Search

When organizations devote various resources to increase its effectiveness and growth, leaders continue to think about the best ways to motivate employees to work more effectively and efficiently. Therefore, this study examines the following questions: (a) the extent to which transformational leadership affects organizational learning culture, intrinsic work motivation, and employee performance? (b) the extent to which organizational learning culture affects employee performance? and (c) the extent to which intrinsic work motivation affects employee performance? Using a questionnaire distributed online to employees at a community health center in Riau island – Indonesia, data were collected and analyzed through Partial Least Squares Structural Equation Modeling (PLS-SEM) employing SmartPLS 3.0 software. The results of the study prove that (a) transformational leadership directly and significantly affects organizational learning culture, intrinsic work motivation, and employee performance, (b) organizational learning culture directly has no significant effect on employee performance, and (c) intrinsic work motivation directly and significantly affects employee performance. The findings and implications of this study indicate that intrinsic work motivation indirectly plays an important role in linking transformational leadership and employee performance.

To analyze the effect of education costs and the quality of lecturers on student decisions to choose universities. Methods: A descriptive research design study was used. This involved 388 students (148 male, 240 female) from ten faculties at Islamic private universities in the city of Bandung. A questionnaire that was validated by experts was created to evaluate students' decision to choose a university. Results: The results report that partially the quality of lecturers has a greater influence on student decisions to choose universities than the cost of education. Meanwhile, simultaneously the cost of education and the quality of lecturers have a significant effect on student decisions to choose universities. Conclusions: Based on the theoretical model developed, this study also succeeded in building a regression model. The results of hypothesis testing indicate that the theoretical model achieved is partially and simultaneously the cost of education and the quality of the lecturers affect the student's decision to choose a university

Amongst oral cancers, malignancies of the palate and the upper gingivo-buccal complex are relatively uncommon. Following resection, defects in the palate lead to a nasal speech and nasal regurgitation on swallowing. This is best overcome with a prosthetic obturator which occludes the palatal defect and has dentures for the upper alveolus. It may not be possible to fit a prosthetic obturator in edentulous patients and in patients with trismus. Microvascular free flaps though commonly used for such defects, are time consuming, expensive and require a specialised setup. This study assesses the submental flap for its feasibility to repair palatal defects, the sturdiness of the flap, its functional outcome and the oncological safety in using the flap. This is a retrospective analysis of 46 patients, where palatal defects for oral cancers were reconstructed with the submental flap. Oncological safety was studied in 41 patients with a median follow-up of 34.5 months. 20 patients were studied for their functional outcomes using the parameters, adopted from the University of Washington-Quality of Life questionnaire. Complete flap loss was seen in 4 (8.7%) patients while 2 (4.35%) patients had minor dehiscence. No donor site morbidity was reported. Locoregional Recurrences and distant metastasis were noted in 13 of the 41 patients studied. The mean score was highest for speech at 95.5% while the lowest mean score was for mouth opening at 42.5%. The submental flap is an effective and reliable alternative for the reconstruction of palatal defects.

Organophosphorus (OP) pesticide poisoning which is common in rural India, usually presents with acute cholinergic crisis, which is due to increased acetylcholine because of the inhibition of the enzyme acetyl-cholinesterase. Central Nervous System (CNS) manifestations are rare, and even rarer is the presentation with extrapyramidal symptoms. The authors report a case of organophosphorus poisoning presenting with torticollis 4 days after organophosphorus exposure. The patient had inhalational exposure to organophosphorus compound while spraying in the elds and developed intermediate syndrome 4 days later. But rather than having respiratory depression, the patient developed torticollis. The patient was successfully managed with Inj Pralidoxime and supportive care. We wish to bring awareness in the medical profession and the general public regarding this rare but life threatening presentation of organophosphorus poisoning.

Background Effective, integrated and coordinated communication is essential in providing high quality patient care. There has been limited research detailing the impact of electronic prescribing and medication administration (ePMA) systems on healthcare professionals’ (HCPs’) communication. We aimed to explore hospital pharmacists’, doctors’ and nurses’ perceptions of how ePMA systems have affected, or are expected to affect, the way they communicate with each other in an inpatient setting.MethodsThis was a qualitative study in three English NHS hospitals: two used different inpatient ePMA systems, and one used paper-based prescribing. We conducted focus groups with pharmacists, and semi-structured individual interviews with doctors and nurses. Transcribed data were analysed inductively using thematic analysis. ResultsNine focus groups, three at each hospital, were conducted with pharmacists with different levels of seniority (58 pharmacists in total). Fourteen doctors and twelve nurses took part in individual interviews. Four themes were identified: modes of communication, reduced pharmacist visibility, system limitations, and future aspirations for ePMA. Whether working with ePMA or paper-based systems, all participants preferred to communicate face-to-face to facilitate collaborative discussions regarding patient care. Participants perceived that ePMA reduced contact time with patients. Pharmacists perceived that both their physical ward presence and their written communication on medication charts had reduced since introduction of ePMA. Doctors felt they were now less likely to ask pharmacists questions due to pharmacists’ reduced physical presence on the ward. Hardware and software limitations were identified by all HCPs, with suggestions made for future developments to better support communication.Conclusion ePMA does not necessarily support communication among HCPs. Pharmacists and doctors were also concerned that ePMA reduces communication between themselves and their patients. Hospital managers should ensure sufficient hardware for HCPs, including pharmacists, to conduct their work in clinical areas, and work with ePMA system suppliers to develop ways of enhancing, rather than inhibiting, communication.

Open-source Electronic Health Records (OS-EHRs) are of pivotal importance in the management, operations, and administration of any healthcare organization. With the advancement of health informatics, researchers and healthcare practitioners have proposed various frameworks to assess the maturation of Open-source EHRs. The significance of OS-EHRs stems from the fact that vendor-based EHR implementations are becoming financially burdensome, with some vendors raking in more than $1 billion with one contract. Contrarily, the adoption of OS-EHRs suffers from a lack of systematic evaluation from the standpoint of a standard reference model. To this end, the Healthcare Information and Management Systems Society (HIMSS) has presented a strategic road map called EMR Adoption and Maturity (EMRAM). The HIMSS-EMRAM model proposes a stage-wise model approach that is globally recognized and can be essentially applied as a benchmark evaluation criteria for open-source EHRs. This paper offers an applied descriptive methodology over the frequently studied open-source EHRs currently operational worldwide or has the potential of adoption in healthcare settings. Besides, we also present profiling (User Support, Developer’ Support, Customization Support, Technical details, and Diagnostic help) of studied OS-EHRs from developer’s and user’s perspectives using updated standard metrics. We carried out multi-aspect objective analysis of studied systems covering EHR functions, software based features and implementation. This review portrays systematic aspects of electronic medical record standards for open-source software implementations. As we observed in the literature, prevalent research and working prototypes lack systematic review of the HIMSS-EMRAM model and do not present evolving software features. Therefore, after the application of our assessment measures, the results obtained indicate that OS-EHRs are yet to acquire standard compliance and implementation. The findings in this paper can be beneficial in the planning and implementation of OS-EHRs projects in the future.

Michelle Blyth, William Innes, Nyma Mohsin-Shaikh, James Talks Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle Upon Tyne, UKCorrespondence: Michelle BlythNewcastle Eye Centre, Claremont Wing, Royal Victoria Infirmary, Newcastle Upon Tyne NE14LP, EnglandTel +44 01912826612Email michelle.dent@nhs.netPurpose: To compare use of the conventional intravitreal injection method to the InVitria intravitreal injection device. Three outcome measures were studied: patient comfort, speed of injection and cost-effectiveness.Patients and Methods: A prospective review of 58 patients was undertaken. Patients scored their perceived pain for each part of the conventional injection method using visual analogue scales (VAS), which allows pain to be scored from 0 (no pain) to 100. The same 58 patients scored their perceived pain for each part of the injection process with the InVitria on their follow-up visit. The procedure was timed in both settings and cost to the Trust was analysed.Results: Pain scores when the InVitria was used were lower than when the conventional method was used for all aspects of the intravitreal injection procedure, in particular, when comparing insertion of drape/speculum (mean score 57.56) to insertion the InVitria (mean score 16.50), needle entry (mean score 37.76 to 27.86) and removal of the drape/speculum (mean score 38.72) to removal of the InVitria (11.07). The reduction in pain scores was statistically significant for all aspects of the procedure, except the initial instillation of drops. The InVitria was an average of 1 minute and 32 seconds faster than the conventional method. Use of the InVitria in place of the conventional method provides an annual saving of £ 24,300 to the Trust based on the number of injections currently performed.Conclusion: The introduction of the InVitria in the Newcastle Eye Centre has had a positive impact on patient comfort, time and cost to the Trust.Keywords: InVitria, drape, speculum, visual analogue scale, pain scores

Purpose To compare use of the conventional intravitreal injection method to the InVitria intravitreal injection device. Three outcome measures were studied: patient comfort, speed of injection and cost-effectiveness. Patients and methods A prospective review of 58 patients was undertaken. Patients scored their perceived pain for each part of the conventional injection method using visual analogue scales (VAS), which allows pain to be scored from 0 (no pain) to 100. The same 58 patients scored their perceived pain for each part of the injection process with the InVitria on their follow-up visit. The procedure was timed in both settings and cost to the Trust was analysed. Results Pain scores when the InVitria was used were lower than when the conventional method was used for all aspects of the intravitreal injection procedure, in particular, when comparing insertion of drape/speculum (mean score 57.56) to insertion the InVitria (mean score 16.50), needle entry (mean score 37.76 to 27.86) and removal of the drape/speculum (mean score 38.72) to removal of the InVitria (11.07). The reduction in pain scores was statistically significant for all aspects of the procedure, except the initial instillation of drops. The InVitria was an average of 1 minute and 32 seconds faster than the conventional method. Use of the InVitria in place of the conventional method provides an annual saving of £24,300 to the Trust based on the number of injections currently performed. Conclusion The introduction of the InVitria in the Newcastle Eye Centre has had a positive impact on patient comfort, time and cost to the Trust.

Aim: To evaluate and compare the antimicrobial efficacy of Chitosan, Ethylenediaminetetraacetic acid, Sodium Hypochlorite and Chlorhexidine against Enterococcus faecalis at room temperature of the irrigant, at warm temperature (60o Celsius) of the irrigant and after intracanal heating (180o Celsius) of the irrigant. Materials and method: A total of 120 extracted single-rooted teeth were infected for 21 days with E. faecalis after instrumentation with Pro Taper system. Before irrigation procedure, dentinal shavings were collected in 1 ml of sterile broth and incubated. The optical density of each broth was measured using digital colorimeter and initial readings were recorded. Samples were then divided into five groups of 24 teeth in each group– Group A: Sodium hypochlorite irrigation, Group B: EDTA irrigation, Group C: Chitosan irrigation, Group D: Chlorhexidine irrigation, Group E: Saline irrigation. Each group was further divided into three subgroups – (I) Room temperature of irrigant (II) Warm temperature of irrigant (III) Intracanal heating of irrigant. After irrigation, dentinal shavings were collected and optical density recorded. The values were analysed statistically with Student’s t test and analysis of variance followed by Post-Hoc Bonferroni’s correction test; p-value < 0.05 was considered to be statistically significant. Results: The post irrigation optical densities in all the groups were significantly lower than pre irrigation values. Sodium hypochlorite and Chlorhexidine demonstrated better antimicrobial efficacy followed by Chitosan and EDTA, whereas the least efficacy was shown by Saline which was the control group. Differences in optical density using different irrigants were found to be higher by intracanal heating of irrigants followed by warm irrigation and room temperature irrigation (p

Aim and objective: To evaluate the accuracy of different impression techniques - namely the closed tray impression technique, the open tray non-splinted impression technique, the open tray splinted technique and an experimental technique for multiple implants placed at an angulation with each other. Materials and Methods: A master model was made of die stone which incorporated four implants having an internal hexagonal connection. The two terminal implants were placed at an angle of 20 degrees (lingually) whereas the two central implants were placed perpendicular to the cast. The samples were divided into four groups (Group I: Closed tray impression technique, Group II: Open tray impression technique non-splinted, Group III: Open tray impression technique splinted and Group IV: Experimental technique) based on the impression technique used. P-values were obtained using one-way analysis of variance (ANOVA) with Tukey’s correction for multiple group comparisons.Results: The P-value was greater than 0.05 (0.869) for Group III. Therefore, open tray splinted technique (Group III) was the most accurate impression technique when compared to the other techniques. On Inter - group comparisons it was noted that the values obtained by experimental technique were within close range of the values obtained by open tray splinted impression technique. Whereas, a comparison of Group I with Group III revealed 2 points of statistical significance (2 points of inaccuracy). Comparison of the Group II with Group III showed that all the points were statistically significant (all points were inaccurate). Conclusion: The open tray splinted impression technique provides best results for multiple implants placed at varying angulations. The experimental technique can be beneficial in areas of limited access, reduced mouth opening and exaggerated gag reflex.

The problem in this research was lack of students' confidence to play the role and the lack of experience of students in the experience of literature which resulted in the ability to appreciate the role play was still not satisfied. One way to tackle the problem was using the role playing method. The research method used was experiment. The population of this research was the fourth semester students of Bahasa Indonesia and Literature Education Program. Research data were obtained through practice test technique. The results showed that there was influence of role playing method on role playing ability in accordance with drama script written by students.

Reliability ensures architectural strength and error free operations of software systems. Software design and architectural measures have been studied as key indicators of faults in software systems. However, association between quantification of reliability prediction using design-level metrics has not been explored. This paper presents a novel approach of developing reliability metrics and it’s prediction using package level metrics. In particular, relevant fault severity information is empirically experimented with package level metrics in an effort-aware classification and ranking scenario. Results obtained hint significant view to predict the reliability of software systems using architectural level metrics. Therefore, the empirical analysis can guide development process to be design-focused and avoid accumulation of faults in implementation phase.

Succession planning is becoming a focus point for discussion in business world as very few organisations are prepared with their successors for occupying the position as and when it is needed. With special reference to Indian pharmaceutical companies, where talent is critical and rare in nature, this becomes a more crucial requirement. This paper, by integrating theory of Internal Labour Market (ILM), deals with the relationship among talent identification (TID), talent development (TD), talent retention (TR), and succession planning in Indian pharmaceutical companies. A survey method was used for collecting the response of senior level managers of pharmaceutical companies located in Hyderabad, India, and the hypothetical model and structural relationships were tested via structural equation modelling (SEM). The findings of the research present that TR plays a role of mediator in the relationship of TID, TD and succession planning in organisations. This study helps pharmaceutical companies to be future ready for succession planning by using their regular talent management strategies skilfully. This study beautifully develops an empirical relationship between TID, TD, and succession planning with the mediating effect of TR. Research also brings out the theoretical importance of ILM theory. This, as per best of researchers’ knowledge, was not presented in earlier research on talent management or on succession planning.

Background The aim of this systematic review was to synthesise peer-reviewed literature assessing the impact of electronic prescribing (eP) systems on the working practices of healthcare professionals (HCPs) in the inpatient setting and identify implications for practice and research. Methods We searched PubMed, Medline, Embase, Cochrane and the Cumulative Index to Nursing Allied Health Literature databases for studies published from inception to November 2018. We included controlled, uncontrolled, observational and descriptive studies that explored the effect of eP on HCPs’ working practices in an inpatient setting. Data on setting, eP system and impact on working practices were extracted. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Emergent themes were identified and subjected to narrative synthesis. The protocol was registered with PROSPERO (registration CRD42017075804). Results Searches identified 1301 titles and abstracts after duplicate removal. 171 papers underwent full-text review. A total of 25 studies met the inclusion criteria, from nine different countries. Nineteen were of commercial eP systems. There were a range of study designs; most (n = 14) adopted quantitative methods such as cross-sectional surveys, ten adopted qualitative approaches and a further one used mixed methods. Fourteen of the 25 studies were deemed to be of high quality. Four key themes were identified: communication, time taken to complete tasks, clinical workflow, and workarounds. Within each theme, study findings differed as to whether the effects of eP on HCPs’ working practices were positive or negative. Conclusion There is a lack of consensus within the literature on the impact of eP on HCPs’ working practices. Future research should explore the strategies resulting in a positive impact on HCPs’ working practices and learn from those that have not been successful.

BACKGROUND Free-flap reconstructions (FFRs) are the standard-of-care following resections for oral cancer. This study assessed an alternative, the pedicled submental flap (SF) for its versatility, oncological outcomes, and comparative operative time and cost. METHODS This was a longitudinal prospective study of 1169 patients of oral cancer reconstructed with the SF. Oncological outcomes in terms of recurrence rate and disease-free survival (DFS), were analyzed in 730 cases with a minimum of 18 months follow-up. Surgical time and cost were compared between 20 SFs and 14 FFRs performed consecutively. RESULTS SF was used to reconstruct defects in the cheek (29.2%), mandible (41.6%), tongue (26.3%) and palate (2.7%) with a 94% flap survival. N+ at level 1 did not adversely affect the recurrence rate as compared with N+ at levels other than level 1 (27.52% vs 29.81%). SFs took a shorter time (186 minutes vs 474 minutes) and cost significantly less than FFRs (P

In current era of technology, information acquisition from images and videos become most important task due to the rapid development of data mining and machine learning.The information can be either textual, visual, or combination of these. Text appearing in images or videos is a significant source of information and plays a vital role to perceive it. Developing a unified method to detect the text is hard, as textual properties (i.e. font, size, color, illumination, orientation, etc.) may vary with the complex background. So far, multimedia and computer vision community unable yet to standardize any ideal approach to extract the text smoothly. In this paper, a novel method is proposed to detect and localize artificial Urdu text in individual video frames. Firstly, Sobel and Canny edge detection operators are applied to input frame and are merged with MSER (Maximally Stable Extremal Region) detected regions. Next, geometric constraints are applied to eliminate obvious non-text regions with large and small variations. Further refining of non-text regions is achieved by stroke width transform. SVM (Support Vector Machine) classifier is trained to classify text and non-text objects. Finally, bounding boxes are used to localize the text.Experimental results show that the proposed method is robust and efficient than state-of-the-art methods.

Polymeric honeycombs have always enticed researchers due to their lightweight, high stiffness-to-weight ratio, and well developed energy absorption characteristics, owing which they find themselves...

Occupational stress in any profession and in any country is likely to be experienced by the employees employed and university academic staffs are no exceptions in this regard. The study is aimed to determine the profile of occupational stress levels and its associated factors among Indonesian and Malaysian university academic staff. The study used a survey method with purposive sampling technique. The validated questionnaire used to collect data, namely the Occupational Stress Scale (OSS) and the Stress Source Scale (SSQ). Data was collected from 263 staffs in several different faculties. The findings showed that in both Indonesia and Malaysia, the level of stress of academic staff is in the moderate category. The occupational environment factors that influenced the occupational stress in Indonesia and Malaysia were experiences of violent and aggressive behaviour. Meanwhile, the health factors in Indonesia were psychological tensions and in Malaysia were mental well-being. Future research is needed in terms of what strategies academic staff may use to cope with the work related stress in the university set up of Indonesia dan Malaysia with a larger sample size and with examination of other causes and effects of work stress as well.

Gigsters are the new derivative of employees who will add value to the employment scape in India. Gigsters are those who take on a gig (Get it Going) project based on their specific skill sets that match the job requirements. The pandemic has just thrown open the door for gigsters to take centre stage in India. This paper looks at the gig boom in India and how it can significantly change the employment landscape in India. It also examines the question of who is a good fit for gig employment and how gigsters can improve their value proposition. It also aims to address the question of challenges for the gigsters, like their inability to engage in collective bargaining, the lack of long term economic security, the safety and security of gigsters in the work place etc.

Research article is a study of employee engagement at a pharma company located in Hyderabad. The main focus of this study is to understand the factors which influence employee engagement and to find the level of employees engaged at this pharma company located in Hyderabad. Research indicates that companies whose level of engaged employees are higher have less attrition rate than other companies and also is marked higher in productivity and customer satisfaction, so this proves that result of employee engagement are impacting the result in bottom line. For the purpose of the study a questionnaire was prepared based on understanding various aspects of company, relationship with the manager and the job. The questionnaire was checked for validation and reliability and responses were collected from employees who are working at a division on this pharma company in Hyderabad. The data analysis of the responses has resulted in some findings on gender & flexible policies, experienced employees & interaction, experienced employees & appreciation and level of engaged employees. If it is not taken care on time such issues can lead to high attrition rate in company. Happy employees keep customers happy. Pharmaceutical sector being a sector of critical talent, the retention of talent is a huge responsibility for HR. To improve the engagement among the employees, based on findings some of the engagement activities like opportunities to share feedback on manager, acknowledge employee contribution on real time basis, paternity leave policy were suggested in the study to retain employees.