Exclusive Approach Research Articles

Yoga and Integrative Healthcare: Lessons from the National Institute of Mental Health and Neurosciences (NIMHANS) in India.

There is growing evidence and increasing interest for systemic integration of medicine (synergistic and evidence-based combination of different systems along with conventional biomedicine). The National Institute of Mental Health and Neurosciences (NIMHANS), an Institute of National Importance and a tertiary mental and neurological healthcare hospital situated in Bengaluru, India, has established one such integrative model. The present manuscript traces the history and describes the important steps followed in this integrative approach. The NIMHANS model followed a stage-wise two-step approach: (1) First stage - Starting with Integration of Yoga: The process began more than a decade ago, with integrating yoga into a clinical department (rather than an exclusive research-based approach) of the institute which had relatively high clinical service load (For example, Department of Psychiatry in NIMHANS). Yoga was gradually formalized into academic and clinical activities (outpatient and inpatient services) by appointing a Yoga faculty with a medical background with an MD/PhD in Yoga. The research was primarily directed by the clinical observations of patients receiving yoga therapy. (2) Second stage: Adding an appropriate and compatible discipline from Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) system (Ayurveda in this case): The center for yoga gradually evolved into the Department of Integrative Medicine with the appointment of faculty from the Ayurveda stream. In this model, specialists from each discipline provide clinical inputs after simultaneous consultation with the patient through systemic integration in clinical, academic, and research domains rather than mere co-location of AYUSH services with mainstream medicine. The NIMHANS model of integration suggests the application of yoga into mainstream clinical service as the first step toward integration. Yoga should be added as a formalized clinical discipline with systemic integration. Gradually, other feasible systems of traditional medicine from AYUSH can be integrated at a later stage in a step-by-step manner based on clinical practice and evidence.

Talent management and organizational performance: applying the amo theory

The purpose of this study is to advance an understanding of the nature and scope of talent management practice in the unique context of the developing economy of Pakistan, and to identify the relationship between talent management and organizational performance applying the AMO theory. This research was exploratory in nature and adopted a case study methodology within three leading Pakistani banks, in Karachi (Sindh). A total of twenty two in-depth interviews were carried out with senior HR and talent managers. All interviews were fully transcribed and analysed thematically. Evaluating interview data from three leading commercial banks, findings show substantial differences in the talent conceptualisation when compared to Western management orthodoxy. The empirical findings revealed that the conceptualisation of talent within the Pakistani banking organisations reflected a specific, path dependent historical, political and social legacy which viewed talent through a conceptual lens of qualifications and experience and had a significant influence on the sourcing and deploying talent. For managers, it should be to review the process of conceptualising talent and talent management within their organisation, to challenge any preconceived assumptions about the nature of talent and to consider alternative approaches to an exclusive approach in order that the right talent can be identified, developed and deployed for competitive advantage.

Virtual Regions Strategy for Development of Tribal Communities

The Scheduled Tribe (ST) population in India is one of the most marginalised and deprived one in the country. The Constitution of India itself mandates exclusive approach, strategies and measures for their development. The Government of India and the state governments, along with other key stakeholders, have been taking very specific policy and programmatic interventions for reducing the disparities between the ST and other social groups for the past 74 years. The impact of these measures is clearly reflected through the improvement in vital development indicators. However, several gaps and challenges continue to persist, implying revisiting the fundamental approaches and planning processes which direct the interventions at policy and implementation level. In this article, an alternative, more focussed approach of ‘virtual region as planning unit’ takes the aspects related to geographical, cultural and developmental heterogeneity into consideration. Concrete strategies for implementation of various policies and programmes adopting the approach of virtual region planning in light of challenges have been presented. JEL Classification: D63, H11, H53, H61, H72, H75, H83, I14, I25, I38, J15, O21, O43, Y10, Z18

Critical Success Factors for Inclusive Talent Management in Malaysia

There are two perspectives to talent management (TM) practices, exclusivity and inclusivity. The limelight, however, has been on the widely practised exclusive TM approach through development of high potentials. As part of the 12th Malaysian Plan, the social reengineering goal seeks to attain an inclusive nation. Thus, this paper sets out to outline propositions and a framework on critical success factors (CSFs) of TM followed by potential research questions for future researches. This paper sets out to explore the under-researched area of inclusive TM by studying its critical success factors (CSFs) that would enable applicability in Malaysia by means of an inclusive talent development plan. In doing so, the stakeholder, resource-based view and ability, motivation and opportunity theories can be synchronously utilised. As a result, four CSFs to inclusive talent development were identified, inclusive TM as a priority, the presence of multiple contingent inclusive employee valuation propositions, the need for strategic recruitment passages, and the ability to generate and develop inclusive talents’ knowledge, skills, and abilities. For Malaysia’s government and respective bodies to realise the goal of their inclusivity targets, they need to recognise CSFs of inclusive TM best practices primarily in relation to talent development.

Step-by-Step Stapedotomy through Transcanal Exclusive Endoscopic Approach.

In recent years there has been an increasing trend in the use of the endoscope to treat a variety of middle ear pathologies, including otosclerosis. Several studies comparing traditional microscopic and endoscopic stapes surgery have reported similar hearing results and an overall low rate of complications. The endoscope has unraveled its full potential in demanding settings of stapes surgery, such as unfavorable anatomy of the oval window niche or revision cases. Reduced manipulation of the chorda tympani and low rate of post-operative dysgeusia are further benefits to mention for endoscopic stapes surgery. Being a one-handed technique, management of bleeding, positioning, and crimping of the prosthesis may be challenging for novice endoscopic surgeons, so some training in endoscopic ear surgery is recommended before performing endoscopic stapedotomy. The problem of sharing the surgical field between the endoscope and the operating instruments could be easily overcome if proper instruments positioning is understood. One-handed bleeding control in the narrow space of the ear canal may represent an issue during the elevation of the tympano-meatal flap, possibly discouraging the surgeon since the preliminary steps of surgery. Following appropriate technique to raise the flap and the collaboration with the anesthesiology team in keeping the blood pressure low guarantee an adequate bleeding control in most cases. The aim of this article is to describe the entire surgical procedure of a transcanal exclusive endoscopic stapedotomy, from operating room set up and patient positioning to post-operative care. A step-by-step description of the surgical maneuvers with technical hints is reported, to guide the surgeon across the procedure and allow any ear surgeon to perform stapes surgery endoscopically.

Step-by-Step Stapedotomy through Transcanal Exclusive Endoscopic Approach

Step-by-Step Stapedotomy through Transcanal Exclusive Endoscopic Approach

Outcomes of talent identification in economically liberalized India: Does organizational justice matter?

Organizations in economically liberalized India face substantial challenges regarding the engagement and turnover of talent. By exploring the outcomes of the firm-level management practice of talent identification, we uncover the effects of identifying valuable employees as high potential. Adopting an organizational justice lens, we consider the social exchange consequences of talent identification for those identified either as high potential or non-high potential, examining how perceived organizational justice moderates the relationship with employee engagement/turnover intention. Based on data from 331 employees in two large organizations in India, perceptions of distributive, procedural, and interactional justice in this highly competitive labor market are found to moderate the relationship between talent identification and work engagement, while distributive justice moderates the relationship with employee turnover intention. The study identifies novel conditions under which talent identification might avoid the negative outcomes associated with an exclusive approach to talent management, commonly adopted in Indian organizations.

Management of psychiatric disorders in patients with cancer.

Management of psychiatric disorders in patients with cancer.

Exclusive Linear Modeling Approach to the Natural Resource Curse in the Azerbaijani Economy: Examples of Stepwise Regression

Exclusive Linear Modeling Approach to the Natural Resource Curse in the Azerbaijani Economy: Examples of Stepwise Regression

Talent management practices in IT companies of Ukraine: Differences in exclusive and inclusive approaches

Employees, their knowledge, and skills are becoming an increasingly important factor in the performance and competitiveness of companies in the XXI century. Approaches to talent management vary around the world. The more technological the company, the more unique the technology of using human capital and the higher the level of employee stress. The aim of the study is to establish statistically significant differences in exclusive and inclusive approaches to talent management in Ukrainian IT companies. The study employed methods of psychodiagnostic and descriptive statistics. The research period is from January to June 2021. The total number of respondents is 150 employees from the TOP-50 largest IT companies in Ukraine as of 2020. The population of the empirical study included 70 men (46.7%) and 80 women (53.3%) aged 21 to 40 years. The results of empirical analysis show that, indeed, the degree of employee burden in IT companies is enormous. The study empirically confirmed and theoretically proved that there are statistically significant differences in exclusive and inclusive approaches to talent management. IT companies that use an exclusive approach show burnout rates at an average level (according to 38.5% of respondents), and talents are already working at the limit of their psycho-emotional resource capabilities.

Distant education in Moroccan medical schools following COVID-19 outbreak at the early phase of lockdown: Were the students really engaged?

The Coronavirus pandemic outbreak has induced many urgent adaptation measures in Morocco including medical education that had to abruptly adopt an exclusive distant education approach, without former sufficient preparation. The present study aimed to assess medical students’ engagement in their acutely implemented distant learning and to identify factors that could be associated to the students’ studying engagement levels. Medical students from 1st to 5th years of medical studies, enrolled in all Moroccan public medical faculties were invited to fill-in an anonymous online questionnaire.3174 medical students took part in the study, with a mean age of 20.4 +/- 1.8 years old, and 65.4% of them were women. 90% of the participants reported moderate to drastic change of their sleeping habits and 65% suffered depression symptoms. 20.7% of students didn't engage at all in their learning, 26% studied for less than one hour daily, and only 53.3% studied for one hour or more daily. Only 46.4% of the participants had access to multimedia studying resources and only 20.9% were offered online interactive sessions with their teachers. 41.8% of the participants were unsatisfied from their distant learning experience. Lower studying engagement rates were significantly associated with older age, male gender, change of sleeping patterns, depression symptoms, and also with lack of access to multimedia studying resources and poor general satisfaction from the distant learning experience.Distant Education needs to include more interactive activities and more multimedia studying resources to engage students more efficiently in their self-regulated learning.

Inclusive learning strategies to enhance reading skill among the students with reading disability: An Occupation and Participation Approach to Reading Intervention (OPARI) in the rural Indian classroom

Reading is a challenging task for reading disability for which they need comprehensive strategies like sensory and neurocognitive requirements. With this notion, the article aims to find, the appropriate pedagogies and clinical practices used for intervening the reading disability in Indian public schools. To examine, qualitative interviews were conducted with ten high school teachers and four special education teachers, who work in Government schools in India especially in the state of Tamil Nadu. The interview focused the opinions of the teachers on reading disability, facilities and pedagogies provided to the reading disability and from the interview, the study has derived the results in three main themes as, teachers’ views on reading disabilities, inadequate teaching strategies for reading disabilities, special education to the reading disabilities. In the discussion section, the article attempts to resolve the issues raised in the interview by introducing an exclusive approach to intervene reading disability. The article incorporates the principles of the Occupational Participation and Adaptation to Reading Intervention approach (OPARI) to intervene the reading disability and attempts to find a solution to the issues. In addition, the article attempts to justify the neuroscience behind the OPARI by highlighting the dopamine activation in the brain while adapting to reading. In the conclusion section, the article emphasizes therapeutic associative teaching and the need to implement OPARI in Indian classrooms.

Asymmetric Hybrid Siloxane Side Chains for Enhanced Mobility and Mechanical Properties of Diketopyrrolopyrrole-Based Polymers.

High performance organic field effect transistor devices based on intrinsically scalable materials are of great significance in wearable electronics. In this work, an exclusive approach is reported to rationale the carrier mobility and stretchability of the conjugate polymers (CPs) by modifying the symmetry of the side chains species. Semiconductor CPs with symmetrical alkyl side chains (P(C-C)), symmetrical siloxane side chains (P(Si-Si)), and asymmetrical silicon-carbon side chains (P(C-Si)) are synthesized to investigate the influence of these side chains on the carrier mobility and mechanical behavior. The result shows that silicon-carbon asymmetric side chains can modulate the aggregation degree of polymer chains with a coherence length of 134 Å and maintain the mobility at 0.90 cm2 V-1 s-1 . P(C-Si) exhibits superior tensile properties that even elongation up to 100% the value of mobility retains a majority properties. The main reason is that the lowest coherence length of P(C-Si) polymer leads to an increased proportion of amorphous zones in its polymer film, which efficiently dissipates mechanical stresses. This study provides an efficient strategy for the design and synthesis of the CPs with high carrier transport properties-mechanical stability.

Is Generation Z changing the understanding of HR work?

This article aims to determine whether and how an increased entry of Generation Z could impact HR work. To answer this, two hypotheses were formulated. Afterward, an extensive literature search was carried out on various databases, with the search results being narrowed down step by step using two selection criteria. The finally selected literature, focusing on German-speaking areas, was then evaluated through qualitative content analysis. First, it was found that the research results on Generation Z are not as uniform as one might assume from the first impression, especially since there is also a tendency in the studies to prefer to interview students. However, it seems that the individual consideration of employees and communication with them will increasingly be demanded by them and thus become the focus of HR work, regardless of whether the employee is a talent or not. This fundamental claim could lead to the fact that the considerations regarding an exclusive or inclusive Talent Management approach are no longer expedient or even rather obstructive, especially since talent management in its current form has apparently not yet arrived at many companies even after more than 20 years. Considering the definition problem of the concept of talent alone, this is not surprising. The advantage of Talent Management over HR Management is that some main tasks from HR management are linked together. However, due to the framework conditions, all employees must be considered individually, and it could make sense to rename inclusive Talent Management to Employee Management. In that case, exclusive Talent Management is understood solely as Talent Management (methodological level), and both terms could be summarized under the generic term Human Resources Management (didactic level). This would result in a hierarchy of terms in which the terms are clearly distinguished from each other. Furthermore, the sharpening of the terms and the concentrated summary of essential aspects of personnel work (see Figure 3) should also make it easier for managers who are inexperienced in personnel work to carry out Human Resources Management. This article aims to contribute to the sharpening of theoretical concepts to facilitate their practical implementation. The article is suitable for entrepreneurs, executives, HR specialists, and academics.

Emergence of Invasive Fungal Rhinosinusitis in Recently Recovered COVID-19 Patients.

The risk of invasive fungal rhinosinusitis is increased in Coronavirus disease 2019 (COVID-19) because of its direct impact in altering innate immunity and is further exacerbated by widespread use of steroids/antibiotics/monoclonal antibodies. The study aims to describe this recently increased clinical entity in association with COVID-19. A prospective, longitudinal study including patients diagnosed with acute invasive fungal rhinosinusitis (AIFRS) who recently recovered from COVID-19 infection or after an asymptomatic carrier state. A single-center, descriptive study investigating demographic details, clinical presentation, radio-pathological aspects, and advocated management. A total of 21 patients were included with a mean age of 49.62 years (SD: 14.24). Diabetes mellitus (DM) was the most common underlying disorder (90.48%), and 63.16% of all patients with DM had a recent onset DM, either diagnosed during or after COVID-19 infection. Nineteen patients (90.48%) had recently recovered from active COVID-19 infection, and all had a history of prior steroid treatment (oral/parenteral). Remaining 2 patients were asymptomatic COVID-19 carriers. Surprisingly, 2 patients had no underlying disorder, and 5 (23.81%) recently received the Covishield vaccine. Fungal analysis exhibited Mucor (95.24%) and Aspergillus species (14.29%). Most common sign/symptom was headache and facial/periorbital pain (85.71%), followed by facial/periorbital swelling (61.90%). Disease involvement: sinonasal (100%), orbital (47.62%), pterygopalatine fossa (28.58%), infratemporal fossa (14.29%), intracranial (23.81%), and skin (9.52%). Exclusive endoscopic debridement and combined approach were utilized in 61.90% and 38.10%, respectively. Both liposomal amphotericin B and posaconazole were given in all patients except one. A high suspicion of AIFRS should be kept in patients with recent COVID-19 infection who received steroids and presenting with headache, facial pain, and/or facial swelling. Asymptomatic COVID-19 carriers and COVID-19 vaccinated candidates are also observed to develop AIFRS, although the exact immuno-pathogenesis is still unknown. Prompt diagnosis and early management are vital for a favorable outcome.

Combined Endoscopic and Intraoral Approach or Intraoral Alone in Surgical Management of Odontogenic Sinusitis

The physiological behavior of paranasal sinuses depends on the potency of the ostiomeatal complex and on normal mucociliary function. The interruption of this delicate equilibrium can lead to pathological conditions such as sinusitis. Anywhere between 10% and over 25% of cases of maxillary sinusitis have an odontogenic origin, such as: dental infection; alveolar dental trauma; or iatrogenic causes, such as extractions, endodontic therapies, maxillary osteotomies or placement of endosseous implants. The resolution of sinus pathology is related to the resolution of odontogenic pathology. Aim: to evaluate the therapeutic efficacy of a combined oral and endoscopic approach in the treatment of chronic odontogenic sinusitis vs. oral dental management through a case control study. Materials and Methods: all patients showing signs and symptoms of odontogenic sinusitis with obliteration (appreciable radiopacity in CT) of unilateral maxillary sinus between January 2018 and September 2019 at Padua University Hospital were enrolled in this retrospective study. The exclusion criteria were: maxillary sinusitis without odontogenic origin, or resolution with a systemic antibiotic therapy; and presence of anatomical abnormalities that promote the onset of rhinosinusitis. The patients were divided into two groups: one group was treated with a combined surgical approach under general anesthesia (Functional Endoscopic Sinus Surgery-FESS and simultaneous closure of oroantral communication with Bichat’s fat pad advancement); while the other group was treated only with an intraoral approach under local anesthesia and conscious sedation (closure of oroantral communication with Bichat’s fat pad advancement). The variable “success of the surgical procedure” in the two groups was compared by a Student test (with p < 0.05). Results: among the patients enrolled, 10 patients (aged between 42 and 70) made up the case group and the other 10 patients (aged between 51 and 74) constituted the control group. There was no statistically significant difference in success between the two groups (p < 0.025). Conclusions: according to this case study, an exclusive annotation invasive intraoral approach seemed to be comparable to the transoral endoscopic combined method. However, during diagnosis it is necessary and fundamental to distinguish between odontogenic and rhinogenic sinusitis in order for the resolution of odontogenic sinusitis to be achieved.

CONCEPT OF RASAYANA AND ITS UTILITY (REJUVENATION THERAPY): A REVIEW

Ayurveda is preponderant and antique health science of prime importance. Being a health science, it adheres to an exclusive approach that is entirely different from contemporary science. It fulfils the goal of health by focusing on maintenance of health and treatment of disease as holistic. Rasayana is an important branch of Ayurveda. It is one of the eight branches of Ayurveda (Ashtanga Ayurveda). Rasayana is useful for persons of all age groups. It is equally important in the treatment of diseases as well as in maintaining health. Given this plethora of information, it can be rightly stated that Rasayana is a boon given to the world by Ayurveda. The description of Rasayana comes in detail in all the Ayurvedic texts. This branch of Ayurveda appears to have been practised in ancient lines as an important speciality aiming at rejuvenation and geriatric care. Rasayana is one of the eight branches of Ayurveda. Rasayana Chikitsa plays a critical role in the prevention as well as cure of the disease. In Ayurveda, too much importance is given to this branch that the chapters of Rasayana find a foremost place in the Charaka Samhita Chikitsa sthana whereas in Sushruta Samhita it is pushed back to chapters 27-30 of Chikitsa sthana. In Ashtanga Hridaya Rasayana does not find a special place in Chikitsa sthana and is described only briefly in the 39th chapter of Uttar Tantra. This reflects on the declining importance of Rasayana therapy in the Samhita period itself. In Sushruta Samhita, which is otherwise considered more precise and practical has given a competitively moderatedescription of the Rasayana in four chapters out of which two chapters deal with Divya Rasayana i.e., the divine drugs, which are not available today. Keywords: Ayurveda, Ashtanga Ayurveda, Rasayana, Rejuvenation, Geriatric Care

Cardiometabolic risk: New chronic care models.

Cardiometabolic risk factors, and the chronic cardiovascular diseases (CVDs) that result from them, are highly prevalent in the US and amenable to clinical nutrition interventions. This creates an urgency to develop comprehensive care models that incorporate prevention-based actions by improving lifestyle routines. Such care models should account for social determinants of health, ethnocultural variables, and challenges to sustainability. The relevance of these newly designed chronic care models is to inform and facilitate early intervention, primarily consisting of lifestyle changes and healthy nutrition, which mitigates progression from one stage to subsequent, higher morbidity stages to a greater extent than late intervention. In this article, the mechanistic drivers and ethnocultural validation of the Cardiometabolic-Based Chronic Disease (CMBCD) model are reviewed. Main findings are that in CMBCD, primary (genetics, environment, and behavior) and metabolic (obesity as Adiposity-Based Chronic Disease [ABCD], type 2 diabetes as Dysglycemia-Based Chronic Disease [DBCD], hypertension, and dyslipidemia) drivers initiate and perpetuate the progression of CVD. Epidemiological findings and molecular mechanisms support intra-ABCD/DBCD, as well as ABCD to DBCD stage progression culminating in CVD. The ABCD definition overcomes weight stigma and body mass index underperformance by considering adiposity amount, distribution, and function; and the DBCD definition overcomes criticisms of prediabetes and an exclusive glucocentric approach by considering insulin resistance and residual vascular risk along a clinical spectrum. In conclusion, clinicians should approach patients using the CMBCD model to incorporate lifestyle changes as early as possible to optimally mitigate the burden of CVD.

Transcanal endoscopic management of lateral semicircular canal fistula: preliminary experience.

Labyrinthine fistula is one of the most frequent complications of cholesteatoma (CHO), occurring in about 8% of cases in the literature. In about 90% of cases, it is located at the level of the lateral semicircular canal, and its clinical manifestation includes vertigo, nystagmus and positive Hennebert and Tullio signs. The management of lateral semicircular canal fistula (LSCF) secondary to CHO classically requires a retroauricular access by performing a canal wall-up (CWU) or canal wall-down (CWD) mastoidectomy. However, in case of a CHO confined to the tympanic cavity causing a LSCF on the ampullar arm, a transcanal exclusive endoscopic approach could be considered. The aim of this study is to describe the feasibility of a transcanal exclusive endoscopic approach in the management of a CHO confined to the tympanic cavity causing a LSCF on the ampullar arm. From January 2019 to December 2020, three patients with LSCF secondary to mesotympanic CHO underwent transcanal exclusive endoscopic ear surgery repair at the Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, Italy. This technique was successfully employed to treat LSCF in all three cases and was planned as a two-stage surgery, performing ossiculoplasty after 12-18 months. Functional outcomes were also satisfactory: complete eradication of CHO, hearing preservation and complete resolution of symptoms. In case of a CHO confined to the tympanic cavity causing an LSCF on the ampullar arm, a transcanal exclusive endoscopic approach could be considered as a feasible and safe technique.

Intraoperative Radiotherapy with Balloon-Based Electronic Brachytherapy System-A Systematic Review and First Bulgarian Experience in Breast Cancer Patients.

(1) Background: We aimed to analyze currently available studies with intraoperative radiotherapy (IORT) as a choice of treatment where the Xoft Axxent® electronic brachytherapy (eBx) system was used as a single-dose irradiation and an exclusive radiotherapy approach at the time of surgery in patients with early breast cancer (EBC). We also compared the results of the systematic review to the Bulgarian experience. (2) Methods and Materials: We performed a systematic review of the studies published before February 2021, which investigate the application of a single-fraction 20 Gy radiation treatment, delivered at the time of lumpectomy in EBC patients with the Xoft Axxent® eBx System. A systematic search in PubMed, Scopus, and ScienceDirect was performed. The results are reported following the PRISMA guidelines. The criteria on patients’ selection for IORT (the additional need for EBRT), cosmetic outcomes, and recurrence rate from the eligible studies are compared to the treatment results in Bulgarian patients. (3) Results: We searched through 1032 results to find 17 eligible studies. There are no published outcomes from randomized trials. When reported, the cosmetic outcomes in most of the studies are defined as excellent. The observed recurrence rate is low (1–5.8%). Still, the number of patients additionally referred to postoperative external breast radiotherapy (EBRT) is up to 31%. Amongst the 20 patients treated in Bulgaria, the cosmetic outcomes are also evaluated as excellent, five of which (25%) are referred for EBRT. Within median follow-up of 39 months, there was one local and one distal recurrence. (4) Conclusions: Current evidence demonstrates the Xoft Axxent® eBx system as a safe and feasible technique for IORT delivery in EBC patients. There are no randomized controlled trials conducted at this time point to prove its long-term effectiveness. Better patient selection and a reimbursement strategy have to be proposed to extend the application of this technique in Bulgaria.