Proper Team Research Articles

Transdisciplinary Team in Rehabilitation of Unconscious Brain-Damaged Persons: Grounds and Practice

The main features of early rehabilitation after severe brain damage are discussed in the article. The most important component for the entire rehabilitation process and the subsequent life of the patient is considered restoration of consciousness. Team seems to be a key factor in regaining consciousness along with the restoration of vital functions, movement, cognition, and behavior in these patients. The basic working principle is feedback to any minimal movement, or vegetative signal of a patient, beyond specific professional targets. A network of feedbacks with a patient and between professionals, that is, free flow of information, can be built only through work in a transdisciplinary team mode. The net of feedbacks with the patient and inter-professional ones builds up the team as Non-linear Complex System. Characteristics of “Team-Patient” system status are energy, entropy, and complexity. Teamwork techniques are individualized for resulting optimization of system condition. Increase of complexity is a powerful tool for propulsion of recovery process. Then consciousness may appear as a result of system self-organization. The article reflects the authors’ view on interdisciplinary studies of the phenomenon of consciousness through its impairment and recovery. It focuses on the work of the “proper rehabilitation team”, the mechanisms of its action and methods for researching the occurring phenomena.

Extracting the Mediation Model of Perceived Organizational Support in the Relationship between HRM Practices and Organizational Commitment of Bankers in Khyber Pakhtunkhwa (Pakistan): A Review Paper

Human resource management is one of the necessary tools of todays modern organizations. Businesses without a trained and skillful human resource (HR) are far left behind in competition and market share. The fundamental role of HR and human resource systems are to hunt, hire and train professionals for different business structures and sections. Without proper and professional team of human resource, organizations simply become machines and thus do not survive in the long run. This paper has been designed to review the existing literature available on HRM practices, organizational commitment, perceived organizational support and demographic attributes to extract the mediation model.

Persistent Severe Bradycardia During Liver Transplantation

Abstract Background Cardiac electrophysiological disturbances are common in end-stage liver disease (ESLD) patients. It is challenging for anesthesiologists to detect and manage cardiac abnormalities during orthotopic liver transplantation (OLT). Case report A 58-year-old male patient, diagnosed with hepatitis B cirrhosis with hepatocellular carcinoma (MELD score 24) and chronic kidney disease stage V (no hemodialysis requirement), was scheduled for combined OLT with kidney transplantation. He had mild anemia, thrombocytopenia, normal electrolytes, and INR 1.47. CXR showed cardiomegaly with blunting of the bilateral costophrenic angle. ECG presented sinus bradycardia (rate, 45/min) with prolonged QT interval. Echocardiography revealed dilatation of all cardiac chambers with ejection fraction of 65%, good RV function, and mild pulmonary hypertension (mPAP, 29 mmHg) without significant valvular abnormality. After uneventful induction and intubation, noninvasive cardiac output monitoring and central venous catheter were applied. During surgery, his heart rate was 35–40 bpm with no response to high-dose inotropic agents. External cardiac pacing pads were attached. ABG showed mild acidosis without electrolyte abnormality. Reperfusion went successfully despite persistent severe bradycardia. He remained intubated and was transferred to the ICU. Twelve-lead ECG was performed. A cardiologist diagnosed cirrhotic cardiomyopathy with high vagal tone. Transvenous pacing was inserted at a rate of 80/min for 48 hours; his heart rate subsequently rose to 50–60 bpm without treatment. Extubation was 36 hours after surgery, and discharge on postoperative day 10 Conclusions Cardiac abnormalities in ESLD patients present in various forms. Proper preoperative assessment, adequate monitoring, and good team communication result in good patient outcomes

118.5: Laparoscopic donor nephrectomy: Introduction, success strategies and outcomes.

Background: Laparoscopic donor nephrectomy (LDN) has become the standard of care and popular among most of the transplant centers across the globe. However, for novices, it remains a challenge because of safety concerns during learning curve and many small volume centers are still hesitant to start laparoscopic donor program. At our institution, we adopted an approach that allowed us implementation of laparoscopic live donor nephrectomy without increased donor morbidity or graft failure, even during the early portion of a learning curve. Methods: From December 2016 to May 2019, 231 Laparoscopic donor nephrectomy were performed by transperitoneal approach. All donors and recipients underwent extensive preoperative evaluation and testing by a multidisciplinary team before the decision was made to proceed with the donation. To reduce beginner’s fear, we made some technical modification in surgical technique. One important modification was use of additional ports and involvement of 2nd consultant or chief surgical resident as assistant in some cases, depending on internal anatomy and the donor’s body habitus. Second important modification was in sequence of hilar dissection. In our approach we completed dissection on both poles of kidney first and did the difficult lumbar vein and hilar dissection in the last. Information that was collected and analyzed included epidemiological data, pre-, intra- and post-operative parameters including operative time, warm ischemia time, delayed graft function, length of stay and complications. Results: The first laparoscopic left donor nephrectomy at our institute was performed in December 2016 and till May 2019, 231 LDN were performed. Mean operation time was 108.4 (72-158) minutes, and Mean warm ischemia time 188(168-553)seconds. 26 donors (11.6%) suffered a total of 29 postoperative complications. All complications were Class I and Class II only. No major (Grade III and Grade IV) perioperative or postoperative complications occurred. So our initial data of 231 patients seems much better. We attribute this to various reasons. First reason for our success is proper planning and team approach. Involvement of experienced assistant and use of additional ports played a vital role. This strategy, facilitated maximum exposure of the renal hilum by simultaneous retraction and suction by assistant, leading to faster dissection, smooth progression and operative time reduction. Second reason in our opinion for our success is the sequence of hilar dissection in the last after dissection of both poles of kidney. It made intrahilar dissection easier and safer because of opportunity of dissection in a relatively stretched hilum with a possible vision from both poles. Conclusions: We propose that with proper planning, team approach and few technical modifications, introduction of laparoscopic live donor nephrectomy is safe and effective.

The ADSA Ten Minutes Saves a Life! App

The ADSA Ten Minutes Saves a Life! App

Organizational Democracy:Collaborative Team Culture

The last 20-25 years have seen the replacement of ‘managers/supervisors’ by ‘team players’. The reason for this transition is simple–Globalization. Gone are the autocratic days of following a team manager’s orders blindly, without thinking or questioning. Today, resources want to know not only what their role is, but also the purpose behind it. Teamwork has grown dramatically in all types of organizations for one simple reason–no one individual has the ability to deliver the kinds of products and services required in today’s highly competitive economy. As the world is getting smaller and smaller, it is seamlessly connecting everyone through the Internet, due to which the business entities are growing in size and operation. As a result of which the workforce is also being ramped up in order to keep pace with the global growth. No more are organizations an operational unit consisting merely of 25-30 people under one team manager or just one department overlooking the overall operations. Their focus now is on bringing about results by co-sharing responsibility and acting as a global team of very committed individuals. The five elements of Mother Nature—Earth, Water, Fire, Air and Sky—bring about a harmonious balance in the human body, which means this same harmony can be transferred from our character to mold every team’s underlying makeup. Every team member is unique because s/he contains a varying ratio of the five elements, but there is one particular element that dominates her/his emotional landscape. It is only a matter of understanding the characteristics of each of these elements for striking a balance and bringing on board the right mix of team members. With the proper collaborative team culture workplace practices and the right number of team member types in place, new members are easily able to plug into the channel of cohesiveness. Their unique knowledge adds to the process maturity too.

A Fuzzy Group Decision-making Model for Determining the Most Influential Persons in the Sustainable Prevention of Accidents in the Construction SMEs

Safety in the sustainable construction is a game with uncertain reality, with human’s life. Managers in power, involved in the construction project life cycle, create rules for the game and are the main players. The project’s success can be perceived differently by stakeholders. A company’s competitiveness, successful implementation of the projects and effective safety management depends on the strategic allocation of its human resources in order to select a proper project team in alignment with employee capabilities. This requires detailed factors reflecting their role (in line with their interests and attitudes) and knowing which of them has a decisive influence on the successful implementation of the project. The real data describing key factors in this concept can be provided as uncertain conditions. This work presents a novel integrated modified fuzzy group decision-making approach to select and rank the most influential persons ensuring the sustainable prevention of accidents at work in the small and medium-sized construction enterprises. This model includes the Delphi method and fuzzy extensions of Eckenrode’s criteria rating method. The proposed model could be expanded in order to select the most suitable individuals for sustainable management of safety and, moreover, for the effective implementation of safety and health measures.

Failure Triage in RTL Regression Verification

We propose an automated failure triage framework for register transfer level debugging in functional verification regression flows which unifies three critical aspects of the problem: the approximation of the general location of root-cause(s) in the design under verification, the binning of all related failures generated by regression runs, and the distribution of these binned failures to the proper engineer(s) for detailed analysis. The proposed triage engine entails two novel methodologies. The first is a classification framework that mines information from SAT-based debugging and simulation to probabilistically reason about the relation of root-causes with their respective failing verification traces. This enables the construction of a priority ranking for these root-causes, and can effectively guide debugging by focusing resources on high-priority root-causes. Second, we propose a formulation of failure binning as exemplar-based clustering for grouping and distributing failing traces to the proper engineering team(s). Experiments on industrial designs show that the proposed methodology achieves 84% and 81% accuracy when it comes to failure grouping and distribution, respectively, with only a 6.5% runtime overhead over existing debugging state-of-the-art techniques.

Total knee replacement in a resource constrained environment: A preliminary report.

Total knee replacement surgery is relatively new in Nigeria and available in few centres only. It has been evolving at a slow pace because of the lack of facilities, structures and adequate surgical expertise alongside patient ignorance and poverty. The aim of this article is to review the cases done in a resource constrained institution in Nigeria and report the short term outcomes. All the patients that were booked for Total knee replacement, using same prosthesis over a 40 month period, were recruited into the study. Using a prepared data tool, information on personal biological information, clinical presentation, peri-operative management, and outcome of management were obtained after an informed verbal consent. All the patients were further followed up for at least one year. 45 knees were replaced in 38 patients. The age range of the patients was 41-85 years with a mean age of 62.6. The male to female ratio was 1: 4.4. The indications for surgery were a combination of pain and deformity. All the patients came with varying forms and degrees of angular deformities. Eight knees had bone defects that required bone grafting while 5 knees had tibia extension rods. The commonest complication, which was recorded, was drop foot (8.9%). Knee society pain scores in the patients improved from the average of 21.35 to 83. Despite the challenges inherent in health care in developing countries, with proper institutional planning and team work, the short term outcome of arthroplasty in our resource constrained environment is good.

Employment duration of Polish Ekstraklasa Managers, and its impact on or-ganizations sport success

Sports team as a integral part of the organization, plays an important part in building its success and its effectiveness impacts the perception of the whole organization. Proper team management plays a key role in building sports success, which leads to a conclusion that a position of a manager in football is a position of a high importance. The duration of the employment on that position varies and often is shorter than a year. That raises a question about the impact of manager’s employment stability on sports team’s performance. The author compared the duration of manager’s employment in polish Ekstraklasa teams over last eleven seasons with the performance of the teams, that comparison led to a conclusion that there is no evident connection between the two, but it can be observed that higher stability often leads to better results. The research is going to be widened and continued to achieve deeper insight on the problem.

A Contract-Ruled Economic Model for QoS Guarantee in Mobile Peer-to-Peer Streaming Services

Current commercial mobile streaming applications call for innovative technologies for stable QoS guarantee. In this paper, we provide a comprehensive treatment of QoS guarantee through a contract-ruled approach. In particular, we envision a peer-assisted mobile peer-to-peer streaming system as a QoS trading market, where all parties involved in the system, i.e., Service Provider (SP), End User (EU), and Assisting Peers (APs), are real economic entities that are organized with contractual constraints to achieve a stable and guaranteed QoS output. The QoS trading in the market is divided into two parts. One is a basic contract that establishes the business agreement between an interested EU and a SP. We propose a QoS contingent payment to mitigate the EU's concern on the uncertainty of QoS delivery and derive an optimal contract that achieves Pareto efficiency. The other is a subcontract, in which we model transactions between the SP and contracted peers as a principal multi-agents problem, that achieves a desired joint QoS output. We further design a sharing scheme with team penalty that could overcome the free-riding problem existed in the subcontract and show that the Pareto efficiency can be achieved by setting a proper team penalty. Both numerical evaluations and prototype experiments demonstrate the effectiveness of our proposed scheme.

Antecedents of ISD team performance: Knowledge management activities

The topic of knowledge management is an important one in team-based studies. Many previous studies have shown that the proper team structure facilitates sharing and applying the expertise and knowledge which is scattered among members, allowing for team tasks to be executed more efficiently and effectively. Knowledge management involves four basic processes: storing/retrieving, transferring, applying, and creating knowledge. This study uses transactive memory system, knowledge sharing, knowledge application and creativity as knowledge management process activities in order to explore their impact on team performance. Based on data from a study of 64 ISD teams, all our hypotheses were found to be significant.

The role of physiotherapy in terminal care

Abstract Introduction: Terminal patients require proper care standards and professional team of doctors, physiotherapists, social workers, educators, psychologists and clergy directly involved in mitigating the suffering of a dying person. A physiotherapist as a member of such a team should be focused on sustaining the patient’s quality of life until the end at the level relevant to the patient’s health state. This quality of life should be perceived integrally as a combination of procedures reducing pain and physical suffering as well as improving physical fitness and mental well-being. Material and methods:The aim of the research was to define the role of physiotherapy in assessing mental and physical state of terminal patients; to determine the applicability of ADLs, GDS and BDI in diagnosing the validity and usefulness of tiresome physiotherapeutic procedures for terminal patients and to assess the applied tests in predicting terminal patients’ survival time. The research was carried out on the turn of 2012 and 2013 in the group of 103 subjects (74 females - 71.8% and 29 males - 28.2%) For the research the following methods were used: - Activity of Daily Living scale (ADL)- - Beck Depression Inventory (BDI) - Geriatric Depression Scale (GDS) - Questionnaire regarding their willingness to participate in physiotherapeutic procedures. Results: In the research the range of diagnostic possibilities of the applied scales and tests, correlations between theses scales and tests as well as correlations between them and subjects’ age and survival time were assessed. Additionally, a questionnaire survey was carried out which assessed the willingness to participate in physiotherapeutic procedures. Strong stress, terminal state of the patient and generalisation of symptoms brought about the fact that only 14.6% of patients declared their willingness to participate in physiotherapeutic procedures. Conclusions: 1. Implementing physiotherapeutic and psychological diagnostic tests in everyday terminal care makes it easier to assess survival time of terminal patients and significantly improves their life and dying with dignity 2. Proper understanding of the symptoms of dying must serve as a basis for organising adequate activities compliant with the progress of a disease of a terminal patient without disturbing the process of dying. 3. Modern physiotherapy in terminal care should limit the range of physiotherapeutic procedures and physical therapy while increasing psychological care in this population.

Board #323 - Technology Innovation High-fidelity Hybrid Simulator for Interprofessional Trauma Team Training (Submission #9456)

Introduction Trauma teams are comprised of a diverse group of interprofessional providers. While there are different configurations, teams commonly consist of physicians, nurses, emergency medical technicians, various hospital-based technicians and administrative staff. There are currently a plethora of task trainers and simulators available for training; however, none address the unique needs of an interprofessional trauma team. Proper trauma team training requires realistic, real-time patient evaluation and management throughout the continuum of care from prehospital stabilization to definitive hospital care. Currently the best platform for this training is live tissue. The tactile sensation and challenges of handling real tissue is not currently matched with simulation technology. However, while the gold standard for trauma training, the animal models still fall short in many aspects. These include not being anatomically correct in size or structure, not being able to provide scenario specific vital signs that respond to interventions, and being unpredictable in their ability to complete the event. These live tissue model challenges, coupled with increasing pressure to stop the use of animals for training, and a lack of an adequate replacement, suggest an alternative is needed. Description Trauma experts were queried on features that an ideal trauma team simulator would incorporate. Analysis of current trainers and simulators was conducted. Findings revealed the need for a full-sized human simulator. For this proof of concept study the Laerdal ALS simulator and Strategic Operations Surgical Cut Suit were selected to create a hybrid simulator due to their capabilities to electronically and physically look and behave like a real trauma patient. Operators and evaluators were trained on standardized scenarios that would challenge a trauma team throughout the continuum of care. Trauma teams received orientation to the hybrid and its capabilities. Operators, evaluators and students conducted post-training surveys. The hybrid simulator was able to challenge all team members simultaneously, at the various stages within the continuum of care. The simulator was more anatomically correct, appeared more human, and provided realistic, real-time visual and physical signs and symptoms. The hybrid allowed for numerous interventions and procedures to be conducted in all settings. Less clinical errors, better performed initial procedures, and more complete documentation were noted by the evaluators. However, the surgical procedures were noted to be inferior to that of animal models. Conclusion While there are numerous prehospital and hospital setting simulators, none fully meets the training needs of a diverse interprofessional trauma team. Simulators must challenge multiple aspects of the team ranging from individual patients to MASCAL situations; penetrating, blunt, thermal and mixed trauma; varied resuscitation and surgical needs; and be capable of challenging all participants simultaneously throughout the continuum of care in real-time. Currently available products do not have the features required to simulate a patient from point of injury to post-surgical recovery. Animal models have great characteristics, but limitations too. Many live tissue limitations are addressed with our full-sized human hybrid simulator. It has the benefit of providing appropriate initial and variable vitals, accommodates almost most prehospital and emergency room interventions and procedures, has a moderate level of surgical capabilities, and can challenge the staff in the post surgical area. Further modification of this hybrid simulator will allow for more capabilities. Our goal was to begin to address this unmet need in healthcare simulation with the hopes that industry will advance the field and granting agencies will begin to fund needed technologies and educational outcomes studies. Disclosures None

GM-020 Characterising an operational team and pushing towards a development-oriented team in a clinical pharmacy setting

BackgroundSuboptimally functioning teams struggle to perform development-oriented tasks. At Glostrup Hospital a team of dedicated and well trained clinical pharmacy staff did not perform as a team and no development...

Safety, reliability and worker satisfaction during organizational change

The research presented in this paper was carried out in four process industry plants in the Netherlands, to identify factors that have the potential to increase safety and reliability while maintaining or improving job satisfaction. The data used were gathered as part of broader trajectories in these firms, aiming at the simultaneous improvement of productivity and safety, while maintaining or improving worker satisfaction. The results show that participative leadership is crucial for combining an increase in safety and reliability with job satisfaction. Participative leadership has a positive effect on job satisfaction and through proper maintenance also on the prevention and absence of disturbances and on the reliability of the production process. The results of this research show the importance of participative leadership for safety, reliability and worker satisfaction, especially during organizational change. Other important factors are operator competences, teamwork, proper handling of variance and disturbances, and proper maintenance. It also confirms that apart from technological factors associated with proper maintenance, people and team related factors are important for increasing safety and reliability in the process industry, especially for being prepared for disturbances and to be able to cope adequately with them.

Enhanced Practical Wireless Communications Education via Blended Instructional Tools

Today's graduating telecommunications engineers need marketable skills that are typically developed beyond the traditional classrooms. These skills set can be acquired by experimenting for hands-on experience that resembles the professional field workplace. In this paper, we address blending of methodologies, applications, and the use of the Internet for delivery of knowledge, and instruction in an undergraduate wireless communications engineering course. This solution combines several different delivery methods, such as face-to-face, team collaboration, field measurements, in conjunction with high-end professional simulation software. Two examples of handover in a dual-mode cellular network and radio frequency (RF) signal propagation modeling are considered. Demonstrations and verification of theoretical models are presented based-on blending of instructional means. Lessons are learned to enhance hands-on experiments beyond traditional laboratories to strengthen in-depth analysis, learning skills of students, in addition to promoting proper team collaboration on projects.

Seroprevalence of Brucella Infection in Camel and Its Public Health Significance in Selected Districts of Afar Region, Ethiopia

This paper reports the results of a cross-sectional study conducted between October 2010 and May 2011 in two conveniently selected camel-rearing districts of Afar, Awash-Fentale and Amibara, North East Ethiopia with the objective of determining the prevalence and risk factors of camel and human brucellosis. A total of 768 camel blood sera were collected by simple random sampling from eight pastoral and agro-pastoral residences and human sera were collected from 200 purposely selected clinical patients from two health centres of the districts. Sera were screened using Rose Bengal Plate Test (RBPT) and positive samples were then confirmed by Complement Fixation Test (CFT). The overall prevalence of camel brucellosis in the districts investigated was 11.9% by RBPT and 7.6% by CFT and the overall prevalence of human brucellosis was 16% by RBPT and 15% by CFT. The logistic regression on animal level including age, herd size, presence of ruminants and parity of the camels showed statistically significant difference and were the potential risk factors associated with camel brucellosis with significance levels of (P= 0.026, 0.004, 0.0001 and 0.004 respectively. The ownership of Milking Camels, living within the pastoral and agro-pastoral communities, keeping of livestock in close contact, consumption of raw camel milk and milk products, assisting animals during parturition and grooming livestock were potential risk factors associated with human brucellosis. The results of the present investigation indicate that human and camel brucellosis is widely distributed in the study districts of Afar Regional State. Hence, controlling the risk factors, proper hygienic practices, public education and team work between veterinary and health personnel should be improved. An effort to mitigate the economic losses and public health hazard caused by the disease has to be made.

Penetrating skull injury with six inch fence rod

In this study we are describing an unusual case of the boundary fence (6 inch long) penetrating through the skull vault and lodging into the middle cranial fossa. A 10 years old male child fell onto his house fence while playing on the terrace. The metal fence penetrated through the scalp, parietal bone, midbrain and the midface, fracturing the parietal and the midfacial bones. CT-scans were obtained to view the trajectory and the position of the fence. The amount of midbrain injury was also accessed. The degree of morbidity vis-à-vis the type of injury was surprisingly low. Safe access to the fence was made through a bicoronal incision and modified bifrontal craniectomy to retrieve the lodged portion of the fence. These kind of penetrating injuries are rare considering the thickness of the vault. Proper preoperative planning and team approach is required for the safe surgical removal of the objects.

Mining knowledge demands from information flow

Among a collaborative team, members usually come from diverse disciplines, and their demands for knowledge are also different from each other. Information flow is a type of collaborative process, which exists behind every collaborative team. This paper is concerned with how to obtain team members’ knowledge demands from the information flow. Firstly, the knowledge demands model is defined. Based on the model of knowledge demands and information filtering technologies, some approaches for mining demands from information flow are proposed. This study on the knowledge demand mining can pave the way for developing knowledge recommender systems, which can recommend proper knowledge to proper team members with a collaborative team.