Experience In Management Research Articles

Laparoscopic management of benign gastric outlet obstruction: a case series with review of literature

Surgery for peptic ulcer disease has since long become a thing of the past, in the era of proton pump inhibitors. Today, it is difficult to believe that these were common operations about 6-7 decades ago. Such has been the impact of proton pump inhibitors (PPI), that, surgery for peptic ulcer has been relegated to the realms of history. However, even in present day, in some rare clinical situations, surgeons may have to resort to surgery for patients suffering from peptic ulcer disease. Herein, we present our experience of laparoscopic surgical management of one of those rare clinical scenarios related to severe peptic ulcer disease. The clinical condition in discussion is gastric outlet obstruction caused by severe peptic ulcer disease in the first part of duodenum. We identified 8 patients (7 males and 1 female) who underwent laparoscopic vagotomy with gastrojejunostomy for benign gastric outlet obstruction, at our institution, operated upon by a single surgeon, between 2004 to 2023. All patients had undergone oesophago-gastro-duodenoscopy (OGD scopy), and contrast enhanced computerised tomography (CECT) of the abdomen. The patients were analysed for age, sex, symptoms, pre-operative evaluation, morbidity/mortality and functional outcomes. They were also reviewed to examine the length of stay, length of procedure, complications and recurrent symptoms on follow-up.

An alternative form of bureaucracy; the operational framework of the city’s governing authority

Background: The background and objectives of the research revolve around bureaucracy as a classic form of the modern division of labor, with Max Weber acknowledging its inevitability. However, the objective implications of the bureaucracy’s iron cage are evident in governance and management experiences. The mayors of Tehran’s districts exemplify how Iranian culture interacts with bureaucracy. This research seeks to establish principles and governance for district governors using an alternative bureaucracy, parallel to conventional bureaucracy. Methods: The methods employed include twenty strategically selected interviews, considering age, municipal area, and work experience for maximum variance. Grounded theory methodology, specifically the approach by Anselm Strauss and Barney Glaser, guides the research, employing open coding, axial coding, and selective coding. MaxQDA 2020 software enhances the qualitative data analysis, facilitating organization, coding, and collaboration within the research team. Results: Findings indicate “inevitable violations” as a common starting point for interviewees, leading to three axes: “preconditions,” “objectives,” and “strategies and mechanisms” of alternative bureaucracy. In conclusion, breaking through bureaucracy becomes necessary for governors to act. Alternative bureaucracy, rooted in experience yet considering the bureaucratic field, requires transcendent goals. Hybridity and ethical principles are crucial when transitioning from conventional bureaucracy to the alternative in urban governance.

Evaluating the Surgical Treatment of Mechanical Icterus in the General Surgery Department of the Hopital Ntional Ignace Deen, Chu De Conkry

<i>Introduction</i>: The aim of this study was to report our experience in the surgical management of mechanical jaundice. <i>Methods</i>: This was a 10-year retrospective descriptive study (January 2011 to August 2022), carried out in the general surgery department of the Hôpital National Ignace Deen. Patients admitted for surgery for mechanical jaundice were included. <i>Results</i>: We collected 22 cases of mechanical icterus out of a total of 4739 surgical procedures performed during the study period. The mean age was 46 years, with extremes of 9 and 80 years. All our patients were seen at the frank icterus stage. Ultrasound was performed in all patients. Etiologies were dominated by tumors of the pancreatic head (54.54%), and lithiasis of the main bile duct (18.18%). The average consultation time was 5.04 months, with extremes of 9 years and 80 years. Cholecystectomy was performed in over half the cases (54.54%), including three cases associated with stone extraction (13.63%). Bilio-digestive shunts were performed in 11 cases (50%), of the choledochoduodenal (13.63%) and cholecysto-jejunal (13.63%) types. Post-operative management was straightforward in 81.81% of cases, with 4 deaths (18.18%). <i>Conclusion</i>: Palliative bypass, due to the delay in consultation, allows remission of the signs of cholestasis, but does not change the natural course of the pathology. Mortality depends on the etiology.

AI based Face Recognition Attendance System

The AI Based Face Recognition Attendance System represents an innovative solution at the intersection of artificial intelligence and attendance management. Leveraging Python open-source libraries such as OpenCV and NumPy, alongside machine learning techniques, the system aims to streamline the attendance tracking process. By employing face detection algorithms and feature extraction methods, the system identifies individuals, records their attendance, and updates the database in real-time. The system architecture incorporates components like a frontend web application, real-time prediction module, registration form module, reporting module, Redis database, Streamlit framework, Insightface library, and AWS deployment. Through continuous improvement and innovation, the system enhances user experience, accuracy, and efficiency in attendance management.

Weight management personas of breast cancer patients undergoing chemotherapy in China: a multi-method study

BackgroundMobile health (mHealth) may be an ideal solution for breast cancer (BC) patients in China to access weight management interventions. User retention and engagement are the main challenges faced by mHealth applications. A user persona, which is a user-centered design process, can lead to the development of mHealth that is more acceptable to the needs of target users. This study aimed to investigate the variety of experiences in weight management and the behavioral preferences of BC patients receiving chemotherapy to develop users’ personal information and persona development for the design and implementation of mHealth interventions.MethodsSixteen individual semi-structured in-depth interviews were conducted with BC patients receiving chemotherapy. We employed the thematic analysis method to analyze the interview transcripts in NVivo 11 software. The themes obtained from the analysis were used as the subdomains of personas. A proforma was designed to extract each participant’s experience in each subdomain. Patients who exhibited similar experience in subdomains were grouped into a persona using affinity diagrams. The personas were named according to their prominent features. A questionnaire survey was conducted to validate the personas and to test whether the personas that were generated from the qualitative interview data were applicable to the Chinese population with BC.ResultsFour themes were identified as subdomains of weight management personas: the perception of weight management while undergoing chemotherapy, symptoms and emotional disturbance, changes in diet and exercise, and health literacy and information seeking. Five personas were ultimately obtained: (1) positive weight controllers, (2) patients who were inactive due to fatigue, (3) young patients who avoided communication, (4) overweight patients with treatment priority, and (5) patients who engaged in irregular exercise. Finally, the quantitative study showed that 51.58% of patients chose one of these five personas to represent themselves in weight management. None of the patient reported selecting options that were not explicitly outlined in the questionnaire and provided personalized descriptions of their weight management characteristics.ConclusionsThe selected personas were developed from in-depth interviews on biopsychosocial areas. They highlight different weight management patterns in Chinese BC patients and provide implications for both the design of mHealth systems and traditional interventions.

Experience of diet in patients with inflammatory bowel disease: A thematic synthesis of qualitative studies.

To synthesise the dietary expesriences of patients with inflammatory bowel disease by reviewing relevant qualitative studies. Diet plays a crucial role in the development and progression of inflammatory bowel disease (IBD). There is no specific diet that can be recommended for all patients. We conducted a synthesis of qualitative studies to gain a comprehensive understanding of the dietary management experience of patients with IBD, aiming to provide better dietary guidance in the future. A qualitative synthesis was conducted following the Thomas and Harden method and reported following the ENTREQ statement. Qualitative studies were systematically searched in five electronic databases: PubMed, PsycINFO, Embase, CINAHL, and Web of Science. There was no time limit for publication, and all database searches were up to 10 May, 2023. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was utilised to appraise the quality of the included studies. Data for inclusion in articles were extracted and analysed using a thematic synthesis method. Six studies involving 119 patients were eventually included. The studies were conducted in six different countries. Four major themes were identified: the diet of patients with IBD is completely different from the normal one; manage symptoms and live with the disease by modifying diet; psychological adjustment to eating (be frustrated; worried and afraid; feel ashamed; growth and resilience); barriers and challenges (barriers from perceived social support; conflicts between diet and nutrition; challenges from food hedonism and cravings). Patients with IBD highlighted the distinction between their diet and the normal diet. Dietary modifications were used as a way to manage symptoms and live with the disease. In addition to physical symptoms, patients experienced diet-related psychological changes. Dietary modifications in patients with IBD encounters difficulties and challenges, necessitating prompt guidance and intervention. (1) The implementation of dietary modifications in patients with IBD encounters numerous obstacles and complexities, necessitating prompt guidance and intervention. No patient or public contribution. The protocol was registered with PROSPERO (CRD42023391545).

FTR and OTIF Through Customized Adaptive Project Framework (APF) in Research & Development of New Projects

Research and development projects are highly unpredictable due to innovation in nature and associated and uncertain aspects. Despite careful planning, and initiating the projects with set timelines with anticipations and available resources, these will projects often face unexpected delays. To address this, the Agile Project Management approach, especially the Adaptive Project Framework (APF), is recommended. APF allows for flexibility in project management, accommodating changes in organizational needs, properties, and resources. By maximizing Experience in project management and automated tools, enhances the delivery of the projects by full-filling FTR and OTIF of TQM. Key Words: OTIF, FTR, Agile, Adaptive Project Framework, Project Management, Research and Development

The knowledge and holistic management indicators to measure the sustainability of area-based infrastructure project (AIP)

For determining the effectiveness of area-based infrastructure management, a comprehensive measurement to implement and develop an infrastructure project would need to be integrated in holistic and knowledge management. The main objective of this study was to identify the keys to measurement the sustainability of area-based infrastructure project (AIP) management. First, the key performance indicators were reviewed and selected. Next, the interviews with project developers and managers of the pilot site were conducted to investigate the real context of significant keys. The discussion with five experts who have relevant experience in area-based infrastructure projects management then arose to validate possible key performance indicators. Based on the expert comments, the questionnaire was revised for its validity and clarity. Then, the data collection using a questionnaire was sent out to representative samples across Thailand. Later, there was the analysis to interpret the survey results. The results revealed that there are two groups of keys to measure the sustainability of AIP management. One was the “Holistic Management (HM)”, which consisted of seventeen components. The other was the “Knowledge Management (KM)”, which involved six similarity items. It was found that the aforementioned factors can explain 70.024% of the total cumulative variance in the entire datasets compiled for the assessment of keys to measurement the sustainability of AIP management. The main outcomes from this study can be beneficial for the development of effective and good governance strategies for achieving sustainability patterns of area-based infrastructure project management. This theory offers the understanding of how the effectiveness of key measurement of AIP management can drive sustainable development project s, which can help in project manager and developer research on identity-related transitions.

Qualitative Insights Into Patients' and Family Members’ Experiences of In-Hospital Medication Management After a Critical Care Episode

BackgroundPatient recovery after a critical illness can be protracted, requiring a care continuum that extends along a patient pathway from the critical care unit, hospital ward and into the community care setting. High-quality care on patient transfer from critical care, including medication safety, is facilitated by education for patients and families, family engagement, support systems and healthcare professional-patient communication. Currently, there is uncertainty on how healthcare professionals can and should engage with critical care patients and family members about their medication. Research QuestionWe aimed to explore the views and experiences of critical care patients and family members about their involvement, communication, understanding, and decision making related to their medication following transfer from critical care to the hospital ward. Study Design and MethodsQualitative study, using semi-structured interviews, conducted with critical care patients and family members after transfer from critical care to a hospital ward in a large National Health Service hospital Trust. Anonymized transcripts of interviews were thematically analysed using a coding framework developed from understandings of patient and family engagement in their medication. ResultsTwenty-seven participants (15 patients and 12 family members of patients) completed the interviews. We identified five themes and 15 sub-themes, providing an overview of patients and family members’ views on their medication management during their acute illness and ongoing recovery. Themes identified were: Impact of acute illness and treatment burden on pre-existing illness; Pre-existing knowledge and capability; Beliefs about persons roles and expectations; Care continuity and individualised information exchange; and Engagement in practice. InterpretationCritical care patients and family members want to engage with healthcare professionals about their medication. Health care professionals must take an individualized approach to communication and timing, acknowledging the dynamic interplay between patients and family members, using multimodal forms of communication.

Training the next generation of community-engaged physicians: a mixed-methods evaluation of a novel course for medical service learning in the COVID-19 era

BackgroundMedical school curricula strive to train community-engaged and culturally competent physicians, and many use service learning to instill these values in students. The current standards for medical service learning frameworks have opportunities for improvement, such as encouraging students to have more sustainable and reciprocal impact and to ingrain service learning as a value to carry throughout their careers rather than a one-time experience. PEDS 220: A COVID-19 Elective is a Stanford University course on the frontlines of this shift; it provides timely education on the COVID-19 pandemic, integrating community-oriented public health work to help mitigate its impact.MethodsTo analyze our medical service learning curriculum, we combined qualitative and quantitative methods to understand our students’ experiences. Participants completed the Course Experience Questionnaire via Qualtrics, and were invited to complete an additional interview via Zoom. Interview transcripts were analyzed using an interactive, inductive, and team-based codebook development process, where recurring themes were identified across participant interviews.ResultsWe demonstrate through self-determination theory that our novel curriculum gives students valuable leadership and project management experience, awards strong academic and community-based connections, and motivates them to pursue future community-engaged work.ConclusionsThis educational framework, revolving around students, communities, and diversity, can be used beyond the COVID-19 pandemic at other educational institutions to teach students how to solve other emergent global health problems. Using proven strategies that empower future physicians to view interdisciplinary, community-engaged work as a core pillar of their responsibility to their patients and communities ensures long-term, sustainable positive impact.Trial registrationN/A.

Advance in occupational health risks and management of shift work

The occupational health issues of shift workers has received increasing attention in the field of occupational health, and discussed in this article through literature review on the health risks and management of shift work both domestically and internationally. Based on this, a series of impacts of shift work on the physiological and psychological health of workers, as well as their family and social life, are revealed. Combined with relatively mature regulations and policies in foreign countries, it is proposed that China should fully learn from the relevant experience of health management in shift work abroad, Strengthen research and explore effective management intervention measures to provide ideas for accelerating the development of scientifically feasible regulations and policies related to occupational health in shift work in China.

CINCA/NOMID is a rare autoinflammatory syndrome in rheumatological practice. Experience of diagnosis, management and therapy with interleukin-1 inhibitors

Objective: to present the experience of diagnosis, management and therapy with interleukin-1 inhibitors (iIL1) in patients with Chronic Infantile Onset Neurologic Cutaneous Articular/Neonatal Onset Multisystem Inflammatory Disease (CINCA/NOMID) according to the Russian Federal Rheumatological Center data.Material and methods. From 2007 to 2023, eight patients were included in the study (7 men) aged 10 months to 33 years, including 3 with a disease duration of more than 10 years (13, 17 and 33 years). Genetic testing was performed in all patients and mutations in the NLRP3 gene were identified in 6 cases.Results and discussion. The age of onset of the disease ranged from 0 to 6 months. The delay in diagnosis and prescription of therapy ranged from 10 months to 33 years. All patients had the classic manifestations of CINCA/NOMID, including fever, rash, central nervous system (CNS) involvement, elevated ESR and CRP levels, 6 patients had articular manifestations, 7 had ocular manifestations and 6 had sensorineural hearing loss. Amyloidosis was detected in 1 case. All patients were prescribed iIL1. Anakinra was used in 6 patients (in 5 as the first line, in 1 as the second line therapy) with a positive response; subsequently 2 of these patients were switched to canakinumab once every 4 weeks (1 patient deteriorated and was readministered anakinra). Five patients received canakinumab (3 as first-line therapy, 2 as second-line therapy), 1 patient was switched to anakinra due to insufficient CNS response. The response to iIL1 therapy was positive in all patients, but incomplete in some of them due to the severity of the manifestations and the presence of irreversible organ damage.Conclusion. Patients with CINCA/NOMID have a severe disease and a poor prognosis. In this context, early administration of iIL1 is necessary. In the case of CNS involvement, the use of anakinra is preferable, as it is characterized by better penetration of the blood-brain barrier and is therefore more effective. Later it is possible to switch the patient to canakinumab, however, to achieve a complete response, it is sometimes necessary to increase the dose of the drug and reduce the interval between doses.

Cardiac transplant rejection assessment with 18F-FDG PET-CT: initial single-centre experience for diagnosis and management

BackgroundRejection is a major cause of mortality and morbidity in heart transplant (HTx) recipients. Current methods for diagnosing rejection have limitations. Imaging methods to map the entire left ventricle and reliably identify potential sites of rejection is lacking. Animal studies suggest FDG PET-CT (FDG PET) could have potential application in human HTx recipients.MethodsBetween December 2020 and February 2022, all HTx recipients at Harefield Hospital, London, with definite or suspected rejection underwent FDG PET in addition to routine work-up.ResultsThirty HTx recipients (12 with definite and 18 with suspected rejection) underwent FDG PET scans. Overall, 12 of the 30 patients had FDG PET with increased myocardial avidity, of whom 2 died (17%). Eighteen patients of the 30 patients had FDG PET with no myocardial avidity and all are alive (100%, p = 0.15). All patients with definite rejection, scanned within 2 weeks of starting anti-rejection treatment, showed increased myocardial avidity. In 5 cases, FDG PET showed myocardial avidity beyond 6 weeks despite pulsed steroid treatment, suggesting unresolved myocardial rejection.ConclusionPreliminary findings suggest FDG PET may have a role in diagnosing cardiac transplant rejection. Future blinded studies are needed to help further validate this.

Nurse anesthetists' perceptions and experiences of managing emergence delirium: A qualitative study.

This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium (ED), a common and complex postoperative complication in the post-anesthesia care unit. The role of nurses in managing ED is critical, yet research on their understanding and management strategies for ED is lacking. To investigate anesthetic nurses' cognition and management experiences of ED in hopes of developing a standardized management protocol. This study employed a descriptive phenomenological approach from qualitative research methodologies. Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects. Semi-structured interviews were conducted, and the data were organized and analyzed using Colaizzi's seven-step analysis method, from which the final themes were extracted. After analyzing the interview content, four main themes and eight subthemes were distilled: Inefficient cognition hinders the identification of ED (conceptual ambiguity, empirical identification), managing diversity and challenges (patient-centered safe care, low level of medical-nursing collaboration), work responsibilities and pressure coexist (heavy work responsibilities, occupational risks and stress), demand for high-quality management (expecting the construction of predictive assessment tools and prevention strategies, and pursuing standardized management processes to enhance management effectiveness). Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.

Of fogs and bogs: Does litigation risk make financial reports less readable?

We predict that firms’ attempts to reduce litigation risk can inadvertently worsen financial report readability by increasing reports’ size, complexity, and altering their linguistic characteristics. We find that litigation risk reduces report readability. Readability worsens after firms experience a securities class action. This persists for several years after lawsuit resolution. To alleviate endogeneity concerns, we show that the litigation experience of a firm's managers and directors at other firms impacts readability. We also find that firms adjust readability around litigation flashpoints. Using an SEC rule change as an exogenous shock, we show that adjustments to readability can moderate firm litigation risk.

Knowledge management in the care for people with intellectual disabilities during the COVID‐19 pandemic

AbstractThe study aimed to gain insight into knowledge management in the intellectual disabilities (ID) care sector during the COVID‐19 pandemic. We explored and described how knowledge producers, intermediaries, and knowledge users experienced knowledge management during this crisis situation, the responses to the specific knowledge needs in the ID‐care sector, and changes in roles and collaboration during this period. Twenty‐five individual in‐depth semi‐structured interviews were conducted with knowledge producers, intermediaries, and knowledge users in the Dutch ID‐care sector. An inductive thematic analysis was conducted. Three key themes were identified: (1) knowledge needs during the COVID‐19 pandemic, (2) experiences with knowledge management, and (3) roles and collaboration in knowledge management. There was an urgent need for specific ID‐related knowledge and how to translate available evidence for the general population into ID‐care settings. In knowledge management, the focus was on knowledge production and exchange, with validation and application receiving less attention. Within stakeholder groups, collaboration and knowledge exchange were intensified by existing or new knowledge infrastructures. Between stakeholder groups, knowledge producers and users created short lines to exchange needs and produce knowledge. This paper provides unique insights into knowledge management in the Dutch ID‐care sector during the COVID‐19 pandemic. Implications are discussed to improve future knowledge management processes. Support with knowledge validation and local knowledge infrastructures (complementary to centralized national knowledge infrastructures) help to assess the reliability and usefulness of knowledge and improve its use in practice during future pandemic‐related crisis situations.

Feasibility and Safety of Bridging Antiplatelet Therapy with Cangrelor in Neuro-Oncology: A Preliminary Experience.

Antiplatelet therapy is mandatory for prevention of thrombotic events in patients with a recent history of acute coronary syndromes and/or percutaneous coronary interventions. However, if an urgent surgery is required during antiplatelet therapy, a compromise between the ischemic/thrombotic and hemorrhagic risk has to be reached. Different bridging schemes are reported in the literature, but there is no clear consensus on the optimal treatment strategy in terms of efficacy and safety. Although some indications about the perioperative management of antiplatelet therapy regarding specific surgical specializations are available, balancing the thrombotic and hemorrhagic risk on an individual basis, no evidence referring to neurosurgical or neuro-oncologic procedures is reported. Herein, we present our preliminary experience in the perioperative management of a patient who underwent a neurosurgical procedure for the resection of a primary malignant brain tumor using an intravenous P2Y12 inhibitor (cangrelor) as bridging therapy after a recent acute myocardial infarction treated with primary percutaneous coronary intervention and stenting. The oral P2Y12 inhibitor (clopidogrel) was withdrawn 5 days prior to the surgical procedure and continuous infusion of cangrelor was started 3 days before the surgery at a dose of 0.75 μg/kg/min. Cangrelor was discontinued 2 hours before surgery and resumed 72 hours after tumor resection for further 60 hours. Neither cangrelor-related bleeding nor cardiac ischemic events were observed in the perioperative period and the following 90 days, supporting data regarding the feasibility and safety of this bridging scheme. Further studies are needed to confirm our promising results.

Experience in conservation and management of bison population in Belarus

Experience in conservation and management of bison population in Belarus

Issues of Improving the Legal Regulation of Elections in the Russian Federation: The Opinion of the Scientist and the Practitioner

Among the many areas of scientific research, there are those where there are very few scientists who are substantively engaged in the study of relevant problems. These areas include the institution of elections within the framework of the science of electoral law. One of the few scientists in Russia who has been studying this issue substantively and consistently for more than 25 years is the Honored Lawyer of the Russian Federation, Doctor of Law, Professor Victor Vasilyevich Ignatenko, who celebrated his 65th birthday on February 26, 2024. And even while working in the legislative and executive authorities of the Irkutsk region, as well as being the head of the Election Commission of the Irkutsk region and the Commissioner for Human Rights in the Irkutsk region, Victor Vasilyevich did not leave science and teaching for a minute, as evidenced by his publication activity and the number of students. His enormous managerial experience, reverent attitude to the issues of legal regulation of the spheres of his professional activity allows him to highlight certain issues of law enforcement practice on topical issues of electoral law at a high level.

Crisis Management Response Strategies of Small-Scale Sport Event Organizations to the Effects of the COVID-19 Pandemic

This study explores the strategies utilized by small-scale sport event organizations to respond to the effects of the COVID-19 pandemic. In doing so, it helps inform future crisis management preparedness in small-scale sport event organizations. Using semi-structured interviews, the crisis management experiences of eight participants from six small-scale UK-based sport event organizations were scrutinized. The interviews focused on a holistic understanding of their pre-, during, and post-pandemic experiences. Three key themes emerged from the data. They were (i) the diversification of revenue streams and reduction of costs; (ii) ensuring a customer centric approach; and (iii) the importance of fostering entrepreneurial and innovative characteristics. The study proposes a framework of effective crisis response strategies to help inform small-scale sport event organizations to better plan, prepare, and prevent future crises. Through the theoretical lens of resilience studies, it advances knowledge on the COVID-19 experiences of small-scale organizations in the events industry.