Aspects Of Performance Research Articles

EXAMINING MALAYSIA'S LOW-INCOME HOUSING ENVIRONMENT: A QUANTITATIVE STUDY OF THE LOW-INCOME HOUSING ENVIRONMENT'S IMPACT ON RESIDENTS' ATTITUDES AND QUALITY OF LIFE

In Malaysia, the burgeoning population has increased the demand for affordable housing, leading to the establishment of Low-Income Housing Programs (PPR) to assist the B40 income group. Despite the noble intentions, PPR communities face challenges, especially with residents' behaviours such as improper waste disposal, which exacerbate cleanliness and safety issues. These behaviours negatively affect living conditions and contribute to an increase in crime rates within these areas. Numerous studies have investigated how the PPR environment impacts residents' quality of life, highlighting the prevalence of detrimental living conditions. Although extensive research has been conducted on the structural and operational aspects of PPR housing, more studies are needed to explore the direct impact of residents' attitudes on their quality of life. This study aims to bridge this gap by examining the intermediary role of residents' attitudes towards their environment and its subsequent effect on their quality of life. Utilizing data from a survey conducted in five states with PPR residents and employing the Partial Least Squares (PLS) method, the study found significant correlations between the PPR environment, residents' attitudes, and their quality of life, underscoring the crucial role of attitude in shaping the living experiences of PPR inhabitants.

Green Supply Chain Management and Sustainability Performance: The Mediating Role of Competitive Advantage in Bandung SMEs

Environmental issues encourage companies, especially food and beverage SMEs in Bandung City, to integrate green supply chains to reduce waste. The implementation of green supply chain management not only supports environmental conservation but also increases economic benefits. Research shows that sustainability performance, which includes environmental, social, and economic aspects, is positively influenced by green supply chain management. However, there are differences in the results in previous studies, so further studies are needed to understand the relationship between supply chain management and sustainability performance in the SME sector. This research explores how Green Supply Chain Management (GSCM) affects Sustainability performance, intervening in the role of competitive advantage within small and medium-sized food and beverage enterprises in the city of Bandung. A quantitative approach is undertaken for the study, where the data was collected from 100 owners of businesses within Bandung City using questionnaires. GSCM includes green purchasing, green manufacturing, and green distribution; therefore, these were analyzed along with competitive advantage indicators: cost efficiency, quality, delivery, and flexibility; and sustainable performance aspects: environmental, social, and economic factors. The results, analyzed using SEM-PLS, show that the GSCM practices are moderately implemented among SMEs, and the competitive advantage significantly positively mediates the relationship between GSCM and Sustainable Performance. The study underlined the crucial role of GSCM in enhancing competitiveness and sustainability performance, meanwhile indicating that the SMEs are in need of further improvements in energy efficiency and the use of recyclable packaging.

أثر المرونة الاستراتيجية في تعزيز الثقافة التنظيمية في الجامعات الأهلية العراقية محافظة بغداد نموذجاً

The study conducted on a sample of 90 individuals from private universities in Baghdad, Iraq, shows that these universities possess a high level of strategic flexibility. This is reflected in their ability to adapt to environmental changes and competition in the educational sector. Innovation in academic programs and services is considered a key element that enhances the competitiveness of these universities. The study also demonstrates a clear positive impact of strategic flexibility on organizational culture. The results indicate that competitive flexibility plays a major role in strengthening organizational culture, while resource flexibility shows an important but less powerful effect. This underscores the importance of focusing on both aspects to improve the work environment in universities. The recommendations emphasize the need for private universities to develop programs that foster creative thinking and innovation. This can be achieved by establishing research and development centers that adopt and implement new ideas in line with market demands and student needs. Additionally, it is advised to implement comprehensive policies that focus on enhancing strategic flexibility in various aspects of university operations, whether in competitiveness or resource management. This will enable universities to adapt to future changes and achieve their goals effectively. Overall, the study highlights the significance of strategic flexibility as a fundamental factor in enhancing organizational culture in Iraqi private universities, necessitating the development of strategies that support continuous innovation and adaptation.

Portuguese Investor’s Perception of Investing in Companies With ESG Practices

Objective: The objective of this study is to identify the perceptions of Portuguese investors regarding ESG (Environmental, Social and Governance) factors. It also aims to identify the criteria that lead investors to consider, or not, ESG criteria in their decisions. Theoretical Framework: The concept of ESG (Environmental, Social, and Governance) has emerged as a fundamental framework for assessing the sustainability and ethical impact of companies. Its three dimensions – environmental, social, and governance – address different aspects of business operations and are increasingly considered in investment decisions and in the integration of their practices in companiesIn this topic, the main concepts and theories that underpin the research are presented. Method: Based on a quantitative approach, 118 questionnaires were collected from Portuguese individuals, with the aim of deepening the understanding of this phenomenon and obtaining empirical data that can contribute to the academic and practical debate on the impact of these criteria in the business context. Results and Discussion: The results obtained revealed [synthesize the main results of the research]. In the discussion section, these results are contextualized in light of the theoretical framework, highlighting the implications and relationships identified. Possible discrepancies and limitations of the study are also considered in this section. Research Implications: The results of this study highlight the complexity of investment decisions in the ESG context and the diversity of factors that influence investor behavior. Familiarity with these factors emerges as a key variable, while other demographic factors such as age, education and location have a less evident influence. Originality/Value: This research contributes to the field of socially responsible investing by identifying the variables that influence the adoption of ESG-aligned investment practices. However, further research is needed to understand how psychological, institutional and cultural factors may interact and influence investors’ perceptions of ESG practices, thus creating a broader field for future research.

Unleashing the process of Industry 4.0 adoption: a resource-based view and new stakeholder theory approach

Purpose The purpose of this research is to advance the conceptual and practitioner understanding concerning the maximisation of Industry 4.0 technologies industries in an emerging economy. The study first examines the internal resources that companies possess to implement Industry 4.0 effectively and, second, identifies the critical gaps that necessitate external resources, both at the industry and government levels.Design/methodology/approach The study embraces qualitative and inductive approaches with semi-structured interviews conducted with 112 company leaders representing nine industries and operating in various cities/regions of Vietnam.Findings The data analysis helped unveil 16 critical dimensions. Notably, the organisation-developed competences dimension illuminates the understanding regarding firms’ available internal resources, while the financial management and technological leap ability dimensions help explain firms’ required resources. More broadly, the business community unity and business community learning dimensions ascertain the significance of industry-level support, while the technological sponsorship and legal framework guide dimensions underline government support.Originality/value First, the study unpacks various key aspects of their daily, mid- and long-term operations associated with their current internal resources, gaps identified and the support they require to progress within the Industry 4.0 environment. Second, the study proposes a framework that advances the extant conceptual understanding of operational, strategic, managerial and production aspects among firms operating in an emerging economy. Third, it focuses on companies operating in nine industries in an emerging economy. Fourth, the study contributes to addressing various extant research gaps.

Combined feature of enhanced stability and multi-level switching observed in TiN/Ta2O5/Ag-NPs/ITO/PET structure

Both stability and multi-level switching are crucial performance aspects for resistive random-access memory (RRAM), each playing a significant role in improving overall device performance. In this study, we successfully integrate these two features into a single RRAM configuration by embedding Ag-nanoparticles (Ag-NPs) into the TiN/Ta2O5/ITO structure. The device exhibits substantially lower switching voltages, a larger switching ratio, and multi-level switching phenomena compared to many other nanoparticle-embedded devices. We attribute it to the embedded Ag-NPs effectively switching the mechanism of conductive filaments and the controlled distribution of Ag-NPs facilitates the occurrence of multi-level switching. Additionally, the fabricated structure demonstrated an impressive optical transmittance of nearly 85%. Undoubtedly, this combined feature of RRAM not only enhances stability but also enables multi-level switching, thereby demonstrating an approach to fabricating versatile and practical electronic devices aimed at boosting storage capacity and speed.

Resilience capabilities and performance dimensions of manufacturing supply chains in a developing economy

PurposeThis paper investigates whether resilience capabilities influence manufacturing performance dimensions. Specifically, it empirically analyses how supply chain agility, alertness, adaptability and preparedness affect manufacturing firms’ operational and sustainable (economic, social and environmental) performance aspects.Design/methodology/approachThe paper employed a deductive approach and an explanatory design. It gathered survey data from 285 managers in 5,329 Ghanaian manufacturing firms and analysed it using structural equation modelling.FindingsThe study found resilience capabilities comprising agility, alertness and adaptability to significantly and positively predict changes in manufacturing firms’ sustainable (environmental, economic and social) and operational performance. However, the preparedness capability positively impacts the firms’ operational and environmental performance, not economic and social.Research limitations/implicationsThis paper is restricted to Ghana’s manufacturing industry. Underpinned by the dynamic capabilities theory and extensive empirical reviews, the model was developed with four resilient capabilities and four manufacturing performance dimensions.Practical implicationsThe study highlights the relevance of resilience in today’s highly disruptive manufacturing environment for achieving sustainable and operational performance. It encourages manufacturing firms to prioritise heavy investments in alertness, adaptability and agile capabilities to overcome supply chain disruptions and enhance sustainable and operational excellence. It also offers significant insights for policymakers, managers and industry players to advance resilience capabilities and swiftly detect and recover from emerging disturbances in manufacturing supply chains, leading to higher performance.Social implicationsThe study contributes to resource conservation and a more sustainable future by projecting resilient capabilities in today’s disruptive environments. The shift towards SCR can influence public attitudes and opinions toward manufacturing and contribute to firms’ sustainability goals.Originality/valueThis study is the first to investigate the linkages between resilient capabilities and performance aspects simultaneously in less developed economies like Ghana. In these economies, manufacturing supply chains often face varying risks that continue to disrupt their operations and sustainability goals.

The changes necessary in the assessment of immunogenicity for the development of Biosimilars.

Immunogenicity knowledge and the analytical capabilities to characterize molecules have evolved within the last decade. This creates opportunities in Biosimilar development by applying new strategies to demonstrate similarity between a proposed Biosimilar to its Reference.Within Immunogenicity Risk Assessment for Biosimilars, in silico and in vitro immunogenicity assessment tools are being evaluated for their utility in Biosimilar development. An ISI including an Immunogenicity Risk Assessment is recommended for Biosimilars within the dossier of licensing applications to facilitate the review by Health Authorities and to explain the immunogenicity in conjunction with analytical and clinical data. Operational aspects should also be considered to refine immunogenicity testing of Biosimilars, e.g. S/N ratio and singlicate sample analysis.

Effects of Feeding Methionine Hydroxyl Analogue Chelated Zinc, Copper, and Manganese on Growth Performance, Nutrient Digestibility, Mineral Excretion and Welfare Conditions of Broiler Chickens: Part 1: Performance Aspects

This floor pen study explored the effects of feeding mineral methionine hydroxyl analogue chelates (MMHACs) zinc (Zn), copper (Cu), and manganese (Mn) on growth performance, carcass processing weight and quality, nutrient digestibility, gizzard erosion score, and bone parameters of broilers. One-day-old Ross 308 male chicks (n = 384) were randomly allocated to four dietary treatments with eight replicate pens per treatment and 12 birds per pen. The treatments were as follows: (1) inorganic trace mineral ZnSO4 110 ppm, CuSO4 16 ppm, MnO 120 ppm (ITM); (2) MMHAC Zn 40 ppm, Cu 10 ppm, Mn 40 ppm (M10); (3) Inorganic trace mineral ZnSO4 110 ppm, tribasic copper chloride 125 ppm, MnO 120 ppm (T125); (4) MMHAC Zn 40 ppm, Cu 30 ppm, Mn 40 ppm (M30). The birds were fed nutritionally complete wheat sorghum soybean meal-based diets from days 0 to 42 with three feeding phases including starter (days 0–10), grower (days 10–21), and finisher (days 21–42). The findings revealed that birds on the T125, M10, and M30 groups possibly had higher feed intake (p = 0.052) and higher weight gain (p < 0.063) than birds on the ITM group from days 0 to 42. Furthermore, birds fed the M30 diet had higher thigh and drumstick weights compared to those fed the ITM diet at day 42 (p = 0.05). Additionally, birds offered the M30 diet had increased ileal Cu digestibility compared to birds offered the M10 and ITM diets at day 21 (p = 0.006). Gizzard erosion scores and bone parameters were similar between the dietary treatments. Hence, the supplementation of MMHACs to broiler diets at 30 ppm may be a more suitable strategy to increase weight gain and the thigh and drumstick processing weight while maintaining the bone health of broiler chickens.

Spiritual Wellbeing in Indian Banking Sector: Sustainable Leadership Practices

In the present business scenario, organisations grapple with continuous disruption driven by competition, technological advancements, geopolitical volatility and an increasingly informed consumer base. This evolving environment has shifted from the VUCA model (volatility, uncertainty, complexity and ambiguity) to the BANI framework (brittle, anxious, nonlinear and incomprehensible). To navigate these challenges, resilience and agility have become crucial for organisations, necessitating the development of a supportive culture and competent workforce. Amidst newspaper reports of toxic leadership and toxic culture prevailing in Indian banking sector, employee wellbeing has become a significant aspect for better performance in recent times. As India aims to become $5 trillion economy by FY 2025–26, the Indian banking sector is expected to align itself with this objective and perform efficiently. In this backdrop, it can be argued that spiritual leadership may act as toxin handler and influence job engagement through spiritual wellbeing. This research study aims to explore the relationship between spiritual leadership, spiritual wellbeing and job engagement in the Indian banking sector. The proposed conceptual framework, derived from Fry’s (2005) Causal Model of Spiritual Leadership, indicates ‘vision’, ‘hope/faith’ and ‘altruistic love’ as components of spiritual leadership and ‘meaning/calling’ and ‘membership’ as components of spiritual wellbeing. The conceptual model is then tested using partial least squares structural equation modelling and the result confirms that spiritual wellbeing is a significant predictor of ‘job engagement’ in the Indian banking sector. Further, this study establishes the critical role of spiritual leadership in enhancing overall employee wellbeing. Leadership is a crucial factor in creating the right work environment and practicing spiritual leadership would help nurture an engaged workforce.

Investment Opportunity Set of Telecommunication Companies Reviewed from Financial Performance Aspects

The telecommunications industry in Indonesia has a strategic role in supporting economic development, especially in supporting economic activities between regions. This study aims to analyze the effect of Return on Asset (ROA), Debt to Equity Ratio (DER), and Sales Growth on Investment Opportunity Set (IOS) in telecommunications companies listed on the Indonesia Stock Exchange (IDX) for the period 2015-2020. This study uses a quantitative method with secondary data obtained from the companies financial statements through the official IDX website. Data analysis was carried out using multiple linear regression with the help of SPSS software. The results of the study show that ROA and DER have a significant effect on IOS, while Sales Growth does not have a significant effect partially. Simultaneously, the variables ROA, DER, and Sales Growth have a significant effect on IOS. This study provides implications that the companies financial performance, especially in increasing ROA and managing DER, can increase investment opportunities. Further studies are expected to expand the research variables by using intervening variables for a more comprehensive understanding.

Progressive scheme via eccentric rotation of abrasive cutting edges for minimum damage machining of fibre reinforced polymer composites: Micro-mechanics and performance aspects

Progressive scheme via eccentric rotation of abrasive cutting edges for minimum damage machining of fibre reinforced polymer composites: Micro-mechanics and performance aspects

Obsessive-compulsive personality disorder increases cognitive inflexibility in people with coronary artery disease.

Cardiovascular diseases such as coronary artery disease (CAD) have a high prevalence of psychiatric comorbidities, that may impact clinically relevant outcomes (e.g., cognitive impairment and executive dysfunction). Obsessive-compulsive personality disorder (OCPD) is a common psychiatric comorbidity in CAD. It has a distinct cognitive profile characterised by inflexible thinking and executive dysfunction, which in turn may affect treatment adherence. However, the impact of OCPD on cognitive functioning in CAD is under-researched. We aimed to investigate the impact of OCPD on executive function in individuals with CAD undergoing rehabilitation, using cognitive tests relating to inflexibility and executive planning. Seventy-eight adults (median age 59 [53.0-66.0] years) with CAD were tested within three days of hospital admission for cardiac rehabilitation occurring within two weeks of experiencing an episode of unstable angina or myocardial infarction. The Compulsive Personality Assessment Scale (CPAS) was used to evaluate OCPD traits. Neurocognitive testing was performed using the Cambridge Automated Neuropsychological Test Battery (CANTAB) including tests of set shifting (Intra-Extra Dimensional [IED] Set Shifting), and executive planning (Stockings of Cambridge [SOC]). Ten individuals with CAD fulfilled the operational criteria for DSM-5 OCPD. Individuals with comorbid OCPD made more IED intra-dimensional shift reversal errors (2.0 [2.0-4.0] vs. 1.0 [1.0-2.0], p=.004), reflecting a difficulty inhibiting previously learnt responses. When all participants were analysed as a group, negative associations were found between individual OCPD traits and other aspects of cognitive performance. Hoarding trait was associated with increased initial thinking time on the SOC at five moves (ρ=0.242, p=.033), while the need for control and rigidity traits were each associated with increased initial thinking time on the SOC at two moves (respectively, ρ=0.259, p=.022; ρ=0.239, p=.035), reflecting slower executive planning. A preoccupation with details trait was associated with fewer errors on a compound discrimination stage of the IED (ρ=-0.251, p=.026). After controlling these correlations for gender and age, significant associations remained with hoarding (β=0.243, p=.036), need for control (β=0.341, p=.005) and rigidity (β=0.259, p=.038) traits. Preliminary evidence suggests that individuals with CAD and comorbid OCPD traits show greater inflexibility than those without OCPD. Several OCPD traits were associated with slower planning, even after controlling them for age and gender. This may have implications for the success of rehabilitation.

Effect of different chamber geometries on combustion formation to reduce harmful emissions

The combustion process in internal combustion engines is the primary aspect of engine performance and emissions. Combustion chamber geometries such as grooved combustion chamber (GCC), shallow depth combustion chamber (SCC), and bathtub combustion chamber (BTCC) are used to investigate the effect of combustion rates on the emission parameters with respect to the standard flat combustion chamber (FCC). The impact of chamber modifications was simulated with an IC engine model using advanced chemical kinetics. Combustion parameters such as in-cylinder temperature, turbulence, and heat release rates were observed. The validated computational model assisted in analyzing combustion formations and their correlation with emissions like mass fractions, CO, CO2, and NOx. The results revealed that the modified chambers avoided the formation of fuel pockets and improved combustion behaviour compared to FCC. At 440 oCA, peak NOx emissions were higher by 14.95%, 27.10%, and 15.89% for GCC, SCC, and BTCC chambers, respectively, compared to the FCC chamber. At 440 oCA, CO2 emissions increased by 2.22%, 2.78%, and 2.78% for GCC, SCC, and BTCC chambers, respectively, compared to the FCC. The GCC chamber’s geometry influences the air–fuel mixture distribution, leading to stratified combustion zones and utilizing both bowl and squish regions. The study concludes that GCC chambers can significantly enhance efficiency and reduce emissions by influencing temperature profiles and mass fraction distributions. The study recommends using the GCC chamber with optimized injection profiles for better combustion and improved swirl rates.

Exploring the Effects of Vocal Training Programs on the Skills and Development of Chorus Performers.

Vocal training is a crucial component in developing a singer's vocal capabilities. It enhances the vocal quality and improves the overall vocal health. Through consistent practice and well-structured exercises, singers can achieve high control, clarity, and expressiveness. In this research, we aim to investigate the impact of a structured vocal training program on older choristers. This research includes 18 older choral singers (with ages above 50years), randomly assigned to either the study group or control group. Data were gathered through pretestand post test assessments of vocal function using perceptual voice analysis, self-assessments, and acoustic evaluation. The vocal training program was exclusively performed for the study group. Additionally, participant feedback and program effectiveness were collected through structured interviews. Respondents in the study group indicated substantial improvements in perceptual roughness, vocal clarity, jitter, shimmer, and pitch accuracy following the training session. However, assessments of subjective breathiness and effort, as well as phonational frequency range, revealed no significant differences. The participants also reported that the training program had a favorable impact on their voices. Overall, the findings suggest that structured vocal training can significantly enhance certain aspects of vocal performance in choristers. This research highlights the potential benefits of vocal training programs for improving vocal health and performance quality for older choristers.

Automatic Identification of Rock Discontinuity Sets by a Fuzzy C-Means Clustering Method Based on Artificial Bee Colony Algorithm

The identification and classification of rock discontinuities are crucial for studying rock mechanical properties and rock engineering optimization design and safety assessment. An improved artificial bee colony (ABC) algorithm is proposed and combined with the fuzzy C-means (FCM) clustering method to develop an FCM clustering method for automatically identifying rock discontinuity sets based on the ABC algorithm (FCM-ABC method). All the equations of the method are fully developed, and the methodology is presented in its entirety. Moreover, the rock structural planes are investigated in a gold mine in China using a ShapeMetriX 3D system. Based on the measured structural plane data, the specific calculation process, selection of parameters, effectiveness of grouping, and the dominant orientation of the proposed method for structural plane occurrence classification are analyzed and discussed, and satisfactory clustering results are achieved. This validates the validity and reliability of the method. Furthermore, multiple aspects of the excellent performance of this method for the identification of structural plane sets compared to traditional clustering methods are demonstrated. In addition, the significance of structural plane identification in the prevention and control of rock engineering disasters is discussed. This new method theoretically expands the technology of rock mass structural plane identification and has important application value in practical engineering.

Chronic Graft-Versus-Host Disease Adversely Impacts School Performance in Children and Young Adults.

Chronic graft-versus-host disease (cGVHD) adversely impacts return to work for adult allogeneic hematopoietic stem cell transplant (HSCT) survivors, but no data exist on children with cGVHD transitioning back to school. We hypothesized that cGVHD adversely impacts broad aspects of school experience of children compared to their allogeneic-HSCT peers without cGVHD. We conducted a single center cross-sectional pilot study using a 42-item questionnaire, investigating academic performance and social-emotional aspects of schooling pre- and post-HSCT. Forty allogeneic-HSCT patients of school-age completed the questionnaire, and responses were compared between patients with and without cGVHD. Twenty patients had cGVHD while 20 age or gender matched allogeneic-HSCT patients without cGVHD were controls. Ten of the 20 cGVHD patients experienced academic delays, of whom 2 were unable to resume or commence school due to cGVHD. All controls resumed/commenced school post-HSCT. Patients with cGVHD were chronically absent, as 8 of the 18 cGVHD patients missed ≥4 days of school per month post-HSCT compared to 0/20 controls (P ≤ .001). Profound barriers to school participation specific to cGVHD were appreciated with an average of 3 concurrent barriers (range 1-7) ranging from physical appearance to clothing discomfort. Significant gaps in school services were identified as only 6 (33%) cGVHD had school accommodations post-HSCT. Academic challenges and emotional and psychosocial impacts are profound. Future studies evaluating the feasibility of standardizing early school-based interventions are required.

Assessment of operator performance during dynamically guided osteotomy and root-end resection in endodontic microsurgery: a cross-sectional in vitro study

ObjectivesTo compare in vitro the magnitude of deviations, task-focused performance, and perspective on instrumentation of two operators with different levels of experience using computer-assisted dynamic navigation (C-ADN) systems during osteotomy/root-end resection (RER) in models mimicking thick bone layers overlying the apices. MethodsEight models with 15 tooth replicas each were assigned equally to two operators (experienced/less experienced). Pre- and post-operative cone-beam computed tomography images were superimposed using a C-ADN software to determine discrepancies between the planned and real trajectory of the trephine bur. Task-focused operator performance and subjective aspects derived from operator's perspective related to C-ADN were also analyzed. Statistical analysis was completed through parametric methods and Chi-square/fisher exact tests. ResultsPearson correlation tests showed positive correlations between the distance from buccal cortical plate to root apex regarding deviation at apex, trephination depth, and visuomotor coordination time. The less experienced operator had significantly greater values of visuomotor coordination time, deviation at buccal entry point and apex, trephination depth, and angular deviation, as well as a significantly higher frequency of apex location failures, poor RER quality, and mishaps in comparison with those of the experienced operator, thus leading to a significantly higher task-focused performance for the experienced operator. Both operators improved the visuomotor task through diverse attempts, acknowledged enhanced situation awareness, surgical procedure quality, and patient safety associated to the use of C-ADN, and reported a positive impact on the developing and maintaining navigational skills. Concerns regarding perceived workload, mental demand, and usability difficulties were reported only by the less experienced operator. ConclusionsDynamically guided osteotomy and RER prepared with trephine burs entail a subset of visuomotor skills requiring a special learning which may vary depending on the operator's experience and the procedure complexity as determined by dentoalveolar anatomy. Likewise, the perceived usability about C-ADN systems increases insofar the complexity of the user interface decreases and upsurge the earlier experience with these systems. Statement of clinical relevanceThis study shows that both the technical characteristics involved in the function of C-ADN systems and the subjective operators' perceptions are critical for the accuracy of task-focused performance during endodontic microsurgery.

Evaluating leadership development programs in healthcare organizations: A profile from practice.

To enhance leadership acumen and intelligence among the managerial ranks, many healthcare organizations establish leadership development programs. Doing so makes perfect sense as the caliber of leadership within health and medical institutions profoundly influences all aspects of operation. Although leadership development programs are very capable mechanisms for advancing the state of leadership within healthcare organizations, a notable enhancement-evaluation-is needed to maximize their potential. Across commerce, techniques for evaluating leadership development programs are highly varied. The specific evaluative approach selected matters not, as long as it satisfactorily assesses program performance. Problems, however, emerge when establishments choose to forgo evaluative pursuits altogether. Omission of such often is attributed to fears concerning the complexity of evaluation and its associated resource requirements. It is further hastened by the dearth of easily accessible examples from practice, with this limiting idea sharing, impeding evaluation system development and proliferation. To encourage the circulation of associated ideas, this article provides a helpful account from practice, describing the approach used by Willis Knighton Health to evaluate its leadership development program. This very lean, conservative application constitutes just one of many possibilities. Through its portrayal, it is hoped that healthcare organizations hesitant to engage in the assessment of their leadership development programs will be encouraged to proceed.

A Systematic Literature Review of Trauma Systems: An Operations Management Perspective.

Trauma systems provide comprehensive care across various settings, from prehospital services to rehabilitation, integrating clinical and social care aspects. Established in the 1970s, these systems are pivotal yet under-researched in their operational management. This study aims to fill this gap by focussing on the integration of operations management (OM) techniques to enhance the efficiency and effectiveness of trauma systems. By leveraging proven OM strategies from other healthcare sectors, we seek to improve patient outcomes and optimise system performance, addressing a crucial need for innovation in trauma care operations. A systematic literature review was conducted using the PICOTS framework to explore operational aspects of trauma systems across varied settings, from emergency departments to specialised centres. Searches were performed in 5 databases, focussing on articles published from 2006 to 2024. Keywords related to operational research and management targeted both trauma systems and emergency management services. Our method involved identifying, synthesising, and summarising studies to evaluate operational performance, with a specific emphasis on articles that applied operational research/management techniques in trauma care. All eligible articles were critically appraised using 2 quality assessment tools. Employing Donabedian's framework to analyse the quality of trauma systems through structure, process, and outcome dimensions, our systematic review included 160 studies. Of these, 5 studies discussed the application of the Donabedian evaluation framework to trauma systems, and 14 studies examined structural elements, focussing on the location of healthcare facilities, trauma resource management, and EMS logistics. The 63 studies on process indicators primarily assessed triage procedures, with some exploring the timeliness of trauma care. Meanwhile, the 78 outcome-oriented studies predominantly evaluated mortality rates, alongside a smaller number assessing functional outcomes. Existing evaluation metrics primarily focussed on triage accuracy and mortality are inadequate. We propose expanding these metrics to include patient length of stay (LOS) and rehabilitation trajectory analyses. There is a critical gap in understanding patient flow management and long-term outcomes, necessitating focussed research on LOS modelling and improved rehabilitation data collection. Addressing these areas is essential for optimising trauma care and improving patient recovery outcomes.