Aspects Of Management Research Articles

Lung Isolation Techniques for Challenging Airway Scenarios: A Narrative Review

Lung isolation is a critical aspect of patient management during thoracic cancer surgeries. While conventional techniques are well established for patients with normal airway anatomy, anatomical alterations in the upper or lower airways, especially due to cancer, can pose significant challenges. This review thoroughly examines the available lung isolation techniques for challenging airway scenarios, aiming to guide clinicians in selecting the most appropriate approach for each patient. Here, we explore the intricacies and nuances of one-lung ventilation in patients with altered airway anatomy. A comprehensive literature search was conducted using PubMed from January 2000 to May 2024, and additional references were identified through manual review. A tailored approach using available techniques is warranted in difficult airway scenarios, especially in patients with complex anatomical variations. The techniques such as a single-lumen endotracheal tube with bronchial blocker and a double-lumen tube insertion using a video laryngoscope or paediatric fibre-optic bronchoscope are discussed in difficult upper airway abnormalities. In some of the lower airway abnormalities, diverse lung isolation techniques mentioned in the literature are described.

Market Access Challenges and Solutions in Cell and Gene Therapy in The Netherlands.

With the increasing pipeline of cell and gene therapies (CGTs) and the expected surge in the number of approvals, understanding the market access landscape becomes crucial for timely patient access. This study evaluates the challenges Dutch stakeholders encounter in CGT market access, offering insights for improving time-to-patient access. A traditional literature review was conducted to identify market access challenges and solutions for CGTs. Based on the findings, participants for semi-structured interviews, designed using an interview guide adapted to the Dutch context, were selected to capture diverse perspectives on market access. This review included 124 relevant articles out of 2449, covering several aspects of market access of CGTs. Subsequently, interviews with 16 stakeholders from academia, patient advocacy groups, manufacturers, health insurers, payers, hospital pharmacists, healthcare practitioners, and the Association of Innovative Medicines were conducted. Stakeholders identified challenges and proposed solutions for reimbursement package management, clinical trials, health economics, payment models, and procedural and organisational aspects. Thematic analysis revealed unique country-specific challenges and solutions in the Netherlands. This research provides insights into these challenges and potential solutions, emphasising the need for collaborative efforts among stakeholders to develop practical and multidisciplinary measures to improve the market access landscape for CGTs in the country.

Study of the Impact of Private Equity Involvement on Corporate IPO Decisions

At present, private equity investment has become a relatively popular option for financing enterprises of unlisted companies. This paper conducts a case study on the changes in profitability, development, and technological innovation ability of NAIXUE before and after its listing. Tiantu invests in this famous listed catering company to explore the issue of how private equity intervention affects the decision-making of enterprises to go public. The single-case study found that personal equity intervention can help enterprises accelerate the speed of financing, improve their soft power, profitability, and competitiveness, and accelerate the listing process. They proposed a profitable way for private equity firms to continue to hold shares after listing. Under its unique operation mode and management ability, private equity supports enterprises in management, technology, resources, and other aspects. Resource integration helps solve the difficulties in developing enterprises before going public so that they can concentrate on technological innovation.

Best practice care for acute low back pain: A new clinical standard to assist general practitioners.

Low back pain is one of the most common presentations in general practice. Although there is excellent evidence regarding best management of the condition, in primary care there is often overuse of less effective and expensive options, whereas effective, inexpensive options are underused.After broad consultation and evidence review, the Australian Commission on Safety and Quality in Health Care has developed a clinical care standard in response to this identified gap between best and actual practice. A clinical care standard focuses only on key areas of care where the need for quality improvement is greatest. We explore the new standard using a typical patient scenario in primary care to highlight evidence-based approaches for challenging aspects of management, such as imaging and pain management. General practitioners (GPs) might find the practical GP 'quick guide' resource from the standard useful to support their care of patients with low back pain.

A Study of waste generation and waste composition in Pasaran Island for the sustainability of tourism industry in Lampung, Indonesia

Abstract To date, no studies have been undertaken on Pasaran Island to investigate waste generation and composition, rendering this research significant for laying the groundwork for precise and sustainable waste management planning. Existing studies predominantly center on waste generation concerning community behaviour, stakeholder roles in management, and the technical assessment of waste management aspects. Consequently, this study aims to quantify waste generation and composition on Pasaran Island. Sampling adhered to the SNI-19-3694-1994 standard over eight consecutive days, focusing on household waste for domestic waste samples and selecting commercial establishments, mosques, and schools as sources for non-domestic waste samples. The research reveals an average waste generation rate of 0.13 kg/person/day on Pasaran Island. Organic waste predominates, constituting 44% of the total, originating from household activities like kitchen waste and waste deposited on the island by the sea. Plastic, encompassing bottles, bags, and food packaging, ranks as the second most prevalent waste type at 26% of the total. Residents in tourist areas exhibit distinct waste generation characteristics. The findings can be utilized for the development of the tourism sector to consider organic waste as the primary focus, it must be addressed first.

A Risk Management Application by Failure Mode and Effect Analysis (FMEA) Method in A Road Drainage Channel Construction Project at H.M Ardan Street of South Sangatta District East Kutai, Indonesia

A construction project of road drainage channel in H.M Ardan Street, South Sangatta District (Multy Years) is included into type of construction project with high level of risk and work accidents since it has large number of workers, the use of sophisticated work tools and machines that require special methods and skills also strong supervision in its usage. These matters could bring undesirable impact potentiality in particular for the occupational safety and health aspect. A negligence of OSH implementation in the construction project can lead to work accident risk within the project. A work safety management is a part of management aspect with function to prevent any work accidents. Its prevention can be done by controlling the occurrence of high-potential work accidents whether in terms of consequences, occurrence probability, also simplicity in its detection. Many safety management methods have been introduced as method that able to be used for potential work accident identification, or measure the level of work accident’s risk, also for evaluating the work accidents; which leads to the Failure Mode and Effect Analysis (FMEA) method as the most appropriate method to achieve the objectives as described above. The selected method for this research was Failure Mode and Effect Analysis (FMEA) method, whereas the data source of this research were primary data obtained from interviews and questionnaires, and secondary data obtained from site plan drawings and identification data of the construction of drainage channels on H.M Ardan Street of South Sanggata District (Multi Years). According to FMEA analysis, there were 15 dominant risks with RPN values above the average value with 4 risks having a value of 48 as the highest RPN value found in this study. Type of risks with the highest RPN value were (a) stricken by heavy equipment and materials during loading and unloading construction materials; (b) fatigue due to an overly busy mobilization schedule; (c) workers fall while installing the formwork; (d) workers’ hand was pierced by nail or getting hit by hammer or wood. Furthermore, by the domino analysis conducted for this research, it produced several precautions and prevention recommendations that grouped into three main stages: Lack of Control, Basic Causes, and Immediate Causes.

ECONOMIC AND LEGAL ASPECTS OF THE ANTI-CRISIS MANAGEMENT OF THE STAFF POTENTIAL OF THE ENTERPRISE UNDER THE CONDITIONS OF STRENGTHENING PROCESSES OF FORCED LABOR MIGRATION

The purpose of the article is to identify the problematic economic and legal aspects of anti-crisis management of the personnel potential of the enterprise in the conditions of strengthening the processes of forced labour migration of the population. The results obtained in the course of the research allow us to ascertain the significant impact on the activities of economic entities of modern challenges and dangers, which cause significant destructive changes in the labour resource management system of enterprises as a result of the threatening increase in the scale of forced labour migration, which exacerbates the shortage of personnel at domestic enterprises. and through the intensification of mobilization measures, which cause the movement of the economically active and highly qualified labour force to the structures of the defence forces and the Armed Forces of Ukraine. The article analyzes the essence, features and interrelationship of the anti-crisis management of the personnel potential of the enterprise with the processes of forced labour migration of the population. It has been established that forced labour migration is a destabilizing factor in enterprise activity and creates prerequisites for the emergence of crisis situations. It has been proven that forced labour migration has a significant negative impact on the formation of labour resources of domestic enterprises, which causes a shortage of highly qualified workers. It was found that the processes of forced labour migration within the regions continue to intensify in Ukraine. In order to overcome crisis situations at the enterprise regarding the management of personnel potential, the most appropriate measures are proposed and substantiated. The model of anti-crisis management of the personnel potential of the enterprise in the conditions of strengthening the processes of forced labour migration of the population is substantiated and proposed.

Analysis of the Effect of Education Fund Budget on Performance Accountability and Transparency in School Fund Management (Cirebon City)

This research aims to analyze the influence of the education budget on performance accountability and transparency in fund management in Cirebon City schools. Using a quantitative approach, this study examines the relationship between education budget allocation and two important aspects in school management, performance accountability and transparency of fund management. Data was collected from school financial reports and surveys conducted among schools and financial managers in schools in Cirebon City. The results of the analysis show that, with a data sample of 14, with 25 total respondents, there is a significant positive correlation between the education budget and performance accountability (r = 1) and transparency of fund management (r = 0.982). These findings confirm that efficient allocation and use of the education budget not only increases accountability for school performance but also strengthens transparency in fund management. Survey responses, which range from 0 (disagree) to 1 (agree) on a rating scale, indicate positive perceptions of existing financial management practices. This study provides empirical evidence about the importance of good education budget management as a tool for improving the quality of education, especially in Cirebon city schools.

Аспекти стратегічного спрямування діяльності підприємств

The article examines aspects of the strategic direction of enterprise activity. We proceed from the fact that the enterprise, by definition, is a purposeful, open system that exchanges goods and material values, energy, and information with the external environment. Pay attention to the strategic direction of the enterprise’s activities from the point of view of its management to maintain its level of system excellence, particularly system potential and the ability for sustainable development. The management of domestic enterprises still perceives most aspects of strategic management as formal processes that are declared but, in fact, still need to form the basis of the enterprise’s activity and, accordingly, reduce the potential for achieving long-term sustainable results in practice. If the management of the enterprise does not deal with these issues, then the staff, depending on the system of their values and culture as a way of life, will consider their work at the enterprise within the scope of their activities. More likely, only from achieving their own goals and satisfying personal interests. The most attention is paid to the task of the enterprise’s mission as an element of a set of strategic targets. However, there is currently no single approach to developing the company’s mission. Considering the list of elements of the mission and choosing those that are most relevant from the point of view of the current system state of the enterprise in the context of its strategic direction is directly reflected in the choice and implementation of the approach to the formation of the mission of the enterprise. The functioning of the enterprise in the direction of the defined mission becomes possible thanks to the establishment and achievement of the goals of its activity. At that time, the goal is a specific state of the desired result in the future, which the company seeks to achieve. The mission of the enterprise and the strategic goals of activity arising from it allow the enterprise to coordinate the level of system potential, harmonizing its ambitions with the state of the external environment in which it operates. The target orientations are the basis of the strategic direction of the enterprise’s activity and determine its future desired state, in particular, the possibility of being potentially competitive in market conditions in the long term. Also, they enable the company’s management to look from the future into the present and determine what actions must be performed by everyone inside the company today to achieve a particular state in the future. In general, it can be said that the task of targeting strategic landmarks allows the enterprise to acquire such characteristics that provide it with the possibility of long-term effective functioning in a highly competitive market environment. In this regard, it is relevant to consider the approaches to the task of target strategic orientations of the enterprise, which exist today in foreign and domestic theory and practice of strategic management. Keywords: strategic management, strategic guidelines, enterprise, strategic direction.

Empowering Natural Medicine: Nanocarrier-based Oral Delivery of Vigna Radiata Extract for Effective Diabetes Management

Background: Poor solubility and low oral bioavailability are major challenges associated with the oral delivery of the antidiabetic drug Vigna radiata (VR). Nanostructured lipid carriers (NLCs) have emerged as a promising strategy to overcome these limitations and improve the therapeutic efficacy of VR. This study investigated the potential of NLCs for VR delivery and explored the influence of formulation parameters on NLC properties and drug release behavior. Method: NLCs loaded with VR were prepared using the melt emulsion ultrafiltration technique. The effect of two key formulation variables – the ratio of liquid lipid to solid lipid and the concentration of the surfactant – were investigated in terms of particle size, zeta potential, and drug encapsulation efficiency. The in vitro release profiles of the VR-NLC formulations were evaluated, and the optimal formulation was subjected to further analysis to investigate its release kinetics. Result: The NLCs exhibited particle sizes ranging from 108.9 to 192.3 nm and all formulations possessed a negative zeta potential (-3.68 to -10.9 mV), indicating good stability and potential for resisting aggregation. Interestingly, the lowest solid lipid to liquid lipid ratio and the lowest surfactant concentration yielded the highest drug encapsulation efficiency, highlighting the complex interplay between these factors. All VR-NLC formulations exhibited a biphasic, time-dependent in vitro release pattern, suggesting an initial burst release followed by a sustained release phase. This biphasic profile is promising for achieving both rapid onset of action and long-lasting glycemic control, which are crucial aspects of effective diabetes management. The optimized NLC formulation showed an in vitro release pattern that adhered to the Higuchi diffusion model, suggesting a controlled release mechanism where the drug diffuses steadily out of the NLC matrix. This finding indicates potentially predictable and consistent drug delivery in vivo. Conclusion: This study demonstrates the potential of NLCs as a promising platform for the controlled oral delivery of VR. NLCs can overcome the inherent limitations of VR and provide a convenient and effective oral antidiabetic option for patients. Further research is needed to confirm the efficacy and safety of NLC-encapsulated VR in vivo using relevant animal models. This will pave the way for the development of a novel and potentially transformative treatment option for diabetes.

THE EFFECT OF GREEN TRANSFORMATIONAL LEADERSHIP AND GREEN HUMAN RESOURCE MANAGEMENT ON ENVIRONMENTAL PERFORMANCE WITH GREEN INNOVATION AS A MEDIATING VARIABLE AT PT INDUKSARANA KEMASINDO IN JAKARTA

This study aims to analyze the influence of Green Transformational Leadership (GTL) and Green Human Resource Management (GHRM) on Environmental Performance and Green Innovation, as well as the relationship between Green Innovation and Environmental Performance. This study uses a quantitative approach with the partial least squares structural equation modeling (PLS-SEM) analysis method, with Green Innovation as the mediating variable. The study uses primary data collected through questionnaires from 110 employees of PT Induksarana Kemasindo. The results show that GHRM and GTL have a significant role in improving environmental performance and green innovation (Green Innovation) at PT. However, Green Innovation does not function as a significantly mediator between GTL, GHR, and environmental performance. As a practical suggestion, companies need to improve the effectiveness of the GTL by integrating environmental sustainability principles into all aspects of human resource management and creating a work environment that supports Green Innovation.

КЫРГЫЗ РЕСПУБЛИКАСЫНДАГЫ БИШКЕК-НАРЫН-ТОРУГАРТ АВТОЖОЛУН КУРУУДА САПАТТЫ БАШКАРУУ СИСТЕМАСЫН БААЛОО

The study focuses on the quality management system during the construction of the Bishkek-Naryn-Torugart motorway in the Kyrgyz Republic. It aims to analyse key aspects of quality management, identify problematic issues and propose recommendations for improvement. The methodology includes analyses of regulatory documents, technical specifications and data collected during the monitoring of construction works. The main focus is on quality control of materials, construction techniques and compliance of completed works with standards. The analysis of data, regulatory framework and practical experience helps to identify the main problems and propose recommendations for improving quality management in road infrastructure construction. The study aims to improve the efficiency of road construction project management and ensure an increased level of quality of road infrastructure in the country. As a result, the key factors affecting the effectiveness of the quality management system in the construction of a motorway are identified. Recommendations on optimisation of quality management processes to improve the level of work performance and ensure long-term sustainability of the Bishkek-Naryn-Torugart road infrastructure in the Kyrgyz Republic are proposed.

Модель психологічного супроводу підлітків з порушенням зору

The article addresses the pressing issue of developing a model of psychological support for adolescents with visual impairments. Adolescents' personality development during their school time ultimately determines their opportunities for successful social integration into society in future. Therefore, the need for psychological support for adolescents with visual impairments proves increasingly relevant. The aim of this study is to analyze scientific views on the essence of psychological support as a phenomenon and develop a model of psychological support for adolescents with visual impairments, which can contribute to their individual development and socialization. The analysis of scientific principles and approaches to the issue of psychological support for adolescents with visual impairments has allowed us to reveal the essence of support as a psychological phenomenon and develop a model of psychological support for adolescents with visual impairments. Scientists have established that adolescence requires systematic support, comprehensive psychological support in the process of personal growth at this complex stage of maturation. We argue that psychological support is a process of organizing and conducting a comprehensive system of psychological measures that help an individual to optimize their mental health condition, effectively adapt and develop progressively. Support system is proved to be based on a theoretical model, a set of conceptual provisions and technologies, which is focused on the content of the development problems of adolescents in various social systems. Three leading constructive principles of the support system have been identified. The first principle calls for a change in research paradigm—from exploring psychic phenomena and manifestations to studying the laws of personality development for persons with visual impairments. The second principle characterizes a change in the paradigm of acting upon the support system, urging and wishing, providing equal opportunities in decision-making. The third conceptual provision is identifying the ground to develop means and methods. A model of psychological support for adolescents with visual impairments has been developed within the social system of "students - educators - parents". It combines managerial and psychological aspects. The theoretical significance of the study is the analysis of scientific views on the essence of psychological support as a phenomenon. The practical significance is the development of a psychological support model for adolescents with visual impairments, which can contribute to their personal growth and socialization. The prospects for further research in this area entail empirical verification of this psychological support model in terms of its effectiveness for adolescents with visual impairments.

Developing Energy Conservation Strategies in Agricultural Enterprises

The article emphasizes that agriculture has specific aspects, particularly regarding energy consumption. The research reveals that some agricultural enterprises are capable of generating their own energy. These characteristics are associated with various types of energy used in the production process: fossil energy, solar energy, and soil energy. The authors highlight the need for special attention to the development of energy-saving strategies in agriculture, as these enterprises often face high energy costs and have significant potential for enhancing energy efficiency. It has been established that reducing the use of fossil energy sources and maximizing the use of renewable sources, such as solar energy and soil energy potential, can substantially contribute to energy conservation in the agricultural sector. The considerable dispersion of agricultural enterprises leads to high costs and differences in energy consumption principles: fossil energy is primary for industry, while in agriculture, it serves a supplementary role, where natural energy forms biological mass (crops, livestock). The importance of management aspects in developing an effective energy-saving strategy, which promotes sustainable development and economic benefit in the agricultural sector, is highlighted. The authors propose key steps for ensuring energy conservation, which should form the basis for creating a comprehensive energy-saving strategy in agriculture.

Handling of Corruption Crimes at the Tanggahan Peken Village Credit Institution, Susut District, Bangli Regency Handled by the Bali Police

Lembaga Perkreditan Desa (LPD) is a vital financial institution for traditional villages in Bali, whose role is to save funds, provide credit, and support village development. However, some LPDs, such as Tanggahan Peken LPD in Bangli Regency, have experienced legal problems related to alleged corruption crimes committed by their administrators. The purpose of this study is to determine and analyze the handling of criminal acts at the Tanggahan Peken Village Credit Institution, Susut District, Bangli Regency handled by the Bali Police. The natural method of this research uses empirical legal research. The results showed that the occurrence of criminal acts of corruption committed by the Tanggahan Peken LPD management was caused by internal factors from the individual aspect of the LPD management to gain profit, enrich themselves and perpetuate their positions and external factors from the organizational aspect, namely the lack of regular guidance, supervision and audits carried out by LPD internal supervisors and LPLPD as technical supervisors and audits. The handling of corruption crimes by the Bali Police at the Tanggahan Peken Village Credit Institution (LPD) uses Standard Operating Procedures (SOP) from the process of receiving public complaints, investigating and investigating. Creating effective investigation and investigation plans. Investigators also conduct independent audits and examinations by involving experts in the field of accounting and auditing, experts in the field of economics and experts in criminal law.

OVERCOMING THE ARCHITECTURAL AND CONSTRUCTION MANAGER’S PROFESSIONAL AND PSYCHOLOGICAL ACADEMICISM TOWARDS CLIENTS: PROBLEMS AND SOLUTIONS

The study is devoted to the problem of the overcoming of the professional and psychological academicism of the manager of the architecture and construction industry when dealing with clients. The term “manager’s psychological academicism” is defined as a manager’s readiness and competence in the field of interaction with clients and partners, combining professional management aspects with psychological knowledge and skills. The authors of the study stress that in order to overcome the psychological academicism of a manager, it is necessary to have an understanding of the psychological characteristics of clients, to be able to perceive their needs and expectations, and to adapt personal communication strategies in accordance with clients’ requirements. Particular attention is given to the ability to listen, understand and communicate effectively with clients, as well as building trust and positive relationships with them. In addressing the issue of psychological academicism, the key aspects of emotional control and emotional intelligence are discussed. The paper also highlights the importance of negotiation skills and adaptation to clients’ cultural characteristics and values for successful co-operation. Thus, the key to successful collaboration and achievement of business goals is the development of psychological academicism in the interaction of the architect and construction manager with the client. Recommendations for overcoming psychological academicism will help managers improve service quality, build trust and achieve success in their work, such as developing empathy, communication skills, cultural awareness, conflict management and building positive relationships. This approach will contribute to the creation of a positive working environment, the promotion of charismatic leadership and the increase in the effectiveness of projects in the architecture and construction industry. To sum up, overcoming psychological academicism is an important component of successful leading and working in a manager’s professional life. Overcoming psychological academicism will contribute to the successful implementation of projects and improve client relations, which will help to strengthen the market position and develop the business.

Analysis of Factors Inhibiting the Implementation of Patient Medical Record Retention and Destruction Activities at Waluyo Jati Hospital

Retention and destruction of medical record documents is a management aspect in health archives to reduce files that have been stored on the filling rack for a long time. This study aims to analyze the factors that hinder the implementation of retention and destruction of medical record documents at RSUD Waluyo Jati. Qualitative descriptive method was used to analyze these factors with data collection using the 5M approach. The results showed that the main obstacles were the lack of D3 Medical Record graduates and the lack of training related to document retention and destruction. RSUD Waluyo Jati does not have an SPO (Standard Operating Procedure) related to retention and planning document retention and destruction schedules and still uses the old ICU room to store inactive documents. Other problems include the lack of shredding and file transfer equipment, and the absence of a dedicated budget for these activities. The conclusion of this study emphasizes the importance of implementing retention and destruction of medical record documents in managing efficient archives. As a solution, efforts such as increased education and training for staff, the development of comprehensive SOPs, planning document retention schedules, improving infrastructure, collaboration with third parties, and proper budget allocation are needed to ensure the effectiveness of the medical record retention and destruction process.

Clinicians' Preferences for Sphingosine-1-Phosphate Receptor Modulators in Multiple Sclerosis Based on Clinical Management Considerations: A Choice Experiment.

Four sphingosine-1-phosphate receptor (S1PR) modulators are currently available in the USA for treating relapsing forms of multiple sclerosis (MS). These S1PR modulators have similar efficacy. Clinicians may therefore consider other factors, such as clinical management considerations, when distinguishing among treatments. This study estimated which S1PR modulator clinicians would choose on the basis of a treatment's clinical management and quantified how individual aspects of clinical management might drive this choice. A multi-criteria decision analysis (MCDA) was conducted on the basis of clinical management preferences elicited in a discrete choice experiment (DCE) and real-world clinical management profiles of the S1PR modulators currently available to treat relapsing forms of MS (fingolimod, ozanimod, ponesimod, siponimod). The DCE was completed by neurologists in the USA experienced in treating MS and included eight clinical management attributes: first-dose observations, genotyping, liver function tests, eye exams, drug-drug interactions, interactions with antidepressants, interactions with foods high in tyramine, and immune system recovery time. Attribute levels were selected on the basis of S1PR modulator product labels. In the MCDA, partial MCDA scores were created for each attribute and summed to produce an overall MCDA score for each S1PR modulator. The DCE was completed by 200 neurologists. The overall MCDA score was highest for ponesimod (4.78 points), followed by siponimod (4.10 points), fingolimod (3.61 points), and ozanimod (2.38 points). Having fewer drug-drug interactions contributed most to the overall scores (up to 1.56 points), followed by having no first-dose observations (0.95 points), the shortest immune system recovery time (0.94 points), and not interacting with foods high in tyramine (0.86 points). When considering clinical management convenience, the average US-based neurologist treating MS is likely to choose ponesimod over siponimod, fingolimod, or ozanimod. The strongest driver of preferences was the number of drug-drug interactions. This information can help inform recommendations for the treatment of MS and facilitate shared decision-making between clinicians and patients.

Physical Medicine and Rehabilitation Approach of Elderly with Atypical COVID-19 Symptoms

COVID-19 has affected the older population disproportionately. These patients are prone to have more severe COVID-19. Clinical manifestation of COVID-19 in the geriatric can be atypical and differs from the younger population. We report an 80-year-old male with atypical presentation of COVID-19. In this case report, we describe a COVID-19 patient with anorexia and gastrointestinal symptoms. We also describe the multidisciplinary aspect of physical medicine and rehabilitation management of the patient. Clinical manifestations in geriatric with COVID-19 can be atypical. Symptoms experienced may include anorexia and gastrointestinal tract symptoms. A multidisciplinary approach is needed to manage more seniors with COVID-19 and maximize their functional abilities.

Current trends in the management of hypospadias: the Ibero-American experience

Introduction: Hypospadias management has seen various trends over the years, likely due to the diverse clinical presentations and evolving surgical techniques. However, there is a lack of consensus among pediatric urologists on many aspects of hypospadias management. To address this, our research aims to survey specialists and establish a consensus on hypospadias management. Methodology: In July 2021, a cross-sectional study was conducted using a Survey Monkey questionnaire consisting of 23 questions. The survey aimed to gather information about the generalities and management preferences of distal and proximal hypospadias from specialists belonging to the Ibero-American Society of Pediatric Urology (SIUP). The data collected was categorized into subgroups based on surgical techniques, perioperative preferences, and complications. Results: Most hypospadias surgeries are performed between 13-18 months. Penile curvature is evaluated with artificial erection and visual inspection. The Nesbit technique (36.1%) and ventral corportomies (26.9%) corrections are more common, while grafts corporoplasties are used less frequently (10.2%) for correction. For urethroplasty, the surveyed group prefers using a running suture or a combination of continuous and interrupted stitches (49.1% and 24.3%, respectively). The use of Polydioxanone 6-0 in a double-layer suture group yielded a higher response rate. The use of prophylactic antibiotics and their maintenance when the catheter is in place was also favored by most surgeons. Discussion: When repairing hypospadias, the surgeon must consider factors such as the quality of the urethral plate, the presence of penile curvature, and the location of the urethral opening. This study highlights the different strategies and technical preferences used for hypospadias repair by a group of specialists from different countries. Conclusion: The survey describes current trends in hypospadias management. Two-stage repair is commonly used for proximal hypospadias, while TIP repair is the most used technique for distal hypospadias. The most common complication is the development of an urethrocutaneous fistula.