Search results for: obstetrics challenges

Authors: Rinat Gabbay-Benziv, Merav Ben-Natan, Ariel Roguin, Benyamine Abbou, Anna Ofir, Adi Klein, Dikla Dahan-Shriki, Mordechai Hallak, Boris Kessel, Mickey Dudkiewicz

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Introduction: Over recent decades, technology has become integral to healthcare, with electronic health records and advanced medical equipment now standard. However, this reliance has made healthcare systems increasingly vulnerable to ransomware attacks. On October 13, 2021, Hillel Yaffe Medical Center experienced a severe ransomware attack that disrupted all IT systems, including electronic health records, laboratory services, and staff communications. The attack, carried out by the group DeepBlueMagic, utilized advanced encryption to lock the hospital's systems and demanded a ransom. This incident caused significant operational and patient care challenges, particularly impacting the obstetrics department. Objective: The objective is to describe the challenges facing the obstetric division following a cyberattack and discuss ways of preparing for and overcoming another one. Methods: A retrospective descriptive study was conducted in a mid-sized medical center. Division activities, including the number of deliveries, cesarean sections, emergency room visits, admissions, maternal-fetal medicine department occupancy, and ambulatory encounters, from 2 weeks before the attack to 8 weeks following it (a total of 11 weeks), were compared with the retrospective period in 2019 (pre-COVID-19). In addition, we present the challenges and adaptation measures taken at the division and hospital levels leading up to the resumption of full division activity. Results: On the day of the cyberattack, critical decisions were made. The media announced the event, calling on patients not to come to our hospital. Also, all elective activities other than cesarean deliveries were stopped. The number of deliveries, admissions, and both emergency room and ambulatory clinic visits decreased by 5%–10% overall for 11 weeks, reflecting the decrease in division activity. Nevertheless, in all stations, there were sufficient activities and adaptation measures to ensure patient safety, decision-making, and workflow of patients were accounted for. Conclusions: The risk of ransomware cyberattacks is growing. Healthcare systems at all levels should recognize this threat and have protocols for dealing with them once they occur.

Keywords: ransomware attack, healthcare cybersecurity, obstetrics challenges, IT system disruption

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Authors: Aena Iqbal

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The lack of access to maternal and reproductive health in Pakistan poses a great threat to global public health. Obstetric issues, including vesicovaginal fistulas (VVF), are the most common in South Asian countries, leaving women in a more vulnerable state. Koohi Goth Women’s Hospital offers free VVF operations, which draws in women from all over Pakistan. Although reproductive health is being handled, mental health is often neglected in these scenarios. Using a series of questions inspired by the Warwick Edinburgh Model, this paper builds on the results from interviewing women who have received vesicovaginal fistula repair surgery on their mental health, a taboo topic in Pakistan.

Keywords: obstetrics, VVF, Pakistan, reproductive health

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Authors: Tan Hui Ying Renee, Stella Rizalina Sasha, Farah Safdar Husain

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Introduction: Menopause Hormone Therapy (MHT) is an effective drug indicated for the treatment of menopausal symptoms and as replacement therapy in women who undergo premature menopause. In 2020, less than 8.8% of perimenopausal Singaporean women are on hormonal therapy, as compared to the Western population, where up to 50% may be on MHT. Factors associated with MHT utilization have been studied from patient characteristics, but the impact of locally prescribing physicians resulting in low MHT utilization has yet to be evaluated. The aim of the study is to determine the level of knowledge physicians in the Obstetrics and Gynaecology specialty have and their attitudes toward MHT. We believe that knowledge of MHT is lacking and that negative attitudes towards MHT may influence its use and undermine the benefits MHT may have for women. This paper is a part of a larger study on Singaporean physicians’ knowledge and attitudes towards MHT. Methods: This is a cross-sectional study intended to assess the knowledge and attitudes of physicians toward Menopausal Hormone Therapy. An anonymous questionnaire was disseminated via institutional internal circulations to optimize reach to physicians who may prescribe MHT, particularly in the fields of Gynaecology, Family Medicine and Endocrinology. Responses were completed voluntarily. Physicians had the option for each question to declare that they were ‘unsure’ or that the question was ‘beyond their expertise’. 21 knowledge questions tested factual recall on indications, contraindications, and risks of MHT. The remaining 6 questions were clinical scenarios crafted with the intention of testing specific principles related to the use of MHT. These questions received face validation from experts in the field. 198 responses were collected, 79 of which were from physicians in the Obstetrics and Gynaecology specialty. The data will be statistically analyzed to investigate areas that can be improved to increase the overall benefits of MHT for the Singaporean population. Results: Preliminary results show that the prevailing factors that limit Singaporean gynecologists and obstetricians from prescribing MHT are a lack of knowledge of MHT and a lack of confidence in prescribing MHT. Risks and indications of MHT were not well known by many physicians, with the majority of the questions having more than 25% incorrect and ‘unsure’ as their reply. The clinical scenario questions revealed significant shortcomings in knowledge on how to navigate real-life challenges in MHT use, with 2 of 6 questions with more than 50% incorrect or ‘beyond their expertise’ as their reply. The portion of the questionnaire that investigated the attitudes of physicians showed that though a large majority believed MHT to be an effective drug, only 40.5% were confident in prescribing it. Conclusion: Physicians in the Obstetrics and Gynaecology specialty lack knowledge and confidence in MHT. Therefore, it is imperative to formulate solutions on both the individual and institutional levels to fill these gaps and ensure that MHT is used appropriately and prescribed to the patients who need it.

Keywords: menopause, menopause hormone therapy, physician factors, obstetrics and gynecology, menopausal symptoms, Singapore

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Authors: Philippe Judlin, Olivier Morel

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Background: In France, the resident curriculum (RC) in Obstetrics and Gynecology (OBGYN) takes five years. In the course of the last 15 years, this RC has undergone major changes, characterized mainly by successive reductions of work hours. The program used to comprise long and frequent shifts, huge workload, poor supervision and erratic theoretical teaching. A decade ago, the French Ministry of Heath recommended a limitation of shift duration up to 24 hours and a minimum of 11 hours off duty between shifts. Last year, in order to comply with European Union directives, new recommendations have further limited residents’ work hours to 48 hours per week. Methods: Assessment of the residency program adjustments recently made to accommodate the recommendations while improving the training quality in resorting to new methods. Results: The challenge facing program directors was to provide an all-encompassing curriculum to OBGYN residents despite fewer work hours. Program has been dramatically redesigned, and several measures have been put in place: -The resident rotation system has been redesigned. Residents used to make 6-month rotations between 10-12 Departments of OBGYN or Surgery. Fewer Departments, those providing the best teaching, have been kept in the new RC. -Extensive inhouse supervision has been implemented for all kinds of clinical activities. Effectual supervision of residents has proved to be an effective tool to improve the quality of training. -The tutorship system, with academic members individually overseeing residents during their curriculum, has been perfected. It allows a better follow-up of residents’ progresses during the 5-year program. -The set up of an extensive program of lectures encompassing all maters in Obstetrics & Gynecology. These mandatory lectures are available online in a dedicated website. Therefore, face-to-face lectures have been limited in order to fit in the 48-hour limit. -The use of simulation has been significantly increased in obstetrics, materno-fetal medicine and surgery (stressing especially laparoscopic training). -Residents’ feedback has been taken into account in the setup of the new RC. Conclusion: This extensive overhaul of the Obstetrics and Gynecology RC has been in place since last year only. Nevertheless, the new program seems to adequately take into account the new recommendations while providing a better and more consistent teaching to the OBGYN residents.

Keywords: education, laparoscopy, residency, simulation

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Authors: Lolwa Alansari, Hanen Mrabet, Kholoud Khaled, Abdelhamid Azhaghdani, Sufia Athar, Aska Kaima, Zaineb Mhamdia, Zubaria Altaf, Almunzer Zakaria, Tamara Alshadafat

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Introduction: The Obstetrics and Gynecology Emergency Department at Alwakra Hospital has faced significant challenges, which have been further worsened by the impact of the COVID-19 pandemic. These challenges involve issues such as overcrowding, extended wait times, and a notable surge in demand for emergency care services. Moreover, prolonged waiting times have emerged as a primary factor contributing to situations where patients leave without receiving attention, known as left without being seen (LWBS), and unexpectedly abscond. Addressing the issue of insufficient patient mobility in the obstetrics and gynecology emergency department has brought about substantial improvements in patient care, healthcare administration, and overall departmental efficiency. These changes have not only alleviated overcrowding but have also elevated the quality of emergency care, resulting in higher patient satisfaction, better outcomes, and operational rewards. Methodology: The COVID-19 pandemic has served as a catalyst for substantial transformations in the obstetrics and gynecology emergency, aligning seamlessly with the strategic direction of Hamad Medical Corporation (HMC). The fundamental aim of this initiative is to revolutionize the operational efficiency of the OB-GYN ED. To accomplish this mission, a range of transformations has been initiated, focusing on essential areas such as digitizing systems, optimizing resource allocation, enhancing budget efficiency, and reducing overall costs. The project utilized the Plan-Do-Study-Act (PDSA) model, involving a diverse team collecting baseline data and introducing throughput improvements. Post-implementation data and feedback were analysed, leading to the integration of effective interventions into standard procedures. These interventions included optimized space utilization, real-time communication, bedside registration, technology integration, pre-triage screening, enhanced communication and patient education, consultant presence, and a culture of continuous improvement. These strategies significantly reduced waiting times, enhancing both patient care and operational efficiency. Results: Results demonstrated a substantial reduction in overall average waiting time, dropping from 35 to approximately 14 minutes by August 2023. The wait times for priority 1 cases have been reduced from 22 to 0 minutes, and for priority 2 cases, the wait times have been reduced from 32 to approximately 13.6 minutes. The proportion of patients spending less than 8 hours in the OB ED observation beds rose from 74% in January 2022 to over 98% in 2023. Notably, there was a remarkable decrease in LWBS and absconded patient rates from 2020 to 2023. Conclusion: The project initiated a profound change in the department's operational environment. Efficiency became deeply embedded in the unit's culture, promoting teamwork among staff that went beyond the project's original focus and had a positive influence on operations in other departments. This effectiveness not only made processes more efficient but also resulted in significant cost reductions for the hospital. These cost savings were achieved by reducing wait times, which in turn led to fewer prolonged patient stays and reduced the need for additional treatments. These continuous improvement initiatives have now become an integral part of the Obstetrics and Gynecology Division's standard operating procedures, ensuring that the positive changes brought about by the project persist and evolve over time.

Keywords: overcrowding, waiting time, person centered care, quality initiatives

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Authors: Policarpio Jr. Joves

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Physicians in most teaching hospitals are commonly promoted into managerial roles, yet their training is mostly in clinical and scientific skills but not in leadership competencies. When they shift into roles of physician leadership, the majority hold on to their primary identity of physicians. These conflicting roles affect their identity and eventually their work. The physician leaders also face additional challenges related to academics which include incorporation of new knowledge into the existing curriculum, use of technology in the delivery of teaching, the need to train medical students outside of hospital wards, etc. The study aims to explore how physician leaders in teaching hospitals of private medical schools enact their leadership roles and how they face the challenges as physician leaders. The study setting shall be teaching hospitals of three private medical schools situated in the National Capital Region, Philippines. A multiple case study design shall be adopted in this research. Physicians shall be eligible to participate in the study if they are practicing clinicians limited to the five major clinical specialty: Internal Medicine, Pediatrics, Family Medicine, Surgery, Obstetrics and Gynecology. They must be teaching in the College of Medicine prior to their appointments as physician leaders in both medical school and teaching hospital. Semi-structured face-to-face interviews shall be utilized as a means of data collection, with open-ended questions, enabling physician leaders to present narratives about their identity, role enactment, conflicts, reaction of colleagues, and the challenges encountered in their day-to-day work as physician leaders. Interviews shall be combined with observations and review of records to gain more insights into how the physician leaders are 'doing' management. Within-case analysis shall be done initially followed by a thematic analysis across the cases, referred to as cross–case analysis or cross-case synthesis.

Keywords: academic leaders, academic managers, physician leaders, physician managers

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Authors: Halima Zaman

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This paper identifies real-life challenges faced by non-English-speaking learners. The author focuses on challenges both inside and outside the classroom. A qualitative approach has been applied to conduct the study with two different groups of ESOL (English to Speakers of Other Languages) learners. The author pays attention to the reasons behind the difficulties in controlling the learners’ focus within the classroom. Learners’ lifestyles, motivations, and previous educational backgrounds have been considered while determining the challenges they face within the classroom. Some existing challenges of teaching English to adults have been discussed in this paper; however, the primary focus is to observe those two groups of learners to identify their challenges. In this paper, the author has applied the academic knowledge of her Master of Arts in English Language teaching program to support and strengthen the observation of this case study. The paper ends with a number of recommendations that can be beneficial for newcomers to ESOL teaching and a scope of further exploratory research.

Keywords: ESOL, challenges, classroom, motivation, adult learners, teaching

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Authors: Owulo Thomas

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Despite Nigeria’s ranking as the 6th among oil producing countries, the country faces great challenges. One of such challenges is how to reduce poverty or eradicating it in the land that promises milk and honey to enhance national development. The government of Nigeria initiated various programmes including the NEEDS programme in which it committed her to meeting these challenges. This paper is an attempt to discuss the concept of National Development, the Nigerian poverty profile and its implication for national development, the NEEDS programmes and the extent to which it has addressed the poverty problem in Nigeria at 53.

Keywords: challenges, poverty, national development, NEEDS programme

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Authors: Le-Quyen Nguyen, Hoang Van Bui, Ngoc Thi Tran, Binh Thanh Le, Linus Olson, Thanh Quang Le

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Objective: We compared of outcomes between infected and non-infected COVID-19 pregnant at the largest obstetrics and gynecology hospital in southern Vietnam. Materials and Methods: A retrospective study was conducted at gestational age (GA) 28-42 weeks, who terminated pregnancy and had a real-time PCR test for SARS-CoV-2 at Tu Du Hospital. Demographic, clinical, laboratory, and epidemiological data were collected from hospital electronic-medical-records. Diagnosis and screening of SARS-CoV-2 used Real-time-PCR. Results: From July to October 2021, 9,246 pregnant with GA of 28-42 weeks were delivered, including 664 infected with COVID-19 and 8,582 non-infected. The cesarean section (CS) rates of pregnant with and without COVID-19 were 47.3% and 46.0%. At GA 32-34 weeks, the rate of CS with COVID-19 was 5.07 times higher than without. The rate of postpartum hemorrhage (PPH) and the Apgar score between these two groups were similar. The mortality rate of infected pregnants was 2.26%. Conclusions: COVID-19 infection increased the CS rate in the group of preterm pregnancies from 32 to less than 34 weeks. COVID-19 did not increase the risk of complications related to adverse pregnancy outcomes such as PPH, Apgar scores, the ratio of stillbirths, deaths due to malformation, and fetal deaths in labor.

Keywords: COVID-19, SARS-CoV-2, pregnancy, outcome, vietnam

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Authors: Seema Chopra, Amandeep Kaur, Vanita Suri, Shalini Gainder, Minakshi Rohilla

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Background: Acute kidney injury (AKI) associated with pregnancy is a serious medical complication which can lead to significant maternal as well as perinatal morbidity and mortality. Material and methods: This prospective observational study was carried out in the Obstetrics and Gynaecology department and dialysis unit of Nephrology department of PGIMER, Chandigarh from July 2013 to June 2014. Forty antenatal/postnatal/postabortal patients who fulfilled the AKIN criteria were enrolled in the study. All patients were followed up till 3 months postpartum. Results: Majority of the patients 23/40 (57.5%) with AKI presented in postpartum period, 14/40 (35%) developed AKI in antenatal period, and 3/40 (7.5%) were postabortal. AKI was attributable mostly to sepsis in 11/40 (27.5%) and PPH in 5/40 (12.5%). Hypertension and its complications causing AKI included eclampsia in 5/40 (12.5%) followed by 3/40 (7.5%) as HELLP syndrome and abruption placentae in 2/40(5%) patients. Three patients each (7.5%) had AFLP, TMA, and HEV as the cause of AKI. Renal replacement therapy in the form of hemodialysis was the treatment in majority of them (28 (70%)). After the acute event, 25 (62.5%) had complete recovery of their renal functions at 3 months follow up. Maternal mortality was seen in 25% (n=10) of the study patients. Conclusion: Timely initiation of RRT in patients with AKI associated with pregnancy has a good maternal outcome in the form of complete recovery of renal functions in 62.5% (25/40) of patients.

Keywords: AKI, dialysis, hypertension, sepsis, renal parameters

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Authors: Chinaza Uleanya, Martin Duma, Bongani Gamede

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The study investigated learning challenges experienced by students in universities situated in developing sub-Saharan African countries using selected universities in South Africa and Nigeria. Questionnaires were administered to 2,335 randomly selected students from selected universities in South Africa and Nigeria. The outcome of the study shows that six common learning challenges are visible in developing sub-Sahara African universities. The causes of these learning challenges cut across the failure in responsibilities of the various stakeholders in the field of education and the effects are monumental both to the students and society. This paper suggests recommendations to university administrators, education policy makers and implementers on the need to take education more seriously, to review and implement appropriate policies, and to ensure provision of quality education through the supply of adequate amenities and other motivating factors.

Keywords: learning, challenges, learning challenges, access with success, participatory access

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Authors: K. Reitner, F. Staberhofer, W. Ortner, M. Gerschberger

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The purpose of this paper is to identify the main challenges faced by companies in the timber construction sector and to provide improvement opportunities that can be implemented on a short-, medium- and long-term basis. To identify the challenges and propose actions for each company a literature review and a multiple case research were conducted using the Quick Scan Audit Methodology. Finally, the findings and outcomes are compared with each other to support companies in the timer construction sector when implementing and restructuring their day-to-day activities.

Keywords: supply chain management, supply chain challenges and opportunities, timber construction sector

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Authors: Amir Ikram, Qin Su, Muhammad Fiaz, Muhammad Waqas Shabbir

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Women entrepreneurship witnessed a healthy rise in the last decade or so, and the scenario in Pakistan is not different. However female leaders are facing various, cultural, career oriented, and professional challenges. The study investigates the impact of social and industry-specific challenges on female entrepreneurship; social challenges was evaluated in terms of culture, and industry-specific challenges was measured in terms of team management and career growth. Purposive sampling was employed to collect data from 75 multicultural organizations operating in the culturally diverse and historic city of Lahore, Pakistan. Cronbach’s alpha was conducted to endorse the reliability of survey questionnaire, while correlation and regression analysis were used to test hypotheses. Industry-specific challenges were found to be more significant as compared to cultural factors. The paper also highlights the importance of female entrepreneurship for emerging economies, and suggests that bringing women to mainstream professions can lead to economic success.

Keywords: cultural challenges, emerging economy, female entrepreneurship, leadership

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Authors: Rawaa El Ayoubi

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Many researchers, academics and practitioners have developed leadership theories during the 20th century. This substantial effort has built more leadership theories, generating considerable organisational research on leadership models in contemporary literature. This paper explores the stages and drivers of leadership theory evolution based on the researcher’s personal conclusions and review of leadership theories. The purpose of this paper is to create a Leadership Process Model (LPM) that can provide guidance in dealing with the key challenges within the organisation. This integrative model of organisational leadership is based on inner meaning, leader values and vision. It further addresses the relationships between leadership theory, practice and development, exploring why challenges exist within the field of leadership theory and how these challenges can be mitigated.

Keywords: leadership challenges, leadership process model, leadership |theories, organisational leadership, paradigm development

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Authors: Marlin Killen

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The American Association of University Professors (AAUP) describes academic freedom as essential to the purposes of research and teaching. The importance of academic freedom as a bedrock foundation that supports the work of the professoriate cannot be overstated, and there have been innumerable challenges that have attempted to curtail it. These challenges come from a variety of sources that span legal, ethical, cultural, institutional, and professional perspective and are amplified by social media, traditional media, and political action efforts. Because of these challenges, the development of a comprehensive institutional policy on academic freedom that addresses the principles, practices, and appropriate responses to modern challenges can be a daunting task. This presentation will focus on a case study of a university’s effort to develop an updated, evolving policy on academic freedom that provides a framework and remedies for contemporary challenges to this critical function in higher education.

Keywords: academic freedom, academic freedom policy, higher education policy

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Authors: Bubaker F. Shareia

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Much of the literature on research design has focussed on research conducted in developed, uni-cultural or primarily English speaking countries. Studies of qualitative case study research, the challenges and prospects have been embedded in Western/Euro-centric society and social theories. Although there have been some theoretical studies, few empirical studies have been conducted to explore the nature of the challenges of qualitative case study in developing countries. These challenges include accessibility to organizations, conducting interviews in developing countries, accessing documents and observing official meetings, language and cultural challenges, the use of consent forms, issues affecting access to companies, respondent issues and data analysis. The author, while conducting qualitative case study research in Libya, faced all these issues. The discussion in this paper examines these issues in order to make a contribution toward the literature in this area.

Keywords: accounting, challenges, prospects, developing countries, Libya, qualitative case study

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Authors: M. M. Muhammed, O. Khuzaima

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This research examined and outlined some of the challenges facing Islam and Muslims in the 21^st century, considering global Islamic representation and knowledge acquisition as key objectives. It was observed that the Western media misrepresentation of Islam and the Western ethos embodied by the acquisition of western civilisation are major challenges faced by Islam and Muslims today. The problem of sectarianism, decline in the socio-economic power of Muslim communities and the archaic nature of the Islamic creed were recorded as major actors to the evolving global Islamic issues. It was therefore concluded that Islam is not the reason for these challenges, rather the action of some Muslims and non-Muslims were the contributing factors to the pandemics faced by Islam and Muslims. Some relevant recommendations were made to the Islamic world that could serve as effectual solutions to these lingering problems.

Keywords: Islam, challenges, representation, knowledge, century, global, twenty-first

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Authors: Amna Batool

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Agile methodology is the current most popular technique in software development projects. Agile methods in software development bring optimistic impact on software performances, quality and customer satisfaction. There are some organizations and small-medium enterprises adopting agile into their local software development projects as well as in distributed software development projects. Adopting agile methods in local software development projects is valuable. However, agile global software deployment needs an attention. There are different key challenges in agile global software development that need to resolve and enhance the global software development cycles. The proposed systematic literature review investigates all key challenges of agile in global software development. Moreover, a quantitative methodology (an actual survey) targeted to present a real case scenario of these particular key challenges faced by one of the software houses that is BestWeb Malaysia. The outcomes of systematic literature and the results of quantitative methodology are compared with each other to evaluate if the key challenges pointed out in systematic review still exist. The proposed research and its exploratory results can assist small medium enterprises to avoid these challenges by adopting the best practices in their global software development projects. Moreover, it is helpful for novice researchers to get valuable information altogether.

Keywords: agile software development, ASD challenges, agile global software development, challenges in agile global software development

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Authors: M. Takhtravanchi, C. Pathirage

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In the construction industry, project members are conveyor of project knowledge which is, often, not managed properly to be used in future projects. As construction projects are temporary and unique, project members are willing to be recruited once a project is completed. Therefore, poor management of knowledge across construction projects will lead to a considerable amount of knowledge loss; the ignoring of which would be detrimental to project performance. This issue is more prominent in projects undertaken through the traditional procurement system, as this system does not incentives project members for integration. Thus, disputes exist between the design and construction phases based on the poor management of knowledge between those two phases. This paper aims to highlight the challenges of the knowledge management that exists within the traditional procurement system. Expert interviews were conducted and challenges were identified and analysed by the Interpretive Structural Modelling (ISM) approach in order to summarise the relationships among them. Two identified key challenges are the Culture of an Organisation and Knowledge Management Policies. A knowledge of the challenges and their relationships will help project manager and stakeholders to have a better understanding of the importance of knowledge management.

Keywords: challenges, construction industry, knowledge management, traditional procurement system

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Authors: Uche A. Nnawulezi

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This study evolved from the need to look at and evaluate the difficulties in the domestication of International Laws and Human Rights Laws in Nigeria. Essentially, the paper-based its examination on documentary evidence and depended much on secondary sources, for example, textbooks, journals, articles, periodicals and research reports emanating from suggestions of international law experts, jurists and human rights lawyers on the development challenges in domesticating international laws and human rights laws in Nigeria. These data were analyzed by the application of content analysis and careful observation of the current municipal laws which has posed great challenges in the domestication of International laws. This paper might follow the historical backdrop of the practices in the use of International law in Nigeria and should likewise consider the challenges inherent in these practices. The paper suggests that a sustainable domestication of International Laws and its application in Nigerian courts will ensure a better enforcement of human rights within the domestic jurisdiction.

Keywords: international law, human rights, domestication, challenges

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Authors: Evgeniia Shavrina, Yan Zeng, Boo Cheong Khoo, Vinh-Tan Nguyen

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The present paper is aimed at providing a review of error sources in cryogenic metering by Coriolis flowmeters (CFMs). Whereas these flowmeters allow accurate water metering, high uncertainty and low repeatability are commonly observed at cryogenic fluid metering, which is often necessary for effective renewable energy production and storage. The sources of these issues might be classified as general and cryogenic specific challenges. A conducted analysis of experimental and theoretical studies shows that material behaviour at cryogenic temperatures, composition variety, and multiphase presence are the most significant cryogenic challenges. At the same time, pipeline diameter limitation, ambient vibration impact, and drawbacks of the installation may be highlighted as the most important general challenges of cryogenic metering by CFM. Finally, the techniques, which mitigate the impact of these challenges are reviewed, and future development direction is indicated.

Keywords: Coriolis flowmeter, cryogenic, multicomponent flow, multiphase flow

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Authors: Asif Zaheer Shaikh, Zhaoyong Zhang, Jaime Yong, Ume Laila Shah

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Islamic finance is growing with remarkable pace, especially Islamic banking, a major segment of Islamic finance, is expanding rapidly. This paper discusses the position of Islamic finance and Islamic banking, around the world in general and particularly in Pakistan. History of Islamic banking in Pakistan is protested, presently a significant growth is observed. However Islamic banking is confronting with number of challenges, which are refraining from sustainable growth of this industry in Pakistan. Growth level of Islamic banks should be steeper to contribute substantial share in country’s economy. It is important to formulate effective policies, at institutional and operational level to address these challenges through close collaboration of key stakeholders.

Keywords: Islamic finance, challenges, Islamic banking, Pakistan

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Authors: A. Haddick, A. Soltan

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Background: During the period of recovery from an operative obstetric procedure, a woman is not only at risk of the life-threatening complications accompanying labour but also those associated with surgery and anaesthesia. It is speculated that women in the recovery area may receive a lower standard of care over a night shift. Thus obstetric recovery room care should be evaluated regularly to ensure all women receive an equally high standard of care 24/7. Aim: The aim of this audit was to undertake an audit in the Liverpool Women’s Hospital on the care in recovery, and to ascertain the extent to which the standards were met. This audit included the full audit cycle. Method: Standards were taken from the AAGBI, RCOA, NICE and CNST guidelines. There were 12 standards including appropriate documentation of vital signs and appropriate length of stay after surgery. Notes from 100 patients were analysed from March 2011-March 2012. There were 52 day notes and 48 night notes; these were accessed to gain the relevant data. In the re audit 35 notes were accessed from March 14-September 14. Results: The Liverpool Women’s Hospital met in total 10 of these standards. 10 were met during the day shift (83%) and 0 met during the night shift. In the re audit, there was a significant improvement in the standards met at night. 9 of the standards were met during the day and 7 of the standards were met at night. Clearly there are still improvements to be made. Conclusions: In the original audit, an audit action plan was formulated. This was following discussion of the results of this audit in an MDT meeting and presentation with a consultant Obstetrician, the head of Midwifery, the head of Obstetrics theatres and a recovery nurse. This audit will be further discussed in the Liverpool Woman's Hospital in July 2015 for further implementation for improvement.

Keywords: care, recovery, room, women

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Authors: Omar Amoudi, Mariya Khalid

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The limitation of the public funds for the infrastructure projects and with the deterioration of international oil prices and the negative consequences on the economies of oil producing and exporting countries, Oman has encouraged the partnership between the public and private sectors. As the private sector has a role in planning, financing, designing, operating and the maintenance of the public services. There is no doubt that, the adoption of Public Private Partnership (PPP) strategy faces many challenges which might affect the project seriously if it is not overcome in earlier time. These challenges depend on the level of understanding of the strategy, the roles and regulations and the availability of resources as well. This research aims at identifying the challenges facing the PPP infrastructure projects in Oman based on the similar previous studies supported by questionnaire survey and semi structured interviews. It also seeks to discuss the rationale for adoption in Oman and uncover the current status of PPP strategy. The identified challenges were ranked according to the importance index of each challenge. After analysis of data, it has observed that, the main challenges facing PPPs projects in Oman are high participation cost, high projects cost and regulation changes. The PPP strategy has to be adopted well and with a high level of experience in order to ensure a successful implementation of PPP projects in Oman.

Keywords: public private partnership (PPP), challenges, infrastructure, Oman

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Authors: Nhabhat Chaimongkol

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Human capital is one of the factors that are vital for economic growth. This is especially true as humans will face increasingly more forms of disruptive technology in the near future. Therefore, there is a need to develop human capital in order to overcome the current uncertainty in the global economy and the future of jobs. In recent years, Thailand has increasingly devoted more attention to developing its human capital. The Thai government has raised this issue in its national agenda, which is part of its 20-year national strategy. Currently, there are multiple challenges and solutions regarding this issue. This study aims to find out what are the challenges and solutions to human capital development in Thailand. The research in this study uses mixed methods consisting of quantitative and qualitative research methods. The results show that while Thailand has many plans to develop human capital, it is still lacking the necessary actions and integrations that are required to achieve its goals. Finally, the challenges and solutions will be discussed in detail.

Keywords: challenges, human capital, solutions, Thailand

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Authors: Asmau Zarma Gogaram

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The paper examines adult education and how it can be employed as a strategy for transformation and security challenges in Nigeria. It defines the meaning of adult education and its objectives.The issue of the necessity of employing adult education as a strategy for transformation and security challenges was also examined in the paper.In doing this it discussed the different types of adult education programmes, i.e.continuing education, literacy education, retirement and pre-retirement education and civic education. The paper concluded by stating that if the programmes stated are internalizes and applied they can help to raise awareness. Finally the paper proffered some recommendations one of which was that government should at all levels increase their efforts or promoting acquisition of adult education.

Keywords: adult education, transformation and security challenges, Nigeria, education and human development

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Authors: F. Demir

Abstract:

Innovation is highly critical for every company, especially for technology-based organizations looking to sustain their competitive advantage. However, this is not an easy task. Regardless of the size of the enterprise, market and location, all organizations face numerous challenges. Even though huge barriers to innovation exist in different countries, firm- and industry-specific challenges can be distinguished. This paper examines innovation strategies and obstacles to innovation in research and technology organizations (RTO) of Turkey. From the most important to the least, nine different challenges are ranked according the results of this survey. The findings reveal that to take the lead in innovation, financial constraint is the biggest challenge, which is consistent with the related literature. It ranked number one in this study. Beyond that, based on a sample of 40 RTOs, regional challenges such as underdeveloped regional innovation ecosystem plays a significant role in hampering innovation. Most of the organizations (55%) embrace an incremental approach to innovation, while only few pursue radical shifts. About 40% of the RTOs focus on product innovation, and 27.5% of them concentrate on technological innovation, while a very limited number aim for operational excellence and customer engagement as the focus of their strategic innovation efforts.

Keywords: innovation strategies, innovation challenges, emerging economies, research and technology organizations

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Authors: Marine Kobalava

Abstract:

Modern forms of public relations function in an integrated manner together with marketing communication in business companies. This ensures continuity of communication, elimination of duplication in activities, reduction of costs, and strengthening and efficient use of communication means. There exist a number of challenges in implementing integrated forms of public relations in Georgia, especially in terms of marketing communications and strategies. Objectives: The goal of the study is to reveal public relations challenges in Georgian business companies and to develop recommendations along with perfecting marketing communications and strategies. Methodologies: Bibliographic and empirical research has been conducted. Analysis, induction, synthesis, and other methods have been used. Contributions: The challenges of Public relations in Georgia are identified; the perception of different population groups on integrated forms of PR is determined; effective forms of marketing communication are defined; mechanisms for developing marketing strategies are proposed.

Keywords: public relations, challenges, marketing communication, strategy

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Authors: Amjad F. Alharbi, Bashayer A. Alotaibi, Fahd S. Alotaibi

Abstract:

The emergence of Internet of Things (IoT) technology provides capabilities for a huge number of smart devices, services and people to be communicate with each other for exchanging data and information over existing network. While as IoT is progressing, it provides many opportunities for new ways of communications as well it introduces many security and privacy threats and challenges which need to be considered for the future of IoT development. In this survey paper, an IoT security issues as threats and current challenges are summarized. The security architecture for IoT are presented from four main layers. Based on these layers, the IoT security requirements are presented to insure security in the whole system. Furthermore, some researches initiatives related to IoT security are discussed as well as the future direction for IoT security are highlighted.

Keywords: Internet of Things (IoT), IoT security challenges, IoT security requirements, IoT security architecture

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Authors: Shaker Aladwan, Paul Forrester

Abstract:

This paper explores the challenges that face leaders when implementing business excellence programmes in the Jordanian public sector. The study adopted a content analysis approach to analyse the excellence assessment reports that have been produced by the King Abdullah II Centre for Excellence (KACE). The sample comprises ten public organisations which have participated in the King Abdullah Award for Excellence (KAA) more than once and acknowledge in their reports that they have failed to achieve satisfactory results. The key challenges to the implementation of leadership criteria in the public sector in Jordan were found to be poor strategic planning, lack of employee empowerment, weaknesses in benchmarking performance, a lack of financial resources, poor integration and coordination, and poor measurement system: This study proposes a conceptual model for the as assessment of challenges that face managers when seeking to implement excellence in leadership in the Jordanian public sector. Theoretically, this paper fills context gaps in the excellence literature in general and organisational excellence in the public sector in particular. Leadership challenges in the public sector are generally widely studied, but it is important to gain a better understanding of how these challenges can be overcome. In comparison to many existing studies, this research has provided specific and detailed insights these organisational excellence challenges in the public sector and provides a conceptual model for use by other researchers into the future.

Keywords: leadership criterion, organisational excellence, challenges, quality awards, public sector, Jordan

Procedia PDF Downloads 378