Search results for: clinical leadership

Authors: Alexey Yu. Martynov, Sulejman Bayramov

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Introduction: The myocardial bridging is the most common anomaly of the coronary arteries (CA). Depending on the examination method, the frequency of detected myocardial bridges (MB) varies in a rather wide range. The typical clinical manifestations of MB are angina pectoris, arrhythmias, sudden cardiac death. Objective: To study the incidence of MB in patients hospitalized with coronary artery disease (CAD). To assess clinical manifestations of MB in patients admitted with CAD. Materials and methods: A retrospective analysis of 19159 case histories of patients admitted at clinical city hospital in Moscow from 01.01.2018 to 31.12 2019 with CAD was performed. 9384 patients’ coronary angiographies (CAG) were examined for MB. The localization of MB, the degree of coronary contraction by MB, the number of MB, isolated MB and combined with CAD were assessed. The clinical manifestations of MB were determined. Results: MB was detected in 52 patients all with one myocardial bridge. 20 patients with MB have intact CA, and 32 patients have MB combined with CAD. Among 20 patients with intact CA: I degree of MB contraction (up to 50%) was detected in 9 patients. Clinical manifestations in five cases were angina pectoris, in 3 myocardial infarction (MI) - 1 patients with ST segment elevation MI (STEMI), 2 without ST segment elevation MI (NSTEMI), 1 post-infarction cardiosclerosis (PICS). Stable angina II FC in 3, III FC in 1, vasospastic angina (VSA) in 1 patient. II degree of MB contraction (up to 50-70%) was determined in 9 patients: in seven cases angina pectoris was detected, 1 NSTEMI, 1 PICS. Stable angina II FC in 3, III FC in 1, VSA in 3 patients. III degree of MB contraction (> 70%) detected in 2 patients. II FC stable angina in one case, PICS in another. Among 32 patients having MB combined with CAD I degree of MB contraction was observed in 20 patients. Clinical manifestations in 12 cases were angina pectoris in 8 II FC and in 4 III FC, 7 MI 6 with STEMI and 1 NSTEMI, 1 PICS. II degree of MB contraction was detected in 7 patients, 4 of them had angina pectoris, 3 MI 2 with STEMI and 1 NSTEMI. Stable angina II FC in 3, VSA in 1 patients. III degree of MB contraction was diagnosed in five patients. In two cases, II FC and III FC stable angina were observed, 2 MI with STEMI and NSTEMI, 1 PICS. Conclusions: MB incidence is one in 368 patients with CAD. The most common involvement (68%) is MB combined with CA atherosclerotic lesions. MB with intact CA are detected in one-third (32%) of patients. The first-degree MB contraction is most frequent condition. MI is more often detected in intact CA with first degree MB than in the second degree. The degree of MB contraction was not correlated with the severity of the clinical manifestations.

Keywords: clinical manifestations, coronary angiography, coronary artery disease, myocardial bridging, myocardial infarction, stable angina

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Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan

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INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.

Keywords: audit, clinical, radiotherapy, improving functionality

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Authors: Ahmet Emre Yonder

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The concept of present time is inevitably and rapidly changing. That provokes unbalanced, uncertain and elusive platform in the world order. Keeping up with this fluctuation requires a willingness to step beyond the comfort zones and to take a step through unknown. That is the perspectives of organizations in which the shareholders persistently create and then they share their creation. Moreover they are adapted to the unpredictable shifts and they establish vision. These are the meaning of innovation which is a process that converts new ideas to invaluable outcomes and that process can be ensured via innovative leaders. Leaders’ creativity is needed when challenging against countless complicated and unsteady situations in the battlefield. However, little attention has been paid to the importance of being innovative leader apart from innovating new technologies so far. Additionally, in most situation militarist organizations are hesitant to welcome different attitudes and that may discourage new ideas. Furthermore military leaders may complain about the lack of sources in today's world where the sources are very rare. In that point military leaders should change the strategies they apply from conventional views to the innovation of different point of views. But the constant occupation in Air Forces can be counted as a huge obstacle for innovative thinking. An organizational structure is needed to be developed for solutions of the problems which the creative leaders will encounter.This article focuses on how to raise innovative military leaders with innovative thinking skills and the need for a change from conventional to the innovative leadership in Air Forces. It also gives important suggestions to encourage raising innovative military leaders.

Keywords: air force, creativity, leadership, military, innovation

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Authors: Anita Bela, Marta Juhasz

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Adapting to the always-changing environment comes with complex determinants. The authors are zooming into one aspect only when the current workforce comes with obstacles by being less keen to stay engaged, even short or mid-term, resulting in additional challenges impacting the business performance. Seeing these occurring in practice made the researchers eager to gain a better understanding of the reasons behind. The paper aims to provide an overview of the theoretical background and research methods planned for the different stages of the research. The theoretical part takes the leadership behaviors under lens while the focus is on finding ways to attract and retain those who prefer working under more flexible employment conditions (e.g. contractor, contingent worker, etc.). These are considered as the organizational values and along with the power of people management are having their engaging relevance. The organizational culture (visible or invisible level) is clearly the mirror of the set of shared values guiding all members of the companies towards acceptable behavior. The applied research method, inductive reasoning was selected since the focus and questions raised in this research are results of specific observations made on the employees (various employment types) and leaders of start-ups and corporates. By comparing the similarities and differences, the researchers are hoping to prove the readiness and agility of the start-up culture for the desired leadership behaviours of the current and future workforce against the corporate culture. While exploring the preferences and engaging factors of the 21st-century workforce the data gathering would happen through website analysis – using ATLAS.ti qualitative software – followed by interview sessions where demographics will be collected and preferred leadership behaviors - using the Critical Incident Technique. Moreover, a short engagement survey will be administered to understand the linkage between the organizational culture type and engagement level. To conclude, after gaining theoretical understanding, we will zoom back to the employees to reveal the behaviors to be followed to achieve engagement in an environment where nothing is stable and where the companies always must keep their agile eyes and reactions vivid.

Keywords: leadership behaviours, organizational culture, qualitative analysis, workforce engagement

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Authors: A. Satty, H. Mwambi

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Much clinical trials data-based research are characterized by the unavoidable problem of dropout as a result of missing or erroneous values. This paper aims to review some of the various techniques to address the dropout problems in longitudinal clinical trials. The fundamental concepts of the patterns and mechanisms of dropout are discussed. This study presents five general techniques for handling dropout: (1) Deletion methods; (2) Imputation-based methods; (3) Data augmentation methods; (4) Likelihood-based methods; and (5) MNAR-based methods. Under each technique, several methods that are commonly used to deal with dropout are presented, including a review of the existing literature in which we examine the effectiveness of these methods in the analysis of incomplete data. Two application examples are presented to study the potential strengths or weaknesses of some of the methods under certain dropout mechanisms as well as to assess the sensitivity of the modelling assumptions.

Keywords: incomplete longitudinal clinical trials, missing at random (MAR), imputation, weighting methods, sensitivity analysis

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Authors: Akram Rasheed

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Background: Simulation in the health care field has been increasingly used over the last years in the training of resuscitation and life support practices. It has shown the advantage of improving the decision-making and technical skills through deliberate practice and return demonstration. Local Problem: This article reports on the integration of simulation-based training (SBT) in the training program about proper team dynamics and leadership skills during cardiopulmonary resuscitation (CPR) in the intensive care unit (ICU). Method and Intervention: Training of 180 critical care nurses was conducted using SBT between 1st January and 30th 2020. We had conducted 15 workshops, with the integration of SBT using high fidelity manikins and using demonstration and return-demonstration approach to train the nursing staff about proper team dynamics and leadership skills during CPR. Results: After completing the SBT session, all 180 nurses completed the evaluation form. The majority of evaluation items were rated over 95% for the effectiveness of the education; four items were less than 95% (88–94%). Lower rated items considered training and practice time, improved competency, and commitment to apply to learn. The team dynamics SBT was evaluated as an effective means to improve team dynamics and leadership skills during CPR in the intensive care unit (ICU). Conclusion: The use of simulation-based training to improve team dynamics and leadership skills is an effective method for better patient management during CPR. Besides skills competency, closed-loop communication, clear messages, clear roles, and assignments, knowing one’s limitations, knowledge sharing, constructive interventions, re-evaluating and summarizing, and mutual respect are all important concepts that should be considered during team dynamics training. However, participants reported the need for a repeated practice opportunity to build competency.

Keywords: cardiopulmonary resuscitation, high fidelity manikins, simulation-based training, team dynamics

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Authors: Khalid Alshaikh

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In recent years, leadership, Corporate Governance (CG) and Corporate Social Responsibility (CSR) have been under scrutiny in the Libyan society. Scholars and institutions have commenced investigating the possible resolutions they can arrange to alleviate the economic, social and environmental problems the war has produced. Thus far, these constructs requisite an in-depth reinvestigation, reconceptualization, and analysis to clearly reconstruct their rules and regulations. With the demise of Qaddafi’s regime, levels, degrees, and efforts to apply CG regulations have varied in public and private commercial banks. CSR is a new organizational culture that still designs its route within these financial institutions. Detaching itself from any notion of dictatorship and autocratic traits, leadership counts on transformational and transactional styles. Therefore, this paper investigates the extent to which the Board of Directors and Chief Executive Officers (CEOs) redefine these concepts and how they entrench CSR within the framework of CG. The research methodology used both public and private banks as a case study and qualitative research to interview ten Board of Directors (BoDs) and eleven Chief executive managers to explore how leadership, CG, and CSR are defined and how leadership integrates CSR into CG structures. The findings suggest that the CG framework in Libya still requires great efforts to be developed. Full CG code implementation appears daunting. Also, the CSR is still influenced by the power of religion. Nevertheless, the Islamic perspective is more consistent with the social contract concept of the CSR. The Libyan commercial banks do not solely focus on the economic side of maximizing profits, but also concentrate on its morality. The issue is that CSR activities are not enough to achieve good charity publicly and needs strategies to address major social issues. Moreover, leadership is more transformational and transactional and endeavors to make economic, social and environmental changes, but these changes are curtailed by tradition and traditional values dominating the Libyan social life where religious and tribal practices establish the relationship between leaders and their subordinates. Finally, the findings reveal that transformational and transactional leadership styles encourage the incorporation of CSR into the CG regulations. The boardroom and executive management have such a particular role in flagging up how embedded corporate Social responsibility is in organizational culture across the commercial banks, yet it is still important that the BoDs and CEOs need to do much more to embed corporate social responsibility through their core functions. They need to boost their standing to be more influential and make sure that the right discussions about CSR happen with the right stakeholders involved.

Keywords: board of directors, chief executive officers, corporate governance, corporate social responsibility

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Authors: Saeed Musaid H. Alzahrani

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The role of middle leaders, especially in primary schools, is a multi-faced role that has been subject to changes in nature over recent decades, with claims for more distributed leadership practices. This research examines the way 18 middle leaders in Saudi and English primary schools conceptualise their roles and responsibilities, and different factors influencing those roles and responsibilities. It begins from the premise that both the power of the role and the values of middle leaders are grounded in cultural and political bases, a belief held by the researcher as an 'insider' within the Saudi educational leadership context. The study consisted of a comparative analysis of the role and the responsibilities of middle leaders in Saudi primary schools and their equivalents in English primary schools. A purely qualitative methodological stance was adopted, using in-depth face-to-face semi-structured interviews, observations and document analysis. Middle leaders were asked to reflect deeply on their perceptions and understanding of their roles and explain what they thought influenced their daily practices and responsibilities. The findings suggest that the concept of middle leadership has been influenced by power imposed from above by political authority, via internal and external hierarchical structures, which shapes the nature of the role of the middle leaders and forces them to comply. Middle leaders seem to believe they have the power to make decisions and promote change, but these findings suggest that this is illusory. The power that keeps middle leaders performing is the power of their cultural and religious values. Those values are the resource to which they turn in their search for more energy when they lack support and are short of time taken. Middle leaders in Saudi, just like their equivalents in English schools must comply with the requirements of their role. However, Saudi middle leaders are given no leeway to make decisions or implement change, neither do they have the culture of collegiality that seems to give middle leaders in England more power over their resources and decisions. However, in neither educational setting have middle leaders been given the power to lead, so they remain managers rather than leaders. The findings of this research suggest that there are more similarities between the educational settings of Saudi and England than differences; and in the light of different factors identified in the study, suggest the establishment of a framework for middle leadership, in the hope of enhancing the way the role is practiced.

Keywords: middle leader, primary school, power, educational leadership, value, culture, model, Saudi Arabia, England

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Authors: Naziema Begum Jappie

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This paper explores the relationship between educational transformation and gender equity in higher education. It draws on various policies and experiences and investigates the paradox of increased female leadership in higher education and the persistence of gender discrimination in the sphere of work. The paper will also address specific aspects of culture and education in post-colonial South Africa. Traditional features of past education systems were not isolated, they became an essential component of the education system, post-democracy. This is currently contested through the call for decolonizing the education system. The debates and discussions seek to rectify the post-colonial education structure within which women suffered triple oppression. Using feminist critical policy analysis and post-colonial theory, the paper examines how transformation over the past two decades has impacted on gender equity and how educational reform is itself gendered. It considers the nature of gender restructuring and key developments in gender equity policy. The social inequality in education is highlighted throughout this discussion. Through an analysis of research and interviews, this paper argues that gender can no longer be privileged when identifying and responding to educational and workplace inequality. In conclusion, the paper discusses the important assumptions that support how social and educational change deliver equity and how social justice may inform equity policy and practice in a culturally diverse educational framework.

Keywords: culture, educational leadership, gender inequality in the workplace, policy implementation

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Authors: Sujata Chaturvedi, Ishita Pant, Deepak Kumar Jha, Vinod Kumar Singh Gautam, Chandra Bhushan Tripathi

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Objective: To describe clinical, histopathological and immunohistochemical profile of glioblastoma in patients and to correlate these findings with patient survival. Material and methods: 30 cases of histopathologically diagnosed glioblastomas were included in this study. These cases were analysed in detail for certain clinical and histopathological parameters. Immunohistochemical staining for p53, epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), mouse double minute 2 homolog (MDM2) and Ki67 was done and scores were calculated. Results of these findings were correlated with patient survival. Results: A retrospective analysis of the histopathology records and clinical case files was done in 30 cases of glioblastoma (WHO grade IV). The mean age of presentation was 50.6 years with a male predilection. The most common involved site was the frontal lobe. Amongst the clinical parameters, age of the patient and extent of surgical resection showed a significant correlation with the patient survival. Histopathological parameters showed no significant correlation with the patient survival, while amongst the immunohistochemical parameters expression of MDM2 showed a significant correlation with the patient survival. Conclusion: In this study incorporating clinical, histopathological and basic panel of immunohistochemistry, age of the patient, extent of the surgical resection and expression of MDM2 showed significant correlation with the patient survival.

Keywords: glioblastoma, p53, EGFR, VEGF, MDM2, Ki67

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Authors: Rashi Mahato

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Talent management represents an organization’s effort to attract, develop and retain highly skilled and valuable employees. The goal is to have people with capabilities and commitment needed for current and future organizational success. The organizational talent pool is its managerial talent referred to as leadership pipeline. It is managed through various systems and processes to help the organization source, reward, evaluate, develop and move employees into various functions and roles. The pipeline bends, turns, and sometimes breaks as organizations identify who is 'ready now' and who is 'on track' for larger leadership roles. From this perspective, talent management designs structured approach and a robust mechanism for high potential employees to meet organization’s needs. The paper attempts to provide a roadmap and a structured approach towards building a high performing organization through well-defined career path. Managers want career paths to be defined, so that an adequate number of individuals may be identified and prepared to fill future vacancies. Once career progression patterns are identified, more systematic forecasting of talent requirements is possible. For the development of senior management talent or leadership team, career paths are needed as guidelines for talent management across functional and organizational lines. Career path is one of the important tools for talent management and aligning talent with business strategy. This paper briefly describes the approach for career path and the concept of

Keywords: career path, career path framework, lateral movement, talent management

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Authors: C. W. F. Che Wan Putra, M. Alshawi, M. S. Al Ahbabi, M. Jabakhanji

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The construction industry is a multi-disciplinary and multi-national industry, which has an important role to play within the overall economy of any country. There are major challenges to an improved performance within the industry. Particularly lacking is, the ability to capture the large amounts of information generated during the life-cycle of projects and to make these available, in the right format, so that professionals can then evaluate alternative solutions based on life-cycle analysis. The fragmented nature of the industry is the main reason behind the unavailability and ill utilisation of project information. The lack of adequately engaging clients and managing their requirements contributes adversely to construction budget and schedule overruns. This is a difficult task to achieve, particularly if clients are not continuously and formally involved in the design and construction process, which means that the design intent is left to designers that may not always satisfy clients’ requirements. Client lead is strongly recognised in bringing change through better collaboration between project stakeholders. However, one of the major challenges is that collaboration is operated under conventional procurement methods, which hugely limit the stakeholders’ roles and responsibilities to bring about the required level of collaboration. A research has been conducted with a typical project in the UAE. A qualitative research work was conducted including semi-structured interviews with project partners to discover the real reasons behind this delay. The case study also investigated the real causes of the problems and if they can be adequately addressed by BIM and IPD. Special focus was also placed on the Client leadership and the role the Client can play to eliminate/minimize these problems. It was found that part of the ‘key elements’ from which the problems exist can be attributed to the client leadership and the collaborative environment and BIM.

Keywords: client leadership, building information modelling (BIM), integrated project delivery (IPD), case study

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Authors: Ligia Alberto

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This study examined the underrepresentation of women of color in school leadership roles. Using social capital as the theoretical framework, this study explored the role of mentoring relationships in the career advancement and promotion of Latina school leaders. This study showed that informal mentoring relationships are essential to the promotion of women of color. Most of the mentoring relationships were established through close work with their immediate supervisors. This study suggests having informal mentors facilitated Latina women's aspirations to become school leaders and counteract the pattern of underrepresentation of Latinas in such roles.

Keywords: women of color, school leadership, social capital, mentoring

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Authors: Lisa Fox, Jill Aylott

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There is a global need to identify ways to engage doctors in non-clinical matters such as medical leadership, service improvement and health system transformation. Using the core principles of Realistic Evaluation (RE), this study examined what works, for doctors of different grades, specialities and experience in an acute NHS Hospital Trust in the UK. Realistic Evaluation is an alternative to more traditional cause and effect evaluation models and seeks to understand the interdependencies of Context, Mechanism and Outcome proposing that Context (C) + Mechanism (M) = Outcome (O). In this study, the context, mechanism and outcome were examined from within individual medical leaders to determine what enables levels of medical engagement in a specific improvement project to reduce hospital inpatient mortality. Five qualitative case studies were undertaken with consultants who had regularly completed mortality reviews over a six month period. The case studies involved semi-structured interviews to test the theory behind the drivers for medical engagement. The interviews were analysed using a theory-driven thematic analysis to identify CMO configurations to explain what works, for whom and in what circumstances. The findings showed that consultants with a longer length of service became more engaged if there were opportunities to be involved in the beginning of an improvement project, with more opportunities to affect the design. Those that are new to a consultant role were more engaged if they felt able to apply any learning directly into their own settings or if they could use it as an opportunity to understand more about the organisation they are working in. This study concludes that RE is a useful methodology for better understanding the complexities of motivation and consultant engagement in a trust wide service improvement project. The study showed that there should be differentiated and bespoke training programmes to maximise each individual doctor’s propensity for medical engagement. The RE identified that there are different ways to ensure that doctors have the right skills to feel confident in service improvement projects.

Keywords: realistic evaluation, medical leadership, medical engagement, patient safety, service improvement

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Authors: Emad Matar Alotaibi

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In line with other Arabic countries, Saudi Arabia is currently undergoing large scale school reform in response to key factors brought about by globalization. While there is a growing body of research exploring these systemic changes in urban environments, there is very little published research regarding rural schools. In fact, rural schools are still under-examined globally comparing to their urban and suburban counterparts over a range of reform dimensions. In Saudi Arabia, there are around 1128 rural areas that contain about 3200 schools. Several challenges face rural schools, especially in relation to recruitment, retention, and professional development opportunities for teachers and school leaders. However, there is very little in depth research which explores these issues “on the ground”. The aim of this research is fill this knowledge gap and explore teachers’ and leaders’ perceptions and experiences of working in rural schools in KSA. In Saudi Arabia, there is a growing body of research into school leadership. However, there is very little published research specifically exploring rural schools. By using an in-depth case study approach and adopting an analytical framework based on the interlinking concepts of leadership practices, culture, and CPD, this study offers and significant and original contribution to knowledge in this area. This study also will adopt a qualitative multiple case studies, which is going to employ semi-structured interviews, focus groups, and documentary analysis.

Keywords: leadership practice, school culture, continuing professional development, rural school

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Authors: Wafaa M. El- Kotb, Soheir Mohamed Weheida, Manal E. Fareed

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The aim of this study was to determine the effect of implementing a teaching module about diet and exercises on clinical outcomes of patients with gout. Subjects: A purposive sample of 60 adult gouty patients was selected and randomly and alternatively divided into two equal groups 30 patients in each. Setting: The study was conducted in orthopedic out patient's clinic of Menoufia University. Tools of the study: Three tools were utilized for data collection: Knowledge assessment structured interview questionnaire, Clinical manifestation assessment tools and Nutritional assessment sheet. Results: All patients of both groups (100 %) had poor total knowledge score pre teaching, while 90 % of the study group had good total knowledge score post teaching by three months compared to 3.3 % of the control group. Moreover the recovery outcomes were significantly improved among study group compared to control group post teaching. Conclusion: Teaching study group about diet and exercises significantly improved their clinical outcomes. Recommendation: Patient's education about diet and exercises should be ongoing process for patients with gout.

Keywords: clinical outcomes, diet, exercises, teaching module

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Authors: Tan Xin Zhong Timothy, Chang Chen Jie Victor, Yew Kwan Tong, Lim Geok Peng Sandy

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Background: Leaders in crisis response teams such as Trauma Teams in hospitals are essential to the effective coordination and direction of the team. The response to emergency trauma situations must be accurate, rapid, and well executed. To this end, the team leader’s social, technical and leadership skills are essential factors that implicate the success of an emergency trauma intervention. While each emergency trauma case varies in severity and complexity, and the experience and expertise of team leaders may vary, it would be productive to identify certain coordinative and directive functions that improve the capacity for leading a team. Methods: This qualitative study of Trauma Team physicians in Singapore General Hospital (SGH) involved 50 in-depth interviews with doctors and nurses involved in Trauma Team activations, observations of Trauma Teams managing emergency patients, and reviews of audio/video recordings of 65 trauma activations. The interviews were conducted with doctors of various ranks across the relevant departments, 12 from the Emergency Department (ED), 11 from General Surgery (GS) and 8 from Orthopaedics, while the 6 nurses were from ED. In accordance with the grounded theory approach, the content of the interviews was coded and analysed in order to derive broad leadership themes that corresponded with certain behavioural traits exhibited by trauma team leaders, supplemented with the observational and audio/video data. Results: The leadership behaviours of the team leaders could be typified into three broad categories: team orientation, engagement and activeness. Team orientation corresponds with the source and form of cognitive responsibility, decision-making and informational contributions, divisible into individualistic and consultative sub-categories. Engagement refers to the type of activity that leaders prefer to engage in, and which implicates their attentional focus, divisible into participatory and supervisory sub-categories. Activeness is a function of the leader’s attitudes towards the behavioural regulation of the team, which manifests in inactivity or activity to augment or merely align with protocol. These factors are not exhaustive and are contextually sensitive, but collectively implicate a significant portion of the leadership activity observed in trauma teams.

Keywords: trauma team activations, critical event management, leadership, teamwork

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Authors: Saeed Musaid Alzahrani

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Shared values, beliefs, norms and assumptions within the organisation can affect personal and team effectiveness. Organisational culture can also affect the performance of organisational members. The nature of middle leadership in a primary school is largely influenced by organizational culture. The effectiveness of middle leadership in primary schools and their performance is strongly determined by the circumstances in which they work and can be political or institutional. This study aims to examine the influence of organisational culture and government policy on the performance and effectiveness of middle managers, using the English and Saudi education systems as case studies. To examine how education policy conditions educational discourse, and answer the research questions, there is a need to collect qualitative data on middle manager’s perceptions and experiences in the English and Saudi Arabian contexts. The study involved a qualitative and interpretative approach. In-depth interviews with 6 middle managers and school supervisors in 3 English primary schools and 6 middle managers in 3 Saudi Arabian primary schools were conducted to answer the research questions. The study also included ethnographic tools such as observations of a sample of three primary schools in both England and Saudi Arabia where the researcher observed middle managers’ interactions with their peers. The sample of three enabled the study to identify trends and make comparisons between leadership approaches in both systems based on observations without the bias of prescriptions. The use of ethnographic tools not only makes the study empirical but also increases the reliability and validity of the findings by reducing prescriptive bias. The observations will be triangulated with the results of the interviews to draw comparisons and conclusions on whether middle managers act as leaders or as followers in their respective political contexts.

Keywords: education management, government education policies, middle managers, organisational culture

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Authors: Eun Jeong Yu, Inn Soo Kang, Tae Ki Yoon, Mi Kyoung Koong

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Advanced female age is associated with higher cycle cancelation rates, lower clinical pregnancy rate, increased miscarriage and aneuploidy rates in IVF (In Vitro Fertilization) cycles. This retrospective cohort study was conducted at a Cha Fertility Center, Seoul Station. All fresh non-donor IVF cycles performed in women aged 40 years and above from January 2016 to December 2016 were reviewed. Donor/recipient treatment, PGD/PGS (Preimplantation Genetic Diagnosis/ Preimplantation Genetic Screening) were excluded from analysis. Of the 1,166 cycles from 753 women who completed ovulation induction, 1,047 were appropriate for the evaluation according to inclusion and exclusion criterion. IVF cycles were categorized according to age and grouped into the following 1-year age groups: 40, 41, 42, 43, 44, 45 and > 46. The mean age of patients was 42.4 ± 1.8 years. The median AMH (Anti-Mullerian Hormone) level was 1.2 ± 1.5 ng/mL. The mean number of retrieved oocytes was 4.9 ± 4.3. The clinical pregnancy rate and live birth rate in women > 40 years significantly decreased with each year of advancing age (p < 0.001). The clinical pregnancy rate decreased from 21% at the age of 40 years to 0% at ages above 45 years. Live birth rate decreased from 12.3% to 0%, respectively. There were no clinical pregnancy outcomes among 95 patients aged above 45 years of age. The overall miscarriage rate was 40.7% (range, 36.7%-70%). The transfer of at least one good quality embryo was associated with about 4-9% increased chance of a clinical pregnancy rate. Therefore, IVF in old age women less than 46 had a reasonable chance for successful pregnancy outcomes especially when good quality embryo is transferred.

Keywords: advanced maternal age, in vitro fertilization, pregnancy rate, live birth rate

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Authors: Olubunmi Kolawole

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This study explored how certain organizational antecedents like work environment, and individual antecedents (e.g. job level and tenure) could affect employees empowerment in the hospitality industry. A total of 200 valid responses from a survey conducted in 10 hotels in Lagos Nigeria were received. Data were analyzed using frequency distribution and percentage analysis. Findings suggest that leadership, work environment, as well as tenure and level in the organization are reliable predictors of employees empowerment in Nigeria's hotel sector. Empowerment is a major factor which determines how employees feel about themselves and their jobs. The study concluded that organizations need to learn that an empowered employee will put in superior performance which would positively impact on the organization.

Keywords: employee empowerment, hospitality industry, individual-level antecedents, leadership, organizational antecedents

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Authors: Jam Harley

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The COVID-19 epidemic accelerated the speed of change in the workplace. Overnight, several individuals shifted from co-location in an office to hybrid or remote work. The pandemic also expedited and intensified the need to address persistent leadership and management concerns, including digital transformation, remote management, leading through fast change, anxiety, and uncertainty. Nonetheless, many leaders have failed to address the problems left behind by the epidemic. In a fundamental work devoted to comprehending what constitutes a human need, Maslow reiterates similar descriptors in his explanation of belongingness as the human need to be accepted, acknowledged, respected, and appreciated by a community of other individuals. This study aims to investigate the lived experiences of dispersed hybrid team members in order to find leadership best practices that improve team performance and retention through an increased individual’s sense of belonging.

Keywords: organizational change, belonging, diversity, equity

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Authors: Meghan E. Murray, Carri R. Tolmie

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This study aims to identify potential factors and widely applicable best practices that can contribute to improving corporate social responsibility (CSR) and corporate performance for firms by exploring the relationship between transformational leadership, spiritual intelligence, and emotional intelligence. Corporate social responsibility is when companies are cognizant of the impact of their actions on the economy, their communities, the environment, and the world as a whole while executing business practices accordingly. The prevalence of CSR has continuously strengthened over the past few years and is now a common practice in the business world, with such efforts coinciding with what stakeholders and the public now expect from corporations. Because of this, it is extremely important to be able to pinpoint factors and best practices that can improve CSR within corporations. One potential factor that may lead to improved CSR is spiritual intelligence (SQ), or the ability to recognize and live with a purpose larger than oneself. Spiritual intelligence is a measurable skill, just like emotional intelligence (EQ), and can be improved through purposeful and targeted coaching. This research project consists of two studies. Study 1 is a case study comparison of a benefit corporation and a non-benefit corporation. This study will examine the role of SQ and EQ as moderators in the relationship between the transformational leadership of employees within each company and the perception of each firm’s CSR and corporate performance. Project methodology includes creating and administering a survey comprised of multiple pre-established scales on transformational leadership, spiritual intelligence, emotional intelligence, CSR, and corporate performance. Multiple regression analysis will be used to extract significant findings from the collected data. Study 2 will dive deeper into spiritual intelligence itself by analyzing pre-existing data and identifying key relationships that may provide value to companies and their stakeholders. This will be done by performing multiple regression analysis on anonymized data provided by Deep Change, a company that has created an advanced, proprietary system to measure spiritual intelligence. Based on the results of both studies, this research aims to uncover best practices, including the unique contribution of spiritual intelligence, that can be utilized by organizations to help enhance their corporate social responsibility. If it is found that high spiritual and emotional intelligence can positively impact CSR effort, then corporations will have a tangible way to enhance their CSR: providing targeted employees with training and coaching to increase their SQ and EQ.

Keywords: corporate social responsibility, CSR, corporate performance, emotional intelligence, EQ, spiritual intelligence, SQ, transformational leadership

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Authors: Dilek Bilgiç

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Configuration Management (CM) is a discipline assuring the consistency between product information the reality all along the product lifecycle. Although the extensive benefits of this discipline, such as the direct impact on increasing return on investment, reducing lifecycle costs, are realized by most organizations. It is worth evaluating that CM functions might be successfully implemented in some organized anarchies. This paper investigates how to manage ambiguity in CM processes as an opportunity within an environment that has different types of complexities and choice arenas. It is not explained how to establish a configuration management organization in a company; more specifically, it is analyzed how to apply configuration management processes when different types of streams exist. From planning to audit, all the CM functions may provide different organization learning opportunities when those applied with the right leadership methods.

Keywords: configuration management, leadership, organizational analysis, organized anarchy, cm process, organizational learning, organizational maturity, configuration status accounting, leading innovation, change management

Procedia PDF Downloads 190

Authors: R. Tariq, R. Lee

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Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.

Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation

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Authors: ZeinolAbedin Rahmani, Marzieh Evazi Borazjani, Nooshin Salehi

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Organizations are increasingly facing changes and developments scientific, technological, social, cultural changes among these organizations those ones are reckoned successful and effective that in addition to coordinating the development of modern society can forecast future changes and be able to accommodate these changes in order to create favorable developments to build a better future. But we can change that with the changes that occur in the organization of the program it will distinguish. Today's organizations need leaders that change and grow them have to survive. In fact, without transformational managers and leaders, it is certainly difficult to create changes in organizations. Both private and public organizations need to increase knowledge and awareness of the cause widespread changes in the structure, culture and practice for the viability and sustainability of life and growth and development. By now, different signs have determined different causes for a suitable function of employees. However, the important thing is that the commitment of the employees to their organization has always been very important. Since the decrease of organization commitment causes the high rate of absenteeism, turnover intentions, and even to reduce the impact of health staff. and these factors prevent organizations from achieving its goals. If organizations want to retain staff, the organization must find a way to be happy and continue their work with commitment, motivation, and willingness. So here is the need for strong leaders, analysts, creative and transformational upper ranks more than ever is felt. The aim of this study is to revise history, the leadership style of managers shipbuilding company by using the MLQ model.

Keywords: leadership style, managers, organizational, manufacturing company, sustainability of life

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Authors: Petronella Jonck, Freda van der Walt

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Despite the benefits of innovation diffusion in the South African public service, implementation thereof seems to be problematic, particularly with regard to e-governance which would enhance the quality of service delivery, especially accessibility, choice, and mode of operation. This paper reports on differences between the public service and the private sector in terms of innovation diffusion. Innovation diffusion will be investigated to explore identified obstacles that are hindering successful implementation of e-governance. The research inquiry is underpinned by the diffusion of innovation theory, which is premised on the assumption that innovation has a distinct channel, time, and mode of adoption within the organisation. A comparative thematic document analysis was conducted to investigate organisational differences with regard to innovation diffusion. A similar approach has been followed in other countries, where the same conceptual framework has been used to guide document analysis in studies in both the private and the public sectors. As per the recommended conceptual framework, three organisational characteristics were emphasised, namely the external characteristics of the organisation, the organisational structure, and the inherent characteristics of the leadership. The results indicated that the main difference in the external characteristics lies in the focus and the clientele of the private sector. With regard to organisational structure, private organisations have veto power, which is not the case in the public service. Regarding leadership, similarities were observed in social and environmental responsibility and employees’ attitudes towards immediate supervision. Differences identified included risk taking, the adequacy of leadership development, organisational approaches to motivation and involvement in decision making, and leadership style. Due to the organisational differences observed, it is recommended that differentiated strategies be employed to ensure effective innovation diffusion, and ultimately e-governance. It is recommended that the results of this research be used to stimulate discussion on ways to improve collaboration between the mentioned sectors, to capitalise on the benefits of each sector.

Keywords: E-governance, ICT, innovation diffusion, comparative analysis

Procedia PDF Downloads 328

Authors: Moon Jung Kim, Guil Rhim

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The clinical sensitivity of the “VEUPLEXTM TBI assay”, a clinical trial medical device, in mild traumatic brain injury was 28.6% (95% CI, 19.7%-37.5%), and the clinical specificity was 94.0% (95% CI, 89.3%). -98.7%). In addition, when the results analyzed by marker were put together, the sensitivity was higher when interpreting the two tests together than the two tests, UCHL1 and GFAP alone. Additionally, when sensitivity and specificity were analyzed based on CT results for the mild traumatic brain injury patient group, the clinical sensitivity for 2 CT-positive cases was 50.0% (95% CI: 1.3%-98.7%), and 19 CT-negative cases. The clinical specificity for cases was 68.4% (95% CI: 43.5% - 87.4%). Since the low clinical sensitivity for the two CT-positive cases was not statistically significant due to the small number of samples analyzed, it was judged necessary to secure and analyze more samples in the future. Regarding the clinical specificity analysis results for 19 CT-negative cases, there were a large number of patients who were actually clinically diagnosed with mild traumatic brain injury but actually received a CT-negative result, and about 31.6% of them showed abnormal results on VEUPLEXTM TBI assay. Although traumatic brain injury could not be detected in 31.6% of the CT scans, the possibility of actually suffering a mild brain injury could not be ruled out, so it was judged that this could be confirmed through follow-up observation of the patient. In addition, among patients with mild traumatic brain injury, CT examinations were not performed in many cases because the symptoms were very mild, but among these patients, about 25% or more showed abnormal results in the VEUPLEXTM TBI assay. In fact, no damage is observed with the naked eye immediately after traumatic brain injury, and traumatic brain injury is not observed even on CT. But in some cases, brain hemorrhage may occur (delayed cerebral hemorrhage) after a certain period of time, so the patients who did show abnormal results on VEUPLEXTM TBI assay should be followed up for the delayed cerebral hemorrhage. In conclusion, it was judged that it was difficult to judge mild traumatic brain injury with the VEUPLEXTM TBI assay only through clinical findings without CT results, that is, based on the GCS value. Even in the case of CT, it does not detect all mild traumatic brain injury, so it is difficult to necessarily judge that there is no traumatic brain injury, even if there is no evidence of traumatic brain injury in CT. And in the long term, more patients should be included to evaluate the usefulness of the VEUPLEXTM TBI assay in the detection of microscopic traumatic brain injuries without using CT.

Keywords: brain injury, traumatic brain injury, GFAP, UCHL1

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Authors: Pornthip Seangsanga

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Sepsis or septic shock needs urgent care because it is a cause of the high mortality rate if patients do not receive timely treatment. Songkhla Hospital does not have a clear system or clinical practice guidelines for treatment of patients with severe sepsis or septic shock, which contributes to the said problem.To compare clinical outcomes based on the protocol after using the clinical guidelines between the Emergency Room, Intensive Care Unit, and the Ward. This quasi-experimental study was conducted on the population and 50 subjects who were diagnosed with severe sepsis or septic shock from December 2013 to May 2014. The data were collected using a nursing care and referring record form for patients with severe sepsis or septic shock at Songkhla Hospital. The record form had been tested for its validity by three experts, and the IOC was 1.The mortality rate in patients with severe sepsis or septic shock who were moved from the ER to the ICU was significantly lower than that of those patients moved from the Ward to the ICU within 48 hours. This was because patients with severe sepsis or septic shock who were moved from the ER to the ICU received more fluid within the first six hours according to the protocol which helped patients to have adequate tissue perfusion within the first six hours, and that helped improve blood flow to the kidneys, and the patients’ urine was found to be with a higher quantity of 0.5 cc/kg/hr, than those patients who were moved from the Ward to the ICU. This study shows that patients with severe sepsis or septic shock need to be treated immediately. Using the clinical practice guidelines along with timely diagnosis and treatment based on the sepsis bundle in giving sufficient and suitable amount of fluid to help improve blood circulation and blood pressure can clearly prevent or reduce severity of complications.

Keywords: clinical practice guidelines, caring, septic shock, sepsis bundle protocol

Procedia PDF Downloads 274

Authors: Sanaa Mekdad, Leenah Alsayed

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Pharmacists play an important role in the CDTM in the care of patients with heart failure (HF). CDTM allows specialized, dedicated clinical pharmacists in a formal agreement in collaborative practice with physicians. Thus, the aim of this study is to investigate the role of cardiology clinical pharmacists in CDTM in decreasing hospitalization and cost. We studied patients with left ventricular systolic dysfunction in a cluster-randomized selection in a tertiary care center. We allocated 296 patients to pharmacist intervention from 1480 patients. Results: With an acceptance rate of 86%, we documented 696 interventions carried out by clinical pharmacists in cardiology. The average intervention was 2.4 patients, and the admission after interventions decreased from 0.79 to. 0.24 (p value = 0.001). Conclusions: In HF CDTM, clinical pharmacists play a crucial role in enhancing medication management, patient education, and lifestyle modification of patients with chronic heart failure. These efforts improve patients' outcomes and lower costs by reducing hospitalization and other associated expenses.

Keywords: cardiology, medication management, heart failure, outpatient therapy, pharmacist-based services, chronic heart failure, heart failure recommendations, CDTM, Middle East, pharmacist-based services, quality of life, pharmacist

Procedia PDF Downloads 48

Authors: Li-Fang CHou, Chun-Jung Tseng, Sung-Chun Tsai

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Zhong-Yong represents unique values and cognitive beliefs of Chinese culture. Zhong-Yong thinking emphasizes (a) holistic thinking and perspective taking, (b) tolerance of contradictions, and (c) pursuance of a person’s interpersonal and inner harmony. With a unique way of naïve dialectical thinking based on Chinese culture, previous studies have found that people with higher Zhong-Yong thinking have more cognitive resources and resilience to make decision for dilemmas and cope stresses. Creativity is defined as the behavior to create novel and value products and viewed as the most important capital for individuals and enterprises. However, the relationship between Zhong-Yong thinking and creativity is still remaining to be unexplored. Three studies were conducted to explore the effects of Zhong-Yong thinking on creativity. In Study1, with 87 undergraduate students from a university in southern Taiwan as participants, we used questionnaire to measure Zhong-Yong thinking and processed creative task (unusual uses task) to get indicators of fluency and flexibility. After controlling background and openness to experience of Big five, the results showed that Zhong-Yong thinking had significant positive effects on fluency and flexibility. In Study 2, 97 undergraduate students were recruited to do Zhong-Yong thinking task and creative task. The result showed that, compared with control group, the participants had higher creative performance after being primed with Zhong-Yong thinking. In Study 3, we adopted questionnaire survey and took 397 employees from private enterprises in Taiwan as sample. Besides the main effects of Zhong-Yong thinking, the moderating effects on the relationship between leadership behavior and employee’s creative performance were also investigated. We found that (a) Zhong-Yong thinking was positively associated to creative performance; (b) Zhong-Yong thinking strengthened the positive effects of transformational and authoritative leadership on creative performance. Finally, the implications of theory/practice and limitations/future directions were also discussed.

Keywords: Zhong-Yong thinking, creativity and creative performance, unusual uses task, transformational leadership, authoritative leadership

Procedia PDF Downloads 545