Search results for: managing
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1109

Search results for: managing

989 A Rare Case of Synchronous Colon Adenocarcinoma

Authors: Mohamed Shafi Bin Mahboob Ali

Abstract:

Introduction: Synchronous tumor is defined as the presence of more than one primary malignant lesion in the same patient at the indexed diagnosis. It is a rare occurrence, especially in the spectrum of colorectal cancer, which accounts for less than 4%. The underlying pathology of a synchronous tumor is thought to be due to a genomic factor, which is microsatellite instability (MIS) with the involvement of BRAF, KRAS, and the GSRM1 gene. There are no specific sites of occurrence for the synchronous colorectal tumor, but many studies have shown that a synchronous tumor has about 43% predominance in the ascending colon with rarity in the sigmoid colon. Case Report: We reported a case of a young lady in the middle of her 30's with no family history of colorectal cancer that was diagnosed with a synchronous adenocarcinoma at the descending colon and rectosigmoid region. The lady's presentation was quite perplexing as she presented to the district hospital initially with simple, uncomplicated hemorrhoids and constipation. She was then referred to our center for further management as she developed a 'football' sized right gluteal swelling with a complete intestinal obstruction and bilateral lower-limb paralysis. We performed a CT scan and biopsy of the lesion, which found that the tumor engulfed the sacrococcygeal region with more than one primary lesion in the colon as well as secondaries in the liver. The patient was operated on after a multidisciplinary meeting was held. Pelvic exenteration with tumor debulking and anterior resection were performed. Postoperatively, she was referred to the oncology team for chemotherapy. She had a tremendous recovery in eight months' time with a partial regain of her lower limb power. The patient is still under our follow-up with an improved quality of life post-intervention. Discussion: Synchronous colon cancer is rare, with an incidence of 2.4% to 12.4%. It has male predominance and is pathologically more advanced compared to a single colon lesion. Down staging the disease by means of chemoradiotherapy has shown to be effective in managing this tumor. It is seen commonly on the right colon, but in our case, we found it on the left colon and the rectosigmoid. Conclusion: Managing a synchronous colon tumor could be challenging to surgeons, especially in deciding the extent of resection and postoperative functional outcomes of the bowel; thus, individual treatment strategies are needed to tackle this pathology.

Keywords: synchronous, colon, tumor, adenocarcinoma

Procedia PDF Downloads 76
988 Deep Q-Network for Navigation in Gazebo Simulator

Authors: Xabier Olaz Moratinos

Abstract:

Drone navigation is critical, particularly during the initial phases, such as the initial ascension, where pilots may fail due to strong external interferences that could potentially lead to a crash. In this ongoing work, a drone has been successfully trained to perform an ascent of up to 6 meters at speeds with external disturbances pushing it up to 24 mph, with the DQN algorithm managing external forces affecting the system. It has been demonstrated that the system can control its height, position, and stability in all three axes (roll, pitch, and yaw) throughout the process. The learning process is carried out in the Gazebo simulator, which emulates interferences, while ROS is used to communicate with the agent.

Keywords: machine learning, DQN, Gazebo, navigation

Procedia PDF Downloads 38
987 Project-Based Learning and Evidence Based Nursing as Tools for Developing Students' Integrative Critical Thinking Skills: Content Analysis of Final Students' Projects

Authors: E. Maoz

Abstract:

Background: As a teaching method, project-based learning is strongly linked to developing students’ critical thinking skills. It combines creative independent thinking, team work, and disciplinary subject-field integration. In the 'Introduction to Nursing Research Methods' course (year 3, Generic Track), project based learning is used to teach the topic of 'Evidence-Based Nursing'. This topic examines a clinical care issue encountered by students in the field. At the end of their project, students present proposals for managing the said issue. Proposals are the product of independent integrative thinking integrating a wide range of factors influencing the issue’s management. Method: Papers by 27 groups of students (165 students) were content analyzed to identify which themes emerged from the students' recommendations for managing the clinical issue. Findings: Five main themes emerged—current management approach; adapting procedures in line with current recent research recommendations; training for change (veteran nursing staff, beginner students, patients, significant others); analysis of 'economic benefit vs. patient benefit'; multidisciplinary team engagement in implementing change in practice. Two surprising themes also emerged: advertising and marketing using new technologies, which reflects how the new generation thinks. Summary and Recommendations: Among the main challenges in nursing education is training nursing graduates to think independently, integratively, and critically. Combining PBL with classical teaching methods stimulates students cognitively while opening new vistas with implications on all levels of the profession: management, research, education, and practice. Advanced students can successfully grasp and interpret the current state of clinical practice. They are competent and open to leading change and able to consider the diverse factors and interconnections that characterize the nurse's work.

Keywords: evidence based nursing, critical thinking skills, project based learning, students education

Procedia PDF Downloads 61
986 Selection of Strategic Suppliers for Partnership: A Model with Two Stages Approach

Authors: Safak Isik, Ozalp Vayvay

Abstract:

Strategic partnerships with suppliers play a vital role for the long-term value-based supply chain. This strategic collaboration keeps still being one of the top priority of many business organizations in order to create more additional value; benefiting mainly from supplier’s specialization, capacity and innovative power, securing supply and better managing costs and quality. However, many organizations encounter difficulties in initiating, developing and managing those partnerships and many attempts result in failures. One of the reasons for such failure is the incompatibility of members of this partnership or in other words wrong supplier selection which emphasize the significance of the selection process since it is the beginning stage. An effective selection process of strategic suppliers is critical to the success of the partnership. Although there are several research studies to select the suppliers in literature, only a few of them is related to strategic supplier selection for long-term partnership. The purpose of this study is to propose a conceptual model for the selection of strategic partnership suppliers. A two-stage approach has been used in proposed model incorporating first segmentation and second selection. In the first stage; considering the fact that not all suppliers are strategically equal and instead of a long list of potential suppliers, Kraljic’s purchasing portfolio matrix can be used for segmentation. This supplier segmentation is the process of categorizing suppliers based on a defined set of criteria in order to identify types of suppliers and determine potential suppliers for strategic partnership. In the second stage, from a pool of potential suppliers defined at first phase, a comprehensive evaluation and selection can be performed to finally define strategic suppliers considering various tangible and intangible criteria. Since a long-term relationship with strategic suppliers is anticipated, criteria should consider both current and future status of the supplier. Based on an extensive literature review; strategical, operational and organizational criteria have been determined and elaborated. The result of the selection can also be used to determine suppliers who are not ready for a partnership but to be developed for strategic partnership. Since the model is based on multiple criteria for both stages, it provides a framework for further utilization of Multi-Criteria Decision Making (MCDM) techniques. The model may also be applied to a wide range of industries and involve managerial features in business organizations.

Keywords: Kraljic’s matrix, purchasing portfolio, strategic supplier selection, supplier collaboration, supplier partnership, supplier segmentation

Procedia PDF Downloads 209
985 Development of a Decision Model to Optimize Total Cost in Food Supply Chain

Authors: Henry Lau, Dilupa Nakandala, Li Zhao

Abstract:

All along the length of the supply chain, fresh food firms face the challenge of managing both product quality, due to the perishable nature of the products, and product cost. This paper develops a method to assist logistics managers upstream in the fresh food supply chain in making cost optimized decisions regarding transportation, with the objective of minimizing the total cost while maintaining the quality of food products above acceptable levels. Considering the case of multiple fresh food products collected from multiple farms being transported to a warehouse or a retailer, this study develops a total cost model that includes various costs incurred during transportation. The practical application of the model is illustrated by using several computational intelligence approaches including Genetic Algorithms (GA), Fuzzy Genetic Algorithms (FGA) as well as an improved Simulated Annealing (SA) procedure applied with a repair mechanism for efficiency benchmarking. We demonstrate the practical viability of these approaches by using a simulation study based on pertinent data and evaluate the simulation outcomes. The application of the proposed total cost model was demonstrated using three approaches of GA, FGA and SA with a repair mechanism. All three approaches are adoptable; however, based on the performance evaluation, it was evident that the FGA is more likely to produce a better performance than the other two approaches of GA and SA. This study provides a pragmatic approach for supporting logistics and supply chain practitioners in fresh food industry in making important decisions on the arrangements and procedures related to the transportation of multiple fresh food products to a warehouse from multiple farms in a cost-effective way without compromising product quality. This study extends the literature on cold supply chain management by investigating cost and quality optimization in a multi-product scenario from farms to a retailer and, minimizing cost by managing the quality above expected quality levels at delivery. The scalability of the proposed generic function enables the application to alternative situations in practice such as different storage environments and transportation conditions.

Keywords: cost optimization, food supply chain, fuzzy sets, genetic algorithms, product quality, transportation

Procedia PDF Downloads 191
984 The Ambivalent Dealing with Diversity: An Ethnographic Study of Diversity and Its Different Faces of Managing in a Mixed Neighborhood in Germany

Authors: Nina Berding

Abstract:

Migration and the ensuing diversity are integral parts of urban societies. However, engaging with the urban society and its diversification is rarely perceived as something trivial but rather as a difficult task and a major challenge. A central aspect of the discourse is the current migration of refugees from countries of the southern hemisphere to Europe and the resulting challenges for cities, their municipalities and the civil society as a whole. Based on exploratory field research in a German inner-city neighborhood, it is aimed to show that the discourses about migration and diversity are completely contrary to the everyday life actions of the urban society. Processes of migration that include leaving one’s hometown and moving to other places, searching for ‘safe’ environments or better opportunities are, historically speaking, not a new phenomenon. The urban dwellers have a large repertoire of strategies in managing processes of difference in everyday life situations, guided them well for centuries and also in these contemporary processes with an increased mobility and diversity. So there is obviously a considerable discrepancy between what is practically lived in everyday life, and how it is talked about. The results of the study demonstrate that the current discourse about the challenges of migration seems to legitimize interventions beyond humanist approaches where migrants serve as collective scapegoats for social problems and affected by different discrimination and criminalization processes. On the one hand, everyone takes advantage of the super-mobility and super-diversity in their daily lives and on the other hand, powerful stakeholders and designated authorities operate a sort of retro- nationalism and identity collectivism. Political players, the municipalities and other stakeholders then follow an urban public policy that takes actions (increasing police presence, concepts and activities for special groups, exclusion from active social life, preventing participation etc.) towards different ‘groups’ of residents, produced along ‘ethnic’ lines. The results also show that, despite the obstacles and adversities placed in their way, the excluded residents perpetually relocate and re-position themselves and attempt to empower themselves by redefining their identities in their neighborhood.

Keywords: coexistence, everyday life, migration and diversity regimes, urban policy

Procedia PDF Downloads 216
983 Risk Measure from Investment in Finance by Value at Risk

Authors: Mohammed El-Arbi Khalfallah, Mohamed Lakhdar Hadji

Abstract:

Managing and controlling risk is a topic research in the world of finance. Before a risky situation, the stakeholders need to do comparison according to the positions and actions, and financial institutions must take measures of a particular market risk and credit. In this work, we study a model of risk measure in finance: Value at Risk (VaR), which is a new tool for measuring an entity's exposure risk. We explain the concept of value at risk, your average, tail, and describe the three methods for computing: Parametric method, Historical method, and numerical method of Monte Carlo. Finally, we briefly describe advantages and disadvantages of the three methods for computing value at risk.

Keywords: average value at risk, conditional value at risk, tail value at risk, value at risk

Procedia PDF Downloads 404
982 Nursing-Related Barriers to Children’s Pain Management at Selected Hospitals in Ghana: A Descriptive Qualitative Study

Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

Abstract:

Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

Procedia PDF Downloads 130
981 Knowledge Management at Spanish Higher Education Institutions

Authors: Yolanda Ramirez, Angel Tejada, Agustin Baidez

Abstract:

In the knowledge-based economy, intangible elements are considered essential in order to achieve competitive advantage in organizations. In this sense, the Balanced Scorecard is a very suitable tool to recognize value and manage intangibles because it translates an organization’s strategic objectives into a set of performance indicators from a financial, as well as customer perspective, internal process and learning and growth perspectives. The aim of this paper is to expose and justify the benefits that the Balanced Scorecard might have for identifying, measuring and managing intellectual capital at universities, by means of reviewing the most important Balanced Scorecard implementations at Spanish public universities.

Keywords: knowledge management, balanced scorecard, universities, Spain

Procedia PDF Downloads 236
980 Creating Positive Learning Environment

Authors: Samia Hassan, Fouzia Latif

Abstract:

In many countries, education is still far from being a knowledge industry in the sense of own practices that are not yet being transformed by knowledge about the efficacy of those practices. The core question of this paper is why students get bored in class? Have we balanced between the creation and advancement of an engaging learning community and effective learning environment? And between, giving kids confidence to achieve their maximum and potential goals, we sand managing student’s behavior. We conclude that creating a positive learning environment enhances opportunities for young children to feel safe, secure, and to supported in order to do their best learning. Many factors can use in classrooms aid to the positive environment like course content, class preparation, and behavior.

Keywords: effective, environment, learning, positive

Procedia PDF Downloads 521
979 Simulated Translator-Client Relations in Translator Training: Translator Behavior around Risk Management

Authors: Maggie Hui

Abstract:

Risk management is not a new concept; however, it is an uncharted area as applied to the translation process and translator training. Risk managers are responsible for managing risk, i.e. adopting strategies with the intention to minimize loss and maximize gains in spite of uncertainty. Which risk strategy to use often depends on the frequency of an event (i.e. probability) and the severity of its outcomes (i.e. impact). This is basically the way translation/localization project managers handle risk management. Although risk management could involve both positive and negative impacts, impact seems to be always negative in professional translators’ management models, e.g. how many days of project time are lost or how many clients are lost. However, for analysis of translation performance, the impact should be possibly positive (e.g. increased readability of the translation) or negative (e.g. loss of source-text information). In other words, the straight business model of risk management is not directly applicable to the study of risk management in the rendition process. This research aims to explore trainee translators’ risk managing while translating in a simulated setting that involves translator-client relations. A two-cycle experiment involving two roles, the translator and the simulated client, was carried out with a class of translation students to test the effects of the main variable of peer-group interaction. The researcher made use of a user-friendly screen-voice recording freeware to record subjects’ screen activities, including every word the translator typed and every change they made to the rendition, the websites they browsed and the reference tools they used, in addition to the verbalization of their thoughts throughout the process. The research observes the translation procedures subjects considered and finally adopted, and looks into the justifications for their procedures, in order to interpret their risk management. The qualitative and quantitative results of this study have some implications for translator training: (a) the experience of being a client seems to reinforce the translator’s risk aversion; (b) there is a wide gap between the translator’s internal risk management and their external presentation of risk; and (c) the use of role-playing simulation can empower students’ learning by enhancing their attitudinal or psycho-physiological competence, interpersonal competence and strategic competence.

Keywords: risk management, role-playing simulation, translation pedagogy, translator-client relations

Procedia PDF Downloads 230
978 Is There a Group of "Digital Natives" at Secondary Schools?

Authors: L. Janská, J. Kubrický

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The article describes a research focused on the influence of the information and communication technology (ICT) on the pupils' learning. The investigation deals with the influences that distinguish between the group of pupils influenced by ICT and the group of pupils not influenced by ICT. The group influenced by ICT should evince a different approach in number of areas (in managing of two and more activities at once, in a quick orientation and searching for information on the Internet, in an ability to quickly and effectively assess the data sources, in the assessment of attitudes and opinions of the other users of the network, in critical thinking, in the preference to work in teams, in the sharing of information and personal data via the virtual social networking, in insisting on the immediate reaction on their every action etc.).

Keywords: ICT influence, digital natives, pupil´s learning

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977 Examining the Relationship Between Job Stress And Burnout Among Academic Staff During The Covid-19 Pandemic; The Importance Of Emotional Intelligence

Authors: Parisa Gharibi Khoshkar

Abstract:

The global outbreak of Covid-19 forced a swift shift in the education sector, transitioning from traditional in-person settings to remote online setups in a short period. This abrupt change, coupled with health risks and other stressors such as the lack of social interaction, has had a negative impact on academic staff, leading to increased job-related stress and psychological pressures that can result in burnout. To address this, the current research aims to investigate the relationship between job stress and burnout among academic staff in Hebron, Palestine. Furthermore, this study examines the moderating role of emotional intelligence to gain a deeper understanding of its effects in reducing burnout among academic staff and teachers. This research posits that emotional intelligence plays a vital role in helping individuals manage job-related stress and anxiety, thereby preventing burnout. Using a self-administered questionnaire, the study gathered data from 185 samples comprising teachers and administrative staff from two universities in Hebron. The data was analyzed using moderated regression analysis, ANOVA model, and interaction plots. The findings indicate that work-related stress has a direct and significant influence on burnout. Moreover, the current results highlight that emotional intelligence serves as a key determinant in managing the negative effects of the pandemic-induced stress that can lead to burnout among individuals. Given the high-demand nature of the education sector, this research strongly recommends that school authorities take proactive measures to provide much-needed support to academic staff, enabling them to better cope with job stress and fostering an environment that prioritizes individuals' wellbeing. The results of this study hold practical implications for both scholars and practitioners, as they highlight the importance of emotional intelligence in managing stress and anxiety effectively. Understanding the significance of emotional intelligence can aid in implementing targeted interventions and support systems to promote the well-being and resilience of academic staff amidst challenging circumstances.

Keywords: job stress, burnout, employee wellbeing, emotional intelligence, industrial organizational psychology, human resource management, organizational psychology

Procedia PDF Downloads 32
976 A Concept of Data Mining with XML Document

Authors: Akshay Agrawal, Anand K. Srivastava

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The increasing amount of XML datasets available to casual users increases the necessity of investigating techniques to extract knowledge from these data. Data mining is widely applied in the database research area in order to extract frequent correlations of values from both structured and semi-structured datasets. The increasing availability of heterogeneous XML sources has raised a number of issues concerning how to represent and manage these semi structured data. In recent years due to the importance of managing these resources and extracting knowledge from them, lots of methods have been proposed in order to represent and cluster them in different ways.

Keywords: XML, similarity measure, clustering, cluster quality, semantic clustering

Procedia PDF Downloads 340
975 Posterior Cortical Atrophy Phenotype of Alzheimer’s Dementia: A Case Report

Authors: Joana Beyer

Abstract:

Background: Alzheimer’s disease (AD) is the predominant cause of dementia, characterized by progressive cognitive decline. Posterior cortical atrophy (PCA) is a less common variant of AD, primarily affecting younger individuals and presenting with visual, visuospatial, and visuoperceptual deficits, often leading to delayed diagnosis due to its atypical presentation. Case Presentation: We report the case of a 58-year-old woman referred to psychiatric services with a two-year history of progressive visuospatial decline, mild memory difficulties, and language impairments, notably anomia. Despite undergoing cataract and squint surgeries, her visual symptoms persisted, impacting her professional life as a music educator. The neuropsychological evaluation revealed profound visuoperceptual and visuospatial disturbances, with neuroimaging supporting a diagnosis of PCA. Treatment with Donepezil showed symptom improvement, highlighting the challenges and importance of early intervention and managing this atypical form of AD. Methods: The diagnostic process involved comprehensive physical, neuropsychological assessments, and neuroimaging, including MRI and F18 FDG PET CT, which demonstrated severe bilateral posterior cortical involvement. The case underscores the utility of these modalities in diagnosing PCA. Results: The initiation of Donepezil, an acetylcholinesterase inhibitor, resulted in symptom improvement, emphasizing the potential for AD treatments to benefit PCA patients. However, challenges in management, including treatment side effects and the necessity of multidisciplinary care, are discussed. Conclusion: This case highlights PCA's diagnostic challenges due to its atypical presentation and the broader implications for managing younger patients with early-onset dementia. It underscores the necessity for early recognition, comprehensive assessment, and tailored management strategies, including both pharmacological and non-pharmacological interventions, to improve patients' quality of life. Additionally, the case illustrates the need for expanding community memory services to accommodate younger patients with atypical forms of dementia, advocating for a more inclusive approach to dementia care.

Keywords: Alzheimer’s disease, posterior cortical atrophy, dementia, diagnosis, management, donepezil, early-onset dementia

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974 Application of Fuzzy Clustering on Classification Agile Supply Chain

Authors: Hamidreza Fallah Lajimi , Elham Karami, Fatemeh Ali nasab, Mostafa Mahdavikia

Abstract:

Being responsive is an increasingly important skill for firms in today’s global economy; thus firms must be agile. Naturally, it follows that an organization’s agility depends on its supply chain being agile. However, achieving supply chain agility is a function of other abilities within the organization. This paper analyses results from a survey of 71 Iran manufacturing companies in order to identify some of the factors for agile organizations in managing their supply chains. Then we classification this company in four cluster with fuzzy c-mean technique and with four validations functional determine automatically the optimal number of clusters.

Keywords: agile supply chain, clustering, fuzzy clustering

Procedia PDF Downloads 410
973 Managing Virtual Teams in a Pandemic

Authors: M. Jafari Toosy, A. Zamani

Abstract:

This article, considering the result of pandemics at the international level and all activities and projects performed virtually and the need for resource management and virtual teams in this period identifies the components of virtual management after searching the available resources. Exploration of virtual management in the pandemic era is explored in 10 international articles. The results of research with this method and according to the tasks and topics related to management knowledge and definition of virtual teams can be divided into topics such as planning, decision making, control, organization, leadership, attention to growth and capability, resources and facilities, Communication, creativity, innovation and security. In order to explain the nature of virtual management, a definition of virtual management was provided.

Keywords: management, virtual, virtual team management, pandemic, team

Procedia PDF Downloads 147
972 Resilient Leadership: An Analysis for Challenges, Transformation and Improvement of Organizational Climate in Gastronomic Companies

Authors: Margarita Santi Becerra Santiago

Abstract:

The following document addresses the descriptive analysis under the qualitative approach of resilient leadership that allows us to know the importance of the application of a new leadership model to face the new challenges within the gastronomic companies in Mexico. Likewise, to know the main factors that influence resilient leaders and companies to develop new skills to elaborate strategies that contribute to overcoming adversities and managing change. Adversities in a company always exist and challenge us to move and apply our knowledge to be competitive as well as to strengthen our work team through motivation to achieve efficiency and develop in a good organizational climate.

Keywords: challenges, efficiency, leadership, resilience skills

Procedia PDF Downloads 36
971 Knowledge Sharing and Organizational Performance: A System Dynamics Approach

Authors: Shachi Pathak

Abstract:

We are living in knowledge based economy where firms can gain competitive advantage with the help of managing knowledge within the organization. The purpose the study is to develop a conceptual model to explain the relationship between factors affecting knowledge sharing, called as knowledge enablers, in an organization, knowledge sharing activities and organizational performance, using system dynamics approach. This research is important since it will provide better understandings on what are the key knowledge enablers to support knowledge sharing activities, and how knowledge sharing activities will affect the capability of an organization to enhance the performance of the organization.

Keywords: knowledge management, knowledge sharing, organizational performance, system dynamics

Procedia PDF Downloads 335
970 Medical Decision-Making in Advanced Dementia from the Family Caregiver Perspective: A Qualitative Study

Authors: Elzbieta Sikorska-Simmons

Abstract:

Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

Procedia PDF Downloads 95
969 Strategic Alliances of US Engineering and Construction Companies in China

Authors: Zonggui Chen, Yuhong Wang, Yun Le

Abstract:

U.S. engineering and construction companies have increased their presence in China. A strategy for them to enter and operate in China is to forge strategic alliances with local firms. Managing the differences in motives and cultures and using proper controls are essential for a productive strategic alliance. Based on literature and in-depth interviews, this paper examines the differences in motives and cultures within Sino–U.S. strategic alliances and the impacts of the differences on control mechanisms. This paper not only contributes to a better understanding of cross-border strategic alliances in construction, but also facilitates the operation of the alliances.

Keywords: strategic alliance, Chinese construction industry, motives, cultural differences

Procedia PDF Downloads 293
968 Employees' Attitude towards Corporate Governance without Unions

Authors: Bamidele Olufemi Ifenowo

Abstract:

The study examined the practice of managing business organizations in Nigeria today without unions. It explored how this phenomenon evolved and became popular in the newly emerging mega banks in Nigeria. Attitudes of selected banks' employees to this phenomenon were surveyed.Simple statistical tools were used for data analysis. The findings revealed that most new employees who form the bulk of the sample never really cared about unionism. On the other hand, old and experienced employees were positively disposed towards unionism. This category of employees abhorred the current display of authoritarianism cum paternalism which seemed to characterize the managerial practice of most new generation banks in Nigeria today.

Keywords: authoritarianism, corporate governance, deunionisation, unionization, paternalism

Procedia PDF Downloads 225
967 Unlocking Health Insights: Studying Data for Better Care

Authors: Valentina Marutyan

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Healthcare data mining is a rapidly developing field at the intersection of technology and medicine that has the potential to change our understanding and approach to providing healthcare. Healthcare and data mining is the process of examining huge amounts of data to extract useful information that can be applied in order to improve patient care, treatment effectiveness, and overall healthcare delivery. This field looks for patterns, trends, and correlations in a variety of healthcare datasets, such as electronic health records (EHRs), medical imaging, patient demographics, and treatment histories. To accomplish this, it uses advanced analytical approaches. Predictive analysis using historical patient data is a major area of interest in healthcare data mining. This enables doctors to get involved early to prevent problems or improve results for patients. It also assists in early disease detection and customized treatment planning for every person. Doctors can customize a patient's care by looking at their medical history, genetic profile, current and previous therapies. In this way, treatments can be more effective and have fewer negative consequences. Moreover, helping patients, it improves the efficiency of hospitals. It helps them determine the number of beds or doctors they require in regard to the number of patients they expect. In this project are used models like logistic regression, random forests, and neural networks for predicting diseases and analyzing medical images. Patients were helped by algorithms such as k-means, and connections between treatments and patient responses were identified by association rule mining. Time series techniques helped in resource management by predicting patient admissions. These methods improved healthcare decision-making and personalized treatment. Also, healthcare data mining must deal with difficulties such as bad data quality, privacy challenges, managing large and complicated datasets, ensuring the reliability of models, managing biases, limited data sharing, and regulatory compliance. Finally, secret code of data mining in healthcare helps medical professionals and hospitals make better decisions, treat patients more efficiently, and work more efficiently. It ultimately comes down to using data to improve treatment, make better choices, and simplify hospital operations for all patients.

Keywords: data mining, healthcare, big data, large amounts of data

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966 Measures for Conflict Management in Nigerian Higher Institutions

Authors: Oyelade Oluwatoyin

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The phenomenon of crises in educational sector in Nigeria has reached its peak in the 21st century. Thus, this paper examines the strategies that can be used in managing the conflict situation in Nigeria Higher Institution of learning. The causes of conflicts such as inadequate funding, insufficient school facilities, poor working condition, poor enrolment, proliferation of higher institutions and unfavourable administrative decision are the major detriment of law and order i.e. strike action, destruction of property and programmes coupled with the student unrest. This write-up will make use of the available information and with the aim of adding value to existing knowledge. It was recommend that steps should be taken by policy maker to prevent scourge of conflicts in tertiary institutions in Nigeria

Keywords: conflicts, higher institutions, management, measures

Procedia PDF Downloads 328
965 A Review of Travel Data Collection Methods

Authors: Muhammad Awais Shafique, Eiji Hato

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Household trip data is of crucial importance for managing present transportation infrastructure as well as to plan and design future facilities. It also provides basis for new policies implemented under Transportation Demand Management. The methods used for household trip data collection have changed with passage of time, starting with the conventional face-to-face interviews or paper-and-pencil interviews and reaching to the recent approach of employing smartphones. This study summarizes the step-wise evolution in the travel data collection methods. It provides a comprehensive review of the topic, for readers interested to know the changing trends in the data collection field.

Keywords: computer, smartphone, telephone, travel survey

Procedia PDF Downloads 279
964 Managing Core Competencies in Innovative Entrepreneurship: Theory and Practice

Authors: Olga Shvetsova

Abstract:

The research paper contains the different issues of competence management in innovation companies. The theoretical bases of human resources management and practical issues of innovative enterprises’ competitiveness are considered. The research is focused on the modern innovative enterprise management problems; it focuses on the effective management of the personnel of innovative enterprises on the basis of competence approach. The concept of core competence approach is discussed. The point of view, that the key competences of the company create the competitive advantages, support strategy development and protect business from external negative factors is considered. The used methodology is background research.

Keywords: competence model, competitiveness, innovation management, implementation

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963 Mental Health Impacts of COVID-19 on Diverse Youth and Families in Canada

Authors: Lucksini Raveendran

Abstract:

Introduction: This mixed-methods study focuses on the experiences of ethnocultural youth and families in Canada, identifying key barriers and opportunities to inform service programming and policies that can better meet their mental health needs during the COVID-19 pandemic and beyond. Methods: Mental Health Commission of Canada's Headstrong initiative administered the youth survey (April – June 2020) and family survey (June – August 2020) with a total sample size of 137 and 481 respondents, respectively. Thematic analysis was conducted to identify key challenges faced, coping strategies used, and help-seeking behaviours. A similar approach was also applied to the family survey data, but instead, a representative sample was collated to analyze geographically variable and ethnically diverse subgroups. Results and analysis: Multiple challenges have impacted families, including increased feelings of loneliness and distress from border travel restrictions, especially among those navigating pregnancy alone or managing children with developmental needs, which is often understudied. Also, marginalized groups were disproportionately affected by inequitable access to communication technologies, further deepening the digital divide. Some reported living in congregated homes with regular conflicts, thus leading to increased anxiety and exposure to violence. For many families, urbanicity and ethnicity played a key role in how families reported coping with feelings of uncertainty while managing work commitments, navigating community resources, fulfilling care responsibilities, and homeschooling children of all ages. Despite these challenges, there was evidence of post-traumatic growth and building community resiliency. Conclusions and implications for policy, practice, or additional research: There is a need to foster opportunities to promote and sustain mental health, wellness, and resilience for families through social connections. Also, intersectionality must be embedded in the collection, analysis, and application of data to improve equitable access to evidence-based and recovery-oriented mental health supports among diverse families in Canada. Lastly, address future research on the long-term COVID-19 impacts of travel border restrictions on family wellness.

Keywords: mental health, youth mental health, family wellness, health equity

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962 Application of Fuzzy Clustering on Classification Agile Supply Chain Firms

Authors: Hamidreza Fallah Lajimi, Elham Karami, Alireza Arab, Fatemeh Alinasab

Abstract:

Being responsive is an increasingly important skill for firms in today’s global economy; thus firms must be agile. Naturally, it follows that an organization’s agility depends on its supply chain being agile. However, achieving supply chain agility is a function of other abilities within the organization. This paper analyses results from a survey of 71 Iran manufacturing companies in order to identify some of the factors for agile organizations in managing their supply chains. Then we classification this company in four cluster with fuzzy c-mean technique and with Four validations functional determine automatically the optimal number of clusters.

Keywords: agile supply chain, clustering, fuzzy clustering, business engineering

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961 Sustainability Framework for Water Management in New Zealand's Canterbury Region

Authors: Bryan Jenkins

Abstract:

Introduction: The expansion of irrigation in the Canterbury region has led to the sustainability limits being reached for water availability and the cumulative effects of land use intensification. The institutional framework under New Zealand’s Resource Management Act was found to be an inadequate basis for managing water at sustainability limits. An alternative paradigm for water management was developed based on collaborative governance and nested adaptive systems. This led to the formulation and implementation of the Canterbury Water Management Strategy. Methods: The nested adaptive system approach was adopted. Sustainability issues were identified at multiple spatial and time scales and defined potential failure pathways for the water resource system. These included biophysical and socio-economic issues such as water availability, cumulative effects on water quality due to land use intensification, projected changes in climate, public health, institutional arrangements, economic outcomes and externalities, and, social effects of changing technology. This led to the derivation of sustainability strategies to address these failure pathways. The collaborative governance approach involved stakeholder participation and community engagement to decide on a regional strategy; regional and zone committees of community and rūnanga (Māori groups) members to develop implementation programmes for the strategy; and, farmer collectives for operational management. Findings: The strategy identified improvements in the efficiency of use of water already allocated was more effective in improving water availability than a reliance on increased storage alone. New forms of storage with less adverse impacts were introduced, such as managed aquifer recharge and off-river storage. Reductions of nutrients from land use intensification by improving management practices has been a priority. Solutions packages for addressing the degradation of vulnerable lakes and rivers have been prepared. Biodiversity enhancement projects have been initiated. Greater involvement of Māori has led to the incorporation of kaitiakitanga (resource stewardship) into implementation programmes. Emerging issues are the need for improved integration of surface water and groundwater interactions, increased use of modelling of water and financial outcomes to guide decision making, and, equity in allocation among existing users as well as between existing and future users. Conclusions: However, sustainability analysis indicates that the proposed levels of management interventions are not sufficient to achieve community targets for water management. There is a need for more proactive recovery and rehabilitation measures. Managing to environmental limits is not sufficient, rather managing adaptive cycles is needed. Better measurement and management of water use efficiency is required. Proposed implementation packages are not sufficient to deliver desired water quality outcomes. Greater attention to targets important to environmental and recreational interests is needed to maintain trust in the collaborative process. Implementation programmes don’t adequately address climate change adaptations and greenhouse gas mitigation. Affordability is a constraint on adaptive capacity of farmers and communities. More funding mechanisms are required to implement proactive measures. The legislative and institutional framework needs to be changed to incorporate water framework legislation, regional sustainability strategies and water infrastructure coordination.

Keywords: collaborative governance, irrigation management, nested adaptive systems, sustainable water management

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960 Transformative Measures in Chemical and Petrochemical Industry Through Agile Principles and Industry 4.0 Technologies

Authors: Bahman Ghorashi

Abstract:

The immense awareness of the global climate change has compelled traditional fossil fuel companies to develop strategies to reduce their carbon footprint and simultaneously consider the production of various sources of clean energy in order to mitigate the environmental impact of their operations. Similarly, supply chain issues, the scarcity of certain raw materials, energy costs as well as market needs, and changing consumer expectations have forced the traditional chemical industry to reexamine their time-honored modes of operation. This study examines how such transformative change might occur through the applications of agile principles as well as industry 4.0 technologies. Clearly, such a transformation is complex, costly, and requires a total commitment on the part of the top leadership and the entire management structure. Factors that need to be considered include organizational speed of change, a restructuring that would lend itself toward collaboration and the selling of solutions to customers’ problems, rather than just products, integrating ‘along’ as well as ‘across’ value chains, mastering change and uncertainty as well as a recognition of the importance of concept-to-cash time, i.e., the velocity of introducing new products to market, and the leveraging of people and information. At the same time, parallel to implementing such major shifts in the ethos, and the fabric of the organization, the change leaders should remain mindful of the companies’ DNA while incorporating the necessary DNA defying shifts. Furthermore, such strategic maneuvers should inevitably incorporate the managing of the upstream and downstream operations, harnessing future opportunities, preparing and training the workforce, implementing faster decision making and quick adaptation to change, managing accelerated response times, as well as forming autonomous and cross-functional teams. Moreover, the leaders should establish the balance between high-value solutions versus high-margin products, fully implement digitization of operations and, when appropriate, incorporate the latest relevant technologies, such as: AI, IIoT, ML, and immersive technologies. This study presents a summary of the agile principles and the relevant technologies and draws lessons from some of the best practices that are already implemented within the chemical industry in order to establish a roadmap to agility. Finally, the critical role of educational institutions in preparing the future workforce for Industry 4.0 is addressed.

Keywords: agile principles, immersive technologies, industry 4.0, workforce preparation

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