Management Issues Research Articles

Severe Vestibular Dysfunction Following Unilateral Cochlear Implant: A Case Report and Management Approach

Abstract Cochlear implantation (CI) is a highly effective treatment for severe-to-profound hearing loss, but it can result in postoperative vestibular dysfunction, including vertigo and imbalance. This case report describes a 22-year-old female who developed severe vertigo and imbalance following right ear CI surgery. Audiological assessment confirmed normal hearing in the left ear and profound sensorineural hearing loss in the right ear. Vestibular tests revealed significant dysfunction, including left-beating spontaneous nystagmus, vestibular hypofunction, and abnormal saccular function in the implanted ear. This case underscores the prevalence of vestibular complications post-CI, reported in up to 75% of recipients. Comprehensive preoperative vestibular assessment is essential for identifying potential risks and guiding surgical decisions, such as choosing between unilateral and bilateral implantation. Early identification and management of vestibular issues can improve outcomes and quality of life for CI patients.

PT DANONE'S HANDLING OF FINANCIAL ISSUES AND CRISIS DUE TO THE ISSUANCE OF THE MUI FATWA BOYCOTT

This article discusses the issue management and crisis communication implemented by the food and beverage company, Danone, in responding to the spread of hoax news related to the MUI fatwa accusing its products of supporting Israel. This fake news poses a serious threat to the reputation and trust of consumers so it also affects the company's finances and requires an effective financial management strategy. This article analyzes in depth the steps taken by Danone in responding to these problems, including problem identification, crisis planning, forming a crisis management team, and implementing appropriate management strategies to maintain financial liquidity. This research also highlights the impact of boycott news on the liquidity of the PT Danone company. The results of this research provide insight into how large companies such as Danone are able to handle complex issue challenges in the era of social media and the rapid dissemination of information in maintaining company financial liquidity. It is hoped that these findings will contribute to business practitioners, policy makers and researchers interested in the financial sector, especially in the highly sensitive food and beverage industry. This research also emphasizes the importance of targeted issues and financial management strategies as a key factor in maintaining company liquidity in the midst of an unexpected crisis situation.

Poor sleep hygiene practice and associated factors among adults with epilepsy attending follow up care at Mettu Karl comprehensive specialized hospitals in Illu Ababora Zone and general hospital in Buno Bedele zone, Southwest Ethiopia’

BackgroundGlobally, sleep disorders are an important global public health problem. Poor sleep hygiene is at the core of chronic insomnia and other sleep disorders. Sleep hygiene practices are effective, practical, and affordable, and have no side effects other than other therapies benefiting patients with epilepsy. However, there is no research regarding sleep hygiene practice and its awareness among people with epilepsy in Ethiopia. This study aimed to assess sleep hygiene practice and its factors in patients with epilepsy.MethodsAn institutional-based cross-sectional study was conducted. The study included 424 participants selected through systematic random sampling. An interviewer-administered Sleep Hygiene Index (SHI) questionnaire was used to collect data.The collected data was analyzed using SPSS Version 25.0. Bi-variable and multi-variable analyses were conducted to identify factors related to poor sleep hygiene.ResultsThe frequency of poor sleep hygiene practice among people with epilepsy was 59.5%. Non-adherence to AED (AOR = 1.86, 95% CI: 1.13, 3.23), depression (AOR = 2.10, 95% CI: 1.42, 4.21), poor sleep quality (AOR = 5.7, 95% CI: 3.12, 10.01), anxiety (AOR = 2.71, 95% CI: 1.67, 4.82), and current alcohol drinkers (AOR = 1.74, 95% CI: 1.27, 3.13) were associated with poor sleep hygiene practice.Conclusion and recommendationThe perception of sleep hygiene practice among patients with epilepsy was poor. Non-adherence to AED, depression, poor sleep quality, anxiety, and current use of alcohol were associated with poor sleep hygiene practices. Therefore, regular screening, sleep issue management, and expanded mental health support are crucial. Training programs and awareness strategies to improve sleep hygiene are highly recommended. Professionals should incorporate sleep hygiene in epilepsy care.

Towards posthuman climate change education

ABSTRACT Climate change is one of the most critical challenges of our time, requiring significant responses from all aspects of society, including education. The prevailing responses to climate change tend towards treating the crisis as a predominantly scientific and managerial issue that requires technological solutions or behaviour changes. Correspondingly, climate change education (CCE) often focuses on teaching climate science and (predominantly individual) behaviour change. We argue that CCE, as part of a broader environmental and sustainability education (ESE), needs, in addition to a short-term damage limitation response, a simultaneous, longer-term, transformational approach that goes beyond critical humanism and engages with posthumanism. We explore ideas about human continuity with the more-than-human world, and the relationality and materiality of humans. Drawing on recent developments within posthuman pedagogies research, we consider how posthumanism might influence ESE/CCE, focussing on how two sustainability competency frameworks, UNESCO’s key competencies and the EU’s GreenComp, might be posthumanised.

Managerial Challenges in Implementing European Rail Traffic Management System, Remote Train Control, and Automatic Train Operation: A Literature Review

This paper explores the management of digitalization projects within the railway industry. It aims to increase and understand the opportunities presented by digitalization and automation in rail operations. Employing a scoping review methodology, this research investigates the execution of European Rail Traffic Management System (ERTMS), remote train control (RTC), and automatic train operation (ATO) projects spanning from 2005 to 2023, with a particular emphasis on metro automation, the remote control of freight and passenger trains, fully automated trains, and highly assisted driving. The refined selection process yielded 30 papers. The analysis of the retrieved papers identified managerial issues, with stakeholder management, change management, and organizational management emerging as recurring themes. Despite the increasing trend in publications, the limited representation managerial issues in ERTMS, RTC, and ATO projects in scientific research persists, with implications for the industry’s advancement. This research sheds light on the critical intersection of change management and digitalization within the railway industry by showing the impact of ERTMS, RTC, and ATO on organizational and scope dynamics. The need for human-centered systems is highlighted, showing the necessity of involving every echelon of the organization in the change management process. These findings provide insights for practitioners, researchers, and policymakers, emphasizing the need for understanding and addressing managerial aspects for successful and sustainable digitalization implementations.

Current research status and progress in neuropsychological development of children with congenital heart disease: A review.

Children with congenital heart disease (CHD) are receiving widespread attention for their neuropsychological developmental issues, which include cognitive, adaptive, motor, speech, behavioral, and executive functioning deficits as well as autism spectrum disorders. Timely identification of risk factors influencing neuropsychological development and implementation of appropriate interventions are crucial for enhancing the neuropsychological outcomes of children with CHD, ultimately benefiting the children, their families, and society as a whole. This comprehensive review article aimed to explore the epidemiology, risk factors, assessment methods, and monitoring strategies of neuropsychological development in children with CHD. By providing a detailed examination of these factors, this review serves as a valuable resource for researchers and practitioners in the field, facilitating deeper understanding and more effective management of neuropsychological issues in this vulnerable population.

A pharmacovigilance analysis of post-marketing safety of tezepelumab

BackgroundTezepelumab has shown promising efficacy for adult patients with severe asthma since its approval. However, the post-marketing safety evaluation of tezepelumab is currently lacking. ObjectiveThe present study aims to investigate the post-marketing safety of tezepelumab based on the FDA Adverse Event Reporting System (FAERS) database. MethodsAdverse events (AEs) reports from January 2022 to December 2023 were extracted from the FAERS database. Disproportionality analysis by reporting odds ratio (ROR) and empirical Bayesian geometric mean (EBGM) was performed to detect potential AEs related to tezepelumab. Clinical characteristics and time to onset of AEs were also assessed. ResultsA total of 1,699 tezepelumab-related AE reports were identified during the study period. Thirty tezepelumab-related AE signals were detected by simultaneously applying the two algorithms. At the system organ class (SOC) level, the most common SOC related to tezepelumab was respiratory, thoracic and mediastinal disorders. At the preferred term (PT) level, common AEs including arthralgia and back pain were detected which were also documented in the label of tezepelumab and clinical trials. New unexpected AEs such as chest pain and myalgia were also identified. The median time to onset of tezepelumab-related AEs was 7.5 days, and the majority of AEs occurred within the first 1 month after tezepelumab initiation. ConclusionThe present study presents a comprehensive evaluation of the post-marketing safety of tezepelumab in the real-world setting. Our findings will provide valuable evidence for future clinical studies and management of safety issues of tezepelumab.

Challenging frontiers in neuroplastic cranial reconstruction: addressing neurosurgical wound healing complications through interdisciplinary collaboration – an observational study

Background and objectivesAlthough rare, complications like skin dehiscence and necrosis after neurosurgery pose significant challenges by increasing the risk of infections spreading to the epidural, subdural, or intracerebral spaces. This retrospective, single-center study aims to assess the prior clinical courses, neuroplastic repair, and outcomes of patients with skin defects following cranial neurosurgical procedures, and to outline our interdisciplinary reconstructive protocol.MethodsA retrospective analysis was performed on cranial surgeries conducted at the Department of Neurosurgery, spanning from 2017 to 2023. Patients with skin defects requiring the combined expertise of neurosurgery and plastic surgery for effective treatment were included. The sizes of the skin defects were measured using intraoperative photographs analyzed with the freeware ImageJ software, version 2018. All patients provided informed consent for the surgeries. If informed consent was not possible due to neurological deterioration, consent was sought from adult representatives or next of kin except for acute circumstances. All patients admitted to our hospital agree to the pseudonymized use of their medical data and tissue specimens for research purposes in their treatment contract.ResultsA cohort of 24 patients experiencing wound healing complications after neurosurgical procedures underwent a total of 29 interdisciplinary surgeries for the reconstruction of skin, dural, and bone defects. After the neuroplastic surgery, 8 out of 24 patients (33.3%) developed surgical complications, with 6 of these requiring revision surgeries due to persistent cranial infection. In all cases, permanent wound closure was successfully achieved following adherence to the proposed treatment algorithm.ConclusionsOur study underscores the necessity of an integrated neurosurgical and plastic surgical approach to effectively manage wound healing complications in a single stage surgery. Key interventions include differentiation between necrosis and gaping lesions, alongside precise management of neurosurgical issues like cerebrospinal fluid fistulas and hydrocephalus. Plastic surgical expertise in assessing the possibilities and limitations of both local and free flap surgeries is essential.

Implementation of a Telemedicine Direct Oral Anticoagulant Monitoring Program at a Safety-Net Hospital.

Purpose: Direct oral anticoagulants (DOACs) are the preferred choice of anticoagulation therapy for nonvalvular atrial fibrillation and venous thromboembolism. Inadequate monitoring of patients on DOACs may lead to suboptimal outcomes and safety concerns. This project aimed to implement a standardized telemedicine-based DOAC monitoring service and track pharmacist-based interventions. Methods: This project was conducted at a safety-net hospital over 6 months. Anticoagulation pharmacists developed a scheduling process for telemedicine DOAC follow-up appointments, integrated them into the electronic health record, and implemented standardized protocols and documentation tools. Outcomes of interest included the average number of pharmacist interventions per encounter and per patient. Results: One hundred sixty-four encounters involving 120 patients were included in the analysis. 92.7% of encounters resulted in at least 1 intervention, with 73.8% involving an education intervention. The average number of interventions per patient was 2.0, with 37.2% of encounters having multiple interventions. Conclusion: Implementation of a standardized telemedicine-based monitoring service allowed for pharmacist identification and management of issues related to DOAC therapy. These findings emphasize the importance of pharmacist-led interventions and telemedicine-based follow-up of DOAC therapy.

Achieving RoutIne Screening for Emotional health (ARISE) in pediatric subspecialty clinics.

This study aims to describe the experience of implementing a psychosocial distress screening system for children with serious or chronic medical conditions. Achieving RoutIne Screening for Emotional health (ARISE) was developed to systematically evaluate psychosocial distress in children with serious medical or chronic medical illnesses, by integrating patient-reported outcome measures (PROM) into care delivery. ARISE was developed using a user-centered approach with extensive input from patients, families, and healthcare professionals to overcome barriers to routine PROM collection and integration into care as usual. It comprises a system to capture PROMs and then relay results to clinicians for changing care. We sought to implement ARISE at four subspecialty pediatric clinics caring for patients with cystic fibrosis, sickle cell disease, hemophilia, and neurological malignancy. Problems with acceptability, appropriateness, and feasibility represented barriers to implementation which were overcome by modifying the intervention using stakeholder input during the planning phase, leading to broad program acceptance. ARISE was implemented in three of the four clinics, in which 79.8% of eligible children and their family completed PROMs. The ARISE program demonstrated the feasibility and effectiveness of integrating psychosocial screenings into subspecialty pediatric clinics, thereby enhancing the identification and management of psychosocial issues in children with serious and chronic medical illnesses.

Air quality disparities and respiratory health risks in critically polluted and relatively non-polluted areas: a prospective child health study.

Air pollution, a significant global health concern, notably impacts human well-being. Children, owing to their distinctive physiology and behavior, are particularly susceptible to its adverse effects. This prospective study examines air quality variations and respiratory risks in children residing in critically polluted areas (CPA) compared to relatively non-polluted areas (NPA), utilizing a prospective design to understand the impacts of air pollution on children's respiratory health, including measures like relative risk (RR) and attributable risk (AR). This prospective study tracked 739 students of 5th- 7th grade residing in CPA and NPA for one year, and measured the ambient and indoor air quality levels in both these areas. Throughout the study, based on the observed respiratory symptoms new episodes of upper and lower respiratory tract illnesses were recorded for each child on a weekly basis. Incidence rate, RR and AR for both the illnesses were compared. Statistical analysis was performed with SPSS 26.0. The study observes higher concentration for particulate matter and gaseous pollutants at CPA in comparison to NPA. Children living in CPA exhibited a notably greater weekly occurrence of both upper and lower respiratory tract illnesses compared to those in NPA, with RR of 1.26 (95% CI: 1.16-1.37) and 1.74 (95% CI: 1.34-2.27), respectively. The AR associated with air pollution for upper and lower respiratory tract illnesses among CPA students was found to be 20.7% and 42.7%, respectively. This research underscores the pressing need to address air pollution in critically polluted areas and its profound effects on children's respiratory health. Public health interventions, such as reducing emissions from industries and creating green spaces, should be prioritized. Furthermore, early respiratory health screening in schools within polluted areas could aid in the timely diagnosis and management of respiratory issues in children.

Programmatic and Organizational Barriers and Facilitators to Addressing High-Risk Issues in Supportive Housing and Housing First Programs.

Risk management is an important component of service delivery in supportive housing and Housing First programs. However, there is no evidence on the implementation of risk management approaches in these settings. This qualitative study examined what service providers working in supportive housing and Housing First programs in Canada identify as the programmatic and organizational factors that affect the prevention and management of high-risk behaviours and challenges (e.g., overdose, suicide attempts, non-suicidal self-injury, falls and fall-related injuries, fire-setting, hoarding, apartment takeovers, violence, property damage, drug selling) in their programs. In-depth interviews were completed with a purposive sample of 32 service providers. Data were analyzed using an integrative approach that incorporated techniques from qualitative description and thematic analysis. Four thematic factors, which were comprised of various barriers and facilitators, that affected management of high-risk issues in supportive housing and Housing First programs were identified: [1] flexibility in addressing risk issues; [2] early identification of risk issues; [3] built environment and housing location; and [4] resource availability. Overall, the findings underscore how service providers aim to identify high-risk issues promptly, beginning as early as referral, and that their capacity to effectively do this and intervene accordingly is dynamically shaped by various aspects of the program model, environment, and availability of internal and external resources. Yet, the findings also highlight how risk management approaches may conflict with other programmatic goals and values, and the importance of considering these collectively. Systems-level changes to strengthen programs' capacity to prevent risk and implications for future research are discussed.

The Rise of Biochemical Sensors: Technology for Real-Time Health Monitoring (Applications and Future Scope)

Biochemical sensors integrated into wearable health technology represent one of the most transformative innovations of the 21st century. This review delves into the evolution, principles, and real-time applications of biochemical sensors and their role in personalized health monitoring. Wearable biochemical sensors, capable of continuously measuring various biomarkers like glucose, lactate, cortisol, and electrolytes, are revolutionizing healthcare by enabling proactive management of chronic diseases, including diabetes, cardiovascular disorders, and mental health issues. Advances in biosensing technologies, coupled with the use of AI and machine learning algorithms, have enhanced the sensitivity and accuracy of these devices, ensuring that critical health data is available in real-time. From glucose monitoring devices like Abbott's FreeStyle Libre to the latest nanomaterial-based sensors, these innovations are reshaping healthcare delivery by shifting the focus from hospital-centered treatments to patient-centric, continuous monitoring systems. This review provides an in-depth analysis of the technological advancements, challenges, and future directions in biochemical sensors, focusing on key technologies such as electrochemical, optical, and enzymatic sensors. It also highlights the critical role of AI in interpreting the complex data generated by these sensors, paving the way for more efficient diagnostics and predictive healthcare models. Furthermore, the paper explores how these sensors have been applied in infectious disease detection, particularly during the COVID-19 pandemic, and discusses their potential to enhance global health surveillance systems. In conclusion, wearable biochemical sensors represent a significant leap forward in the pursuit of personalized medicine, offering real-time diagnostics and timely interventions for disease management. The future of healthcare is closely tied to the ongoing innovations in sensor technology, with the promise of even more advanced and multifunctional devices on the horizon.

Health-related quality of life and clinical characteristics of hidradenitis suppurativa in a paediatric population

Hidradenitis Suppurativa (HS) is a chronic, Skin Immune-Mediated Inflammatory Disease (sIMID), with a high impact on Quality of Life (QoL). Data on clinical management, comorbidities, psychosocial burden, and psychiatric disorders in paediatric patients with HS is scarce. The aim of our study was to compare clinical characteristics and Patient-Reported Outcome Measures (PROMs) for Health-Related Quality of Life (HRQoL) in adult and paediatric patients with HS. Data were collected on 601 patients with HS, 60 of whom (10.0%) were paediatric. The psychological and HRQoL impact was generally higher in adults than in children, but it was noteworthy also in paediatric patients. Early diagnosis and interventions based on education for the patients and their families and psychological support are the key to optimal disease management and adherence. Our study underlines the need for screening for HS-associated psychiatric disorders and for using age-specific tools to evaluate HRQoL. A multidisciplinary approach involving several specialists is needed, as well as liaison with primary care specialists to improve care, and management of comorbidities and psychological issues in patients with HS.

Exploring and assessing issue communication – issue communication practices and consequences of issue response strategies for organizational reputation and legitimacy

PurposeAlthough issue management has received ample attention, changes in the media landscape and increased societal scrutiny are currently challenging organizations’ communicative handling of issues. This raises the question of how communication professionals currently perceive and communicatively deal with issues, and what impact issue response strategies have when organizations are addressed regarding their involvement in an issue.Design/methodology/approachWe explore issue communication perceptions and practices by communication professionals in two focus groups. A subsequent experimental study assesses the consequences of issue response strategies for corporate reputation and legitimacy and examines to what extent this relationship can be explained by skepticism while taking issue phase into account.FindingsAlthough most issue communication practices (still) resemble earlier descriptions, the focus groups also indicate the importance of timing and medium of issue communication. The experiment shows that organizations are better off responding to an issue than not responding at all. Organizations should choose for an accommodative or adaptive response to positively impact reputation and legitimacy, and should be aware of the phase of an issue. Remarkably, these empirical differences only apply for a sustainability issue, not for a social issue.Originality/valueThe focus group study illuminates current issue monitoring and communication practices in today’s challenging media and societal landscape. The subsequent experiment enhances our understanding of a sub-field of issue communication: the communicative options of organizations when they are the addressed actor in issues.

Raising Awareness of the Impact of Stunting on Toddler Development Through Parental Education

In 2023, the prevalence of stunting in Indonesia remains at 21.5%, showing only a marginal decrease of 0.1% from the previous year and still exceeding the WHO standard of 20%. Stunting adversely affects children, leading to impaired physical and cognitive development, increased risk of developmental disorders, and a higher likelihood of metabolic diseases in adulthood.This study utilized a multi-stage approach: data and area analysis, educational and developmental screening, and evaluation. Participants included 44 parents with their toddlers, 5 cadres, and 3 village officials. Knowledge among participants improved significantly, with 76% demonstrating enhanced understanding. Statistical analysis revealed a significant increase in knowledge post-intervention (p=0.000). Developmental assessments showed that 11% of toddlers were classified as "doubtful" and 23% as having "deviant" results. Parents of these children received education on age-appropriate stimulation, and cases were reported to local health workers. The goal is for the acquired knowledge to be widely applied, with ongoing routine screening for early detection and timely management of developmental issues.

Institutional investors’ role in implementing book building: Views of market participants

The aim of this paper is to assess the views of market participants concerning the institutional investors’ role in implementing book-building pricing of IPOs as Nepal seeks to implement it. A total of 125 market participants were approached for data collection using a structured questionnaire that took a six-month period from January to June 2020. Descriptive and inferential statistics were employed to analyze the collected data. The study found that the role of institutional investors in the prevailing stock market is brutally meager because of the restrained regulatory provisions. Market participants opined that institutional investors play a vital role in developing the stock market and executing book building. Implementation of book building demands a rigorous amendment in the existing regulations that allow institutional investors to enter and play in the market. A precise classification and definition of the potential roles of institutional investors are essential so that the application of the building pricing mechanism could be expected to be more effective. Market participants believed that the active participation of institutional investors will help lure manufacturing and real sector companies, trading houses and hotels into the capital market for public offerings. Issue managers, portfolio managers, share registrars, and stockbrokers agree that the role of institutional investors is inevitable in implementing book-building pricing.

Effective Management of Multi-Cultural Construction Project Teams Issues and Strategies for Improving Team Performance

Effective Management of Multi-Cultural Construction Project Teams Issues and Strategies for Improving Team Performance

On Digital Transformation Experience of the Order Fulfillment Process

The paper examines the process of order execution being won on a tender platform. Due to the short order fulfillment deadline, the work starts not at the moment of contract signing, but at the moment of winning the tender. This leads to additional risks of non-fulfillment of the order and the emergence of unfinished production. In the conditions of stock exchange prices in commodity markets, the process of the production cost determination becomes a more complex task, requiring daily cost reevaluation with the integration of heterogeneous information systems. Therefore, a transition from automation to digital transformation is required. The literature review on the issue of manufacturing enterprise digital transformation has been completed at work. The differences between the definitions of digitalization, automation and digital transformation are described. The most promising technologies for digital transformation are outlined. Based on the reviewed literature, the main problems of digital transformation, including managerial issues highlighted by the authors as the most important, are identified. The operations of several enterprises within one information space are described, indicating the information systems used. The process of creating an order on a tender platform for the examined manufacturing enterprise is detailed, as well as a detailed description of order creation. The issue of production cost determination in the conditions of order execution start prior to contract signing is discussed. The pressing issue of digital development of an industrial enterprise due to the transition to new information systems is presented. The problems of using current information systems in production are described. The market analysis of modern Russian, foreign, and open-source systems with a description of the issues of their application is provided. A method for unfinished product automation in a new order is proposed.

Challenges and Opportunities to Work and Industry Practice in Occupational Therapy: A Practitioner Survey.

Work and industry (W&I) is a vital yet underrepresented area of occupational therapy practice. Describing the current practice trends, challenges, and opportunities in W&I provides a foundation for future development and advancements. To describe the state of W&I occupational therapy practice and to identify challenges and opportunities in this specialty practice area. Cross-sectional survey conducted June 12 to July 17, 2020. Online survey distributed through direct email invitations and online platforms (i.e., CommunOT, LinkedIn). One hundred twenty occupational therapy practitioners who had worked in W&I within the most recent 5 yr. We used 30 multiple-choice, Likert-scale, and free-response questions across three topics: (1) training, resources, and research; (2) challenges and barriers; and (3) opportunities. Most respondents were occupational therapy practitioners working in clinical settings with >5 yr of experience; 29.2% identified as male. The most frequently provided services were ergonomic consultation and worksite evaluation; clinic-based W&I services were less frequently provided. Workplace injury prevention, management of psychosocial issues, and employee wellness programs were ranked as the top opportunities for occupational therapy in W&I. A shortage of accessible training and resources to support W&I practice was found, particularly mentoring and occupational therapy-focused research evidence. Maintaining referrals, competition from other professions, and limited support from professional organizations were key challenges. This study illustrates the evolution of W&I occupational therapy practice and highlights an urgent need for increased professional recognition and educational support to maintain occupational therapy's presence in this practice area. Plain-Language Summary: In this study, we describe the current practice trends in work and industry occupational therapy practice. We identify challenges related to resources and training in this practice area and provide insights into opportunities for future development. The study findings show the evolution of work and industry occupational therapy practice and highlight an urgent need for more professional recognition and educational support to maintain occupational therapy's presence in this practice area.