Management Department Research Articles

Opioid Consumption Following Isolated and Recurrent Shoulder Dislocation and Reduction.

Recurrent shoulder dislocations often lead to multiple encounters for reduction and eventual surgical stabilization, both of which involve exposure to opioids and potentially increase the risk of chronic opioid exposure. The purpose of our study was to characterize shoulder instability and compare pre- and post-reduction opioid usage in singular dislocators (SD) and recurrent dislocators (RD). This retrospective study was performed at a single academic institution using a prospective database. Patients were included if they were 1) age 18 or older and 2) sustained a shoulder dislocation evaluated within our institution. Electronic medical records were reviewed for patient demographics, emergency department management, and opioid exposure (number and mean morphine equivalent [MME] of opioid prescriptions) both pre- and post-reduction. Cohorts were compared using Wilcoxon rank sum tests for continuous variables and chi-squared or Fischer's exact tests for categorical variables with statistical significance set at p<0.05. 222 patients were included with mean follow-up 4.4 months (range: 0-70.1 months). 53 (23.8%) patients sustained recurrent dislocations. RDs were significantly younger (median age 26.7 years, IQR: 21.6-44.9) than SDs (55.3 years, IQR: 32.8-70.4; p<0.001) and more likely to have sustained a prior shoulder fracture (n=11 [21.2%] vs. n=3 [1.8%], p<0.001). There were no differences in sex, laterality, or follow-up duration. 18 (34.0%) RDs and 18 (10.7%) SDs underwent surgery including shoulder stabilization procedures, rotator cuff repairs, and fracture fixation (p<0.001). RDs used significantly more opioids at the first follow-up in both the prescribed number of opioids (mean 0.23± 0.5 prescriptions vs. 0.10 ± 0.3, p=0.038) and MME (mean 38.3 ± 96.2 MME vs. 10.7 ± 66.4 MME, p=0.013). This difference is not appreciated from the 30-day postoperative visit onwards. Emergency Room opioid MME prescription and consumption was similar between cohorts. Patients who sustain recurrent shoulder dislocations exhibit a higher likelihood of consuming significantly greater amounts of opioids following shoulder reduction and ultimately undergoing surgical intervention. The proportion of opioid tolerance and pre-reduction total MME up to 90-days prior to reduction in the recurrent dislocator cohort trended towards significance, but there were no differences observed between rates of opioid usage during ED encounters or at the 30-, 60-, and 90-day timepoints. Patients with chronic shoulder instability should be counseled regarding the increased risk of opioid prescription patterns in the immediate post-reduction period however this risk may decrease over time.

Pharmacotherapy for Agitation Management in a Pediatric Emergency Department.

In the treatment of agitation in a pediatric emergency department (PED), it is common to use once or as needed (PRN) medications when nonpharmacological management options have failed. Currently, there is limited available evidence on the treatment of pediatric agitation. The objective of this analysis was to characterize the prescribing practices of once or PRN medications for the treatment of agitation in a PED at an academic medical center. This was a retrospective chart review of all encounters in which a patient was administered once or PRN medications for agitation treatment in the PED from July 1, 2021, to June 30, 2022. Once or PRN medications were defined as any medication in the antipsychotic, benzodiazepine, and barbiturate classes along with diphenhydramine, clonidine, ketamine, and guanfacine. The primary outcome was to describe the prescribing patterns of the most utilized agents for the treatment of agitation in the PED. Secondary outcomes were to assess effectiveness and safety of the agents utilized. We reviewed 109 patient encounters in which a once or PRN medication was used for agitation treatment. The most common initial regimens were benzodiazepine monotherapy (n = 47; 43%), antipsychotic monotherapy (n = 23; 21%), and concurrent use of an antipsychotic, benzodiazepine, and diphenhydramine (n = 16; 15%). Patients required another administration of a once or PRN medication within 5 to 120 minutes of initial administration 11% (n = 12) of the time. No patients required rapid sequence intubation and one patient (0.9%) needed treatment for extrapyramidal symptoms. Results indicate that there is not a standard regimen choice in the treatment of agitation in the PED; however, benzodiazepine monotherapy was used most frequently. Few adverse events occurred. Further research is needed to identify the optimal regimen choice for patients presenting with agitation in a PED.

Dissociative and Deep Sedations Administered by Trained Unsupervised Pediatric Residents in Israeli Emergency Departments.

To cover pediatric emergency physicians' off-hours, third-year pediatric residents in Israel are trained for unsupervised administration of emergency department (ED) dissociative and deep sedation. We assessed the frequency of critical sedation events associated with resident-performed sedations. We conducted a retrospective chart review on all patients receiving intravenous sedation across 10 pediatric EDs between January 2018 and September 2022. We defined a critical sedation event as one or more of the following: chest compressions, tracheal intubation, neuromuscular blockers, vasopressors, atropine for bradycardia, aspiration syndrome, death, or unplanned hospital admission due to sedation. We liaised with the Ministry of Health's reporting department and ED directors to verify complete identification of all sentinel events. Pediatric residents and pediatric emergency physicians performed 12,733 and 10,845 sedations, respectively, most frequently for fracture reduction (44.4%) and laceration repair (25.6%). Patients' mean (SD) age was 6.9 (4.4) years. Residents and emergency physicians administered ketamine or propofol alone in 6,473 and 3,465 cases, respectively, with drug combinations for the remainder. We identified 6 critical sedation events, of which 3 were resident-performed sedations. The frequency of critical sedation events among pediatric residents and emergency physicians was 0.024% (95% CI, 0.005% to 0.069%) and 0.028% (95% CI, 0.006% to 0.080%), respectively. We observed a low frequency of critical sedation events in this large sample of dissociative and deep sedations performed by pediatric residents and pediatric emergency physicians. Our findings suggest that ED sedation by unsupervised, trained pediatric residents is a safe practice in Israel.

Risk Management Practices and their Implications for Performance and Market Share in Indonesian Islamic Banks

This paper analyzes Indonesian Islamic banks' risk management and market share. The mixed-methods research includes a comprehensive literature review and a qualitative case study of three of Indonesia's major Islamic banks. The case study finds that risk management best practices helped the chosen Islamic banks prosper. These steps include some common practices such as diversification of the financing portfolio, efficient internal control systems, and strict compliance with Shariah principles. Additionally, the study suggests that the implementation of risk management practices should be tailored to the specific needs and characteristics of each Islamic bank. practices such as diversification of investment portfolios, strict adherence to Shariah principles, and the use of advanced risk management tools and techniques. Additionally, the study suggests that effective risk management can enhance the reputation and credibility of Islamic banks in the eyes of their stakeholders. Getting up a department for risk management, integrating risk management, and making the organization's risk culture stronger This study emphasizes risk management's role in Indonesia's Islamic banking's long-term growth. By tackling risk management challenges and creating solid risk management methods, Indonesian Islamic banks can enhance their performance, increase their market share, and help grow a vibrant Islamic banking industry

AVALIAÇÃO DA RESPONSABILIDADE COMPARTILHADA E DO PROCESSO DE LOGÍSTICA REVERSA EM UMA LOJA DE ASSISTÊNCIA TÉCNICA DE COMPUTADORES NO MUNICÍPIO DE ALTAMIRA – PA

Computers are electro-electronic devices widely used in today's society. Technological advancements result in these computerized devices becoming obsolete within a short period, prompting constant product replacement and, consequently, a growing issue of disposal. Inadequate disposal of Waste Electrical and Electronic Equipment (WEEE), including computers, laptops, and components, leads to negative impacts on the environment and human health. In this study, we assess the reverse logistics of computer and component waste in the municipality of Altamira-Pará, considering the shared responsibility among involved stakeholders, as established by the 2010 Law 12,305, which institutes the National Solid Waste Policy. The study adopts an exploratory and descriptive approach, collecting data through questionnaires and semi-structured interviews with users, IT technicians, and merchants. The results are derived from targeted questionnaires aimed at the primary audience: users/general public and IT technicians located in Altamira-PA. It becomes evident that these agents lack awareness of their involvement in computer reverse logistics. During semi-structured interviews with the manager of the technical assistance department and employees of an IT store, it is observed that there is a lack of incentives from the government to implement an adequate reverse logistics system for WEEEs. Sustainability indicators are employed to evaluate the WEEE management process of the studied store, confirming the influence of shared responsibility in waste management. Therefore, it is crucial to propose improvements in the reverse logistics system in the municipality.

Revamping field practicum: insights for future health services management professionals

BackgroundThe effectiveness of Health Services Management curricula relies heavily on practical experiences that reflect the evolving needs of the healthcare sector. This study focuses on revising Field Practicum 4 for undergraduate students to better prepare them for leadership roles in healthcare.MethodsThis qualitative and cross-sectional case study was conducted during the 2022–2023 academic year at Zabol University of Medical Sciences. Data were collected through semi-structured, in-depth interviews and document analysis of the undergraduate curriculum. Purposeful sampling was used to select a diverse group of interviewees, including faculty members, healthcare managers, graduates, and current students, with a total of 38 interviews conducted until data saturation was reached. Thematic analysis was performed using MAXQDA software version 11. The CIPP (Context, Input, Process, Product) evaluation model was applied to systematically assess and enhance the practicum program.For the quantitative data analysis, SPSS version 23 was utilized.ResultsThe central finding from this study was the enhancement of productivity in Field Practicum 4. Thirteen core issues were identified and categorized into primary codes, including causal, contextual, intervening, focal, strategies, and outcomes. To achieve desirable outcomes through a fundamental revision strategy, it was decided that, in addition to students’ presence in hospitals (including the office of senior hospital managers and the quality improvement and accreditation unit), students should also be present in the deputyships and central units of Zabol University of Medical Sciences (treatment, resource development and management, food and drug administration, and the center for management of medical emergencies). Furthermore, students should engage with the county health insurance organization and a private insurance company to gain comprehensive familiarity with their operations. The level of consensus among the faculty members of the Health Services Management Department was at least 90%. The findings indicate that both students and internship supervisors generally rated the program positively (Mean > 4.5), although areas for improvement are highlighted, particularly in aspects of process and product.ConclusionsThe study concludes that revising Field Practicum 4 using the CIPP model provides a structured approach to enhancing practical training for Health Services Management students. Implementing these modifications in the apprenticeship syllabus is expected to improve the capabilities of graduates, better preparing them to meet the needs of healthcare system.

How university governance affects education service quality: insights from Ethiopian public universities

University governance plays a significant role in bringing about change because it is one of the most critical variables in determining the success of higher education institutions. Hence, this study aimed to investigate the influence of university governance on the education service quality of Ethiopian public universities. Accordingly, the current study focuses on five key university governance principles: accountability, autonomy, academic freedom, transparency and responsibility. The study utilized a multiple linear regression model, which made use of quantitative data sources. Data was collected from 378 instructors and academic officials from six public institutions, including department heads, deans, faculty heads, and directors. The research utilized a closed-ended questionnaire. Using SPSS software version 20, the quantitative data were examined using the descriptive statistics and inferential statistics techniques. The results of the regression analysis and correlation were discovered. The correlation result indicates that accountability and academic freedom parameters had a positive and strong correlation with education service quality. The regression results showed that academic freedom positively affected the education service quality while accountability and responsibility negatively affected the quality of education services of Ethiopian public universities. Academic leaders and staff of public universities should therefore practice academic freedom, transparency, and autonomous decision-making through implementing university governance principles in their respective public universities in Ethiopia.

The impact of strategic agility on the strategic orientation during the Covid-19 crisis in Jordanian medical and pharmaceutical industries companies

Purpose This study aims to explore the impact of strategic agility on strategic orientation and its dimensions (retrenchment, perseverance, innovation and exit strategies) in Jordanian medical and pharmaceutical industries companies during the COVID-19 crisis. Design/methodology/approach The researchers relied on a descriptive-analytic methodology. The study population consisted of 23 companies in the medical and pharmaceutical industries in Amman, Jordan. The sampling units were the top managers of these companies, represented by chief executive officers and main department managers. The sample size was 193. Questionnaires were distributed to collect the data, while the valid for analysis were 165 questionnaires. Findings The results showed that strategic agility has a positive effect on strategic orientation, as well as on, perseverance, and innovation strategies, but it has an opposite effect on retrenchment strategy. However, it has no statistically significant effect on the exit strategy. Originality/value This pioneering study is uniquely valuable through filling a gap in the literature by examining the dynamic relationship between strategic agility and strategic orientation, offering practical insights for decision-makers to enhance resilience that contributes to overcoming the COVID-19 and future crises.

The Effect of Moderation Role of Institutional Factors on Performance of Savings and Credit Cooperative Societies in Tanzania

The study was conducted in Tanzania intending to assess the effect of moderation role of institutional factors on performance of SACCOS in Tanzania. The objective of the study was to determine the relationship of training, recruitment and incentive as independent variables to the moderation roles of institutional factors norms, rules and culture on performance of SACCOS in Tanzania. The study was guided by Institutional theory. It used positivist research philosophy and deductive research approach. The researcher adopted explanatory research design and used simple random sampling technique. Primary data collected by using structured questionnaires from 143 SACCOS in Dar es Salaam region. Sample of 143 was selected from population of 517 SACCOS. Data was analysed using multiple regressions with the assistance of IBM SPSS version 26. The findings suggested that moderation factor culture had positive and significant effect on performance of SACCOS. The study recommends the Government through Tanzania Cooperative Development Commission (TCDC) to set policies which will guide all SACCOS in Tanzania to establish a department of human resource management to ensure culture is given emphases in the institutions,

EMCREG-International Multidisciplinary Consensus Panel on Management of Hyperkalemia in Chronic Kidney Disease (CKD) and Heart Failure.

Hyperkalemia, generally defined as serum potassium levels greater than 5.0 mEq/L, poses significant clinical risks, including cardiac toxicity and muscle weakness. Its prevalence and severity increase in patients with chronic kidney disease (CKD), diabetes mellitus, and heart failure (HF), particularly when compounded by medications like Angiotensin converting inhibitors, Angiotensin receptor blockers, and potassium sparing diuretics. Hyperkalemia arises from disruptions in potassium regulation involving intake, excretion, and intracellular-extracellular distribution. In CKD and acute kidney injury, these regulatory mechanisms are impaired, leading to heightened risk. The management of chronic hyperkalemia presents a challenge due to the necessity of balancing effective cardiovascular and renal therapies against the risk of elevated potassium levels. The emergency department management of acute hyperkalemia focuses on preventing cardiac complications through strategies that stabilize cellular membranes and shift potassium intracellularly. Chronic management often involves dietary interventions and pharmacological treatments. Pharmacological management of acute hyperkalemia includes diuretics, which enhance kaliuresis, and potassium binders such as patiromer and sodium zirconium cyclosilicate (SZC), which facilitate fecal excretion of potassium. While diuretics are commonly used, they carry risks of volume contraction and renal function deterioration. The newer potassium binders have shown efficacy in lowering chronically elevated potassium levels in CKD and HF patients, offering an alternative to diuretics and other older agents such as sodium polystyrene sulfonate , which has significant adverse effects and limited evidence for chronic use. We convened a consensus panel to describe the optimal management across multiple clinical settings when caring for patients with hyperkalemia. This consensus emphasizes a multidisciplinary approach to managing hyperkalemia, particularly in patients with cardiovascular kidney metabolic (CKM) syndrome, to avoid fragmentation of care and ensure comprehensive treatment strategies. The primary goal of this manuscript is to describe strategies to maintain cardiovascular benefits of essential medications while effectively managing potassium levels.

The effects of patient triage management strategies on clinical outcomes and risk management in emergency departments: a prospective comparative study

Aims: The aim of this study is to compare the impact of the emergency severity index (ESI) and the Manchester triage system (MTS) on clinical outcomes, patients' satisfaction, and risk management using a prospective approach. Methods: In this study, which includes 12,000 patients who visited the emergency department of Esenyurt Necmi Kadıoğlu State Hospital between September 1, 2024, 2024, and October 15, 2024, 6,000 patients were triaged using the ESI, and 6,000 patients were triaged using the MTS. The study was conducted by randomly selecting patients between the ages of 18-85 who were visiting the emergency department for the first time. Data were collected using the observations of healthcare personnel, electronic health system data, and patient admission records. The primary variables include treatment times, clinical outcomes, resource utilization in the emergency department, and patient waiting times. Surveys were used to measure patients' satisfaction, and medical inaccuracies were evaluated based on error reports and inconsistencies in medical records. Statistical analyses were performed using SPSS software, applying independent sample t-tests, chi-square tests, and logistic regression analyses. Results: It was found that patients triaged using the ESI had significantly lower waiting times compared to those triaged using the MTS (OR: 0.65, 95% CI: 0.50-0.85, p

Effectiveness Of Financial Performance Through Cash Flow Ratio Analysis (Study Case At PT Furniture Gresik)

This study analyzes the cash flow management of PT Furniture Gresik using a quantitative descriptive approach. The focus of this research is to evaluate the effectiveness of the company's fund management through the analysis of financial statements, including cash flow statements, balance sheets, and profit and loss. Data was collected through interviews with the Head of Administrative Manager and Finance Department Staff, documentation, such as the company's daily financial and cash reports. The results showed that PT Furniture Gresik has largely complied with the GENERAL SAK in the preparation of financial statements, with several appropriate components, such as the balance sheet, profit and loss, and cash flow. However, there are some shortcomings, such as unrecorded liabilities that require estimation and incomplete financial disclosures. The cash flow ratio analysis shows fluctuations between 2022 and 2023, with a decrease in the operating cash flow and fund flow coverage ratios, despite an increase in cash to interest. These findings provide an important insight into the company's financial condition and the importance of efficient cash flow management to support the continuity and growth of the company.

Evaluation of a Global Initiative for Asthma Education and Implementation Program to Improve Asthma Care Quality (CARE4ALL): Protocol for a Multicenter, Single-Arm Study.

Poor symptom control and exacerbations of asthma diminish quality of life and pose a significant burden to patients and society. Implementing evidence-based management as recommended by the Global Initiative for Asthma (GINA), especially introducing inhaled corticosteroid-containing treatments, has the potential to vastly reduce exacerbations and the high burden of asthma in China. However, domestic implementation of the GINA recommendations has been unsatisfactory, especially in lower-level hospitals; thus, an enhancement to the awareness of and adherence to the GINA recommendations among Chinese physicians is needed to improve patient outcomes. This study aims to bridge the gap between the GINA recommendations and the current clinical practice in China by demonstrating the benefits of an asthma quality improvement program (QIP). A single-arm study will be conducted at around 30 hospitals across China to assess the impact of a specially designed asthma QIP. Approximately 1500 patients with asthma aged ≥14 years will be enrolled in participating hospitals and followed up for 48 weeks. The QIP-targeted at all pulmonologists and specialist nurses-will include an initial comprehensive training (including a pretraining questionnaire and posttraining quizzes) provided by a dedicated, qualified training team based on the GINA 2021 recommendations, followed by regular reinforcement learnings (integrated into the regular department lectures delivered by department directors), with multiple offline and online approaches (eg, an online patient management platform) provided as supportive tools. During this study, GINA implementation performance will be continuously monitored to inform necessary adjustments at the hospital level. The primary end point is change from baseline in the proportion of participants with an inhaled corticosteroid-based maintenance or reliever treatment at week 48. Secondary end points and exploratory end points include changes in clinical practice and patient outcomes such as treatment patterns, asthma control, and hospitalization rates due to exacerbations. This study has been completed, with 1500 patients enrolled and 1271 patients completing the study. The last visit of the last patient was on September 3, 2024, and the database lock was on September 28, 2024. Final analysis of data has started in October 2024. The Change Asthma Clinical Practice through GINA Education and Implementation for All Patients With Asthma (CARE4ALL) study will hopefully help improve asthma management and patient outcomes in China by bridging the gap between evidence-based GINA recommendations and the current clinical practice. ClinicalTrials.gov NCT05440097; https://clinicaltrials.gov/study/NCT05440097. DERR1-10.2196/65197.

Penetrating Orbital Injury: A Narrative Review for Emergency Clinicians.

Penetrating orbit injury is a rare but complex and life-threatening occurrence that may easily be overlooked. Management in the emergency department requires an early multidisciplinary approach but still lacks standard guidelines. This narrative review aims to provide a systematic approach to the management of penetrating orbital injuries for emergency clinicians. Mortality and morbidity are significant due to the orbit's proximity to numerous anatomical structures. Complications may be infectious, ocular, or cerebro-vascular. Their incidence depends on the mechanism of injury, entry point, and object's characteristics such as its shape, composition, and velocity. Non-occult cases are often associated with medial orbital rim or medial eyelid penetration, whereas occult cases mainly present with trivial lateral eyelid injury and could be overlooked. Radiological workup consists of computed tomography or magnetic resonance according to the object's composition. Treatment in the emergency department focuses on initial resuscitation, broad-spectrum antibiotics, and tetanus immunization. Subsequently, early removal of the foreign object in a controlled environment and other specific treatments must be discussed with a multidisciplinary team. Penetrating orbital injury is an uncommon but complex type of head trauma that may be challenging to diagnose. Systematic and multidisciplinary management in the emergency department is crucial to improve overall prognosis.

The Impact of Emotional Intelligence on Audit Quality through Job Stress: Evidence from Vietnamese Independent Auditors

Introduction: This study was conducted to examine how emotional intelligence can affect audit quality through its impact on job stress. Objectives: The aim of the study is to determine whether higher levels of emotional intelligence can reduce job stress and improve audit quality, taking into account the pressures that auditors face in Vietnam, such as tight deadlines and complex regulatory requirements. Methods: Using quantitative research methods, using a structured survey to collect data from 327 auditors, audit team leaders, audit department heads and directors of 125 independent auditing companies in Vietnam and using the SEM structure model on SPSS and AMOS 20 software to test hypotheses. Results: The results show that all dimensions of emotional intelligence (Assessing one's own emotions, Assessing others' emotions, Using Emotions, and Regulating Emotions) significantly reduce work stress and work stress, which in turn negatively affect audit quality. Conclusions: These findings are significant because they highlight the importance of emotional intelligence training and stress management interventions in improving auditor health and improving audit quality. By addressing work stress, audit firms can ensure better performance and higher audit standards in a fiercely competitive market like Vietnam, where Big4 audit firms account for 70% of the audit market share

An internship in the quality and risk management department: An added value in initial nursing training?

As part of an innovative project initiated by the Quality and Risk Management Department and the Institut de Formation en Soins Infirmiers (Ifsi) at the Laon hospital in the Aisne region of France, a semester 5 nursing student was given the opportunity to put her initial training in quality, risk management and assessment of professional practices to good use during a five-week work placement. Her feedback, like that of the quality department and Ifsi, was positive.

Exploring spatiotemporal heterogeneity of urban green freight delivery parking based on new energy vehicle GPS data

To enhance the efficiency and sustainability of urban freight operations, China has initiated the Urban Green Freight Delivery (UGFD) project, which involves optimizing access control policies and introducing new energy vehicles. Identifying the parking trips of new energy vehicles and exploring the spatiotemporal patterns is crucial to actively promoting the optimal layout of temporary stops and the formulation of parking policies in the UGFD project. In this study, we aim to comprehend the spatiotemporal heterogeneity of parking for new energy vehicles both on roads (on-street) and within urban communities (off-street) for promoting the UGFD project. Its specific content includes: (1) proposing a method for identifying valid parking trips for the loading and unloading of goods based on trajectory data of UGFD new energy vehicles; and (2) mapping the identification results of valid parking trips onto communities and roads to analyze the spatiotemporal heterogeneity. Taking Suzhou, Jiangsu Province, China as an example, the identification results show that the established valid parking trips identification method can outperform state-of-the-art methods. The accuracy, precision, recall, and F1 value were found to be 0.957, 0.908, 0.937, and 0.922, respectively. Further examination of parking patterns indicates a bimodal temporal distribution of delivery demand, with peak activity occurring between 08:00–09:00 and between 14:00–17:00, with a higher delivery demand in the morning. Spatially, delivery demand was aggregated, while the parking time distribution of most delivery activities was normal. Additionally, the parking characteristics of communities and roads conformed to the ‘Rank–size rule’, suggesting that most delivery parking activities were concentrated in a few communities and roads. These findings can also be used in UGFD stop station utilization, travel time, arrival time prediction, and other related fields, all of which can further support relevant management departments in discovering abnormal delivery behaviors and reduce their negative impacts.

Radiographers' emotional reactions to suspected child abuse.

In cases of suspected physical abuse (SPA) in children, a full skeletal survey is performed. Radiographers performing the survey may experience emotional challenges during the examination. The purpose of the study was to explore the emotional aspects of SPA imaging among radiographers and how they respond to potential challenges. Data were collected from 8 paediatric radiographers with responsibility for SPA imaging working in three Danish university hospitals using semi-structured in-depth interviews. Interviews were carried out by an experienced radiographer and a social anthropologist. Recordings were transcribed verbatim and thematic analysis applied. Most radiographers described skeletal surveys as a potential emotional challenge. Four over-arching themes were identified; Interactions with caregivers and child, Fear of making errors, Dealing with the dead, and Coping with challenges. Except 'Dealing with the dead', each theme had several sub-themes. Emotional challenges in SPA imaging among radiographers form a complex pattern with interactions with caregivers and the child unfolding in an intense atmosphere where staff are required to regulate feelings. In the highly demanding context of SPA, potential emotionally challenging experiences require both organisational and individual attention. The results of this study should inspire department managers and paediatric radiographers to establish or maintain space in working patterns for informal collegial debriefing, or more systematic formal debriefing, thereby promoting a culture where emotional impact is recognised and supported.

Information technology and its impact on strategic performance in Yemeni telecommunications companies

Information technology is critical to improve and raise the level of strategic performance of organizations. This study aimed to investigate the impact of information technology and information technology dimensions (hardware, software, databases, communication networks, and personnel skills) on the strategic performance of Yemeni telecommunications companies and assess the overall level of information technologies and strategic performance of respective companies. The study adopted a descriptive-analytical approach and used a questionnaire for data collection. The sample of the study comprised 560 employees out of the total population of 2,238 employees in chosen Yemeni companies. The selected employees included CEOs, deputy executive managers, department managers, section heads, supervisors, and specialists due to the relevance of their roles to information technology and strategic performance. Accordingly, 479 questionnaires were successfully retrieved and analyzed. The findings showed that information technology positively impacts strategic performance (R2 = 0.385; p &amp;amp;lt; 0.05), indicating that information technology plays a significant role in enhancing strategic performance. The dimensions (hardware, databases, and personnel skills) have a statistically significant effect on strategic performance (β = 0.212, 0.205, 0.340; p &amp;amp;lt; 0.05), while software and communication networks showed no statistically significant effect (β = 0.043, 0.033; p &amp;amp;gt; 0.05). Additionally, the findings revealed a high level of information technology and strategic performance in Yemeni companies. These findings indicate that Yemeni telecommunications companies place significant emphasis on information technology and strategic performance.

Clinicolaboratory characteristics and 1-year survival among group 1 pulmonary hypertension in a university hospital

Abstract Background Pulmonary arterial hypertension is a life-threatening disorder of the pulmonary vascular system that can lead to right-sided heart failure, respiratory failure, and death. Still, more knowledge is needed to understand this complex disease. The study objective is to evaluate the clinicolaboratory characteristics of group 1 pulmonary hypertension patients and their survival in the Assiut University pulmonary hypertension unit throughout the study time. Patients and methods Consecutive patients were referred to the Assiut University Chest Department Pulmonary Hypertension unit in collaboration with the cardiology department for diagnosis and management. Patients were diagnosed as group 1 pulmonary hypertension (PH) included in the study. Patient demographic data, clinical presentation, electrocardiography, laboratory data, and invasive and noninvasive hemodynamics at presentation were recorded. The patients were followed through the study time to identify their survival. Results Out of 40 patients referred to the pulmonary hypertension unit throughout the study period, 29 patients have group 1 PH and were included. Their mean age was 44.10 ± 15.14 years, most of them were females (86.2%), 44.8% of patients presented with WHO functional class II, 48.3% of patients with FC III, and 6.9% of patients with FC IV. The mean 6 min walking distance was 256.97 ± 89.46 m. Pulmonary artery catheterization hemodynamic parameters were mean pulmonary artery pressure 52.48 ± 18.24 mmHg, pulmonary vascular resistance 13.32 ± 7.31 WU, cardiac index 2.32 ± 0.83 L/min/m2, and mixed venous oxygen saturation 59.6 ± 7%. The mean follow-up duration is 12.6 ± 8.8 months, and their survival at the end of study time was 82.35%. Serum uric acid, pulmonary vascular resistance, pulmonary artery systolic pressure, and age are predictors of disease progression and mortality. Conclusion Group 1 pulmonary hypertension is an uncommon complex disease with a difficult early diagnosis. Its clinical presentation varies from insidious breathlessness, syncope, palpitation, and obvious right heart failure. Some factors as serum uric acid, pulmonary vascular resistance, pulmonary artery systolic pressure, and age are associated with prognosis. One-year survival was 82.35%. Trial registration ClinicalTrials.gov ID: NCT0479145.