical concepts as design principles. Using secondary evidence from literature, it will show examples of transforming textual findings into visuals that will be extensively explored through multidisciplinary collaborative sessions (these are scheduled to be conducted between February and April 2017).

Keywords: creative process, design pedagogy, design thinking, Islamic art, Islamic designs, Islamic philosophy

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Authors: Swati Bhasin, Ali Ahmed, Valence Xavier, Ben Liu

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Aims: Diarrhea is a problem that is a frequent clinic referral to the gastroenterology and surgical team from the General practitioner. To establish a diagnosis, these patients undergo colonoscopy. The current practice at our district general hospital is to perform random left and right colonic biopsies. National guidelines issued by the British Society of Gastroenterology advise all patients presenting with chronic diarrhea should have an Ileoscopy as an indicator for colonoscopy completion. Our primary aim was to check if Terminal ileum (TI) biopsy is required to establish a diagnosis of inflammatory bowel disease (IBD). Methods: Data was collected retrospectively from November 2018 to November 2019. The target population were patients who underwent colonoscopies for diarrhea. Demographic data, endoscopic and histology findings of TI were assessed and analyzed. Results: 140 patients with a mean age of 57 years (19-84) underwent a colonoscopy (M: F; 1:2.3). 92 patients had random colonic biopsies taken and based on the histological results of these, 15 patients (16%) were diagnosed with IBD. The TI was successfully intubated in 40 patients, of which 32 patients had colonic biopsies taken as well. 8 patients did not have a colonic biopsy taken. Macroscopic abnormality in the TI was detected in 5 patients, all of whom were biopsied. Based on histological results of the biopsy, 3 patients (12%) were diagnosed with IBD. These 3 patients (100%) also had colonic biopsies taken simultaneously and showed inflammation. None of the patients had a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were not done). None of the patients has a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were negative). Conclusion: TI intubation is a highly-skilled, time-consuming procedure with a higher risk of perforation, which as per our study, has little additional diagnostic value in finding IBD for symptoms of diarrhea if colonic biopsies are taken. We propose that diarrhea is a colonic symptom; therefore, colonic biopsies are positive for inflammation if the diarrhea is secondary to IBD. We conclude that all of the IBDs can be diagnosed simply with colonic biopsies.

Keywords: biopsy, colon, IBD, terminal ileum

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