A rare and challenging case of anaesthetic management of paediatric laryngo-tracheo-broncho-malacia for supraglottoplasty

Paediatric laryngotracheobronchomalacia is a rare and extremely challenging scenario with risk of complete airway collapse under general anaesthesia. Laryngomalacia causes collapse of the supralaryngeal structures during inspiration as it is associated with short aryepiglottic folds, redundant arytenoid mucosa prolapsing into the glottis and a long curled epiglottis. Tracheomalacia and tracheo-bronchomalacia are characterized by abnormally compliant trachea and major bronchi. Most of the general anaesthetic agents decreases the airway tone and may predispose these patients to unremmitable airway obstruction under anaesthesia. We report successful anaesthetic management of one-year-old child with laryngotracheobronhcomalacia posted for supraglotoplasty. This needs a profound understanding of the pathophysiology of the complex airway condition and the effects of various anaesthetic agents on airway

IMPACT OF ORGANIZATIONAL CULTURE ON TECHNOLOGY USE IN A DEVELOPING COUNTRY

Governments all over the world are spending millions in information technology to collect and distribute valuable information to their citizens. Unified Theory of Acceptance and Use of Technology (UTAUT) is a useful model for managers to assess the likelihood of acceptance of a new technology within an organization. In this paper, we consider organizational culture as an antecedent to the UTAUT model to evaluate factors that influence users acceptance and use of the Internet technology. We investigated the role of organizational culture in the adoption of Internet technology in a government agency in a developing country, India. We found that organizational culture influences adoption of Internet technology. We also found that the UTAUT is a valid model that can explain technology adoption in a developing country

Espoused Organizational Culture Traits and Internet Technology Adoption

The Technology Acceptance Model, popularly known as the TAM, has been widely used in the information systems literature to explain individual adoption of information technology. In the late 1990’s, and the early part of this century, a number of studies either extended the model by identifying antecedents to technology acceptance or have replicated and validated the model. An aspect that has captured the interest of information systems researchers is the role of culture in the acceptance, adoption, and diffusion. We examine the role of espoused organizational culture traits in technology acceptance, adoption and diffusion, that is, we consider organizational cultural values to be antecedents of TAM. We empirically test this model in an e-government setting in a developing country and report on our findings

Role of Organizational Culture in Internet Technology Adoption: An Empirical Study

The Technology Acceptance Model, popularly known as the TAM, has been widely used in the information systems literature to explain individual adoption of information technology. In the 1990’s a number of studies either extended the model by identifying antecedents to technology acceptance or have replicated and validated the model. But few studies have examined the role of organization culture in the acceptance of technology. In this paper, we use the Technology Acceptance Model to examine acceptance of Internet technology in a government agency in India. We examine the role of organizational culture in technology acceptance, that is, we consider organizational culture values to be antecedents of TAM. We found that organizational culture has a significant impact on Internet technology adoption

Organizational Culture and Technology Use in a Developing Country: An Empirical Study

In recent years, growth of the Internet and the World Wide Web has had an impact on the way local, state and national governments work. Use of information electronically in government, popularly known as e-government, is on the rise. E-government is described as the use of technology to enhance the access to, and delivery of, government services to benefit citizens, business partners and employees (Turban, King, Lee, Warkentin, & Chung, 2002). Digital government or e-government, often used interchangeably, is not just putting public services on line – it is about government harnessing information technology in order to remain relevant in a more interactive and more informational era (Tapscott & Agnew, 1999). E-governance in broader perspective encompasses all the key factors in governance – better delivery of government services to citizens, improved interactions with business and industry, employee and citizen empowerment through access to information, and more efficient management, i.e., the use of Internet infrastructure to transform delivery of government services. Four perspectives are used to understand e-government initiatives: e-business perspective to understand how the information and communication technologies are used to increase government services offered; end user i.e. citizen perspective; understanding employees’ contributions to facilitate e-government processes (knowledge perspective); and process perspective to understand how government service delivery can be made more efficient (Devadoss, Pan, & Huang, 2002)

Information Sharing Behavior of the Older Adults: An Empirical Study of Their Online Privacy Concerns

This empirical study investigates the contribution of different predictors to the privacy concerns and the online behavior of older adults, and the moderating effect of potential benefits of online interactions on their actual online usage. We propose a research model based on the Theory of Reasoned Action. Data was collected from 287 older adults and analyzed using PLS structural modeling. The results suggest that older adults’ privacy concerns of engaging in online interactions is significantly affected by the extent of their prior online usage and prior exposure to vulnerabilities related to online fraud. Actual online behavior is significantly affected by the privacy concerns. Additionally, our model explores the potential benefits of online use as an antecedent of actual behavior and finds it is not significant. However, potential benefits significantly moderate the effect of privacy concerns of online use of older adults. Based on the findings, we discuss the study’s implications

Applying Blockchain for Dual Use Technologies Supply Chain Security

Blockchain technology is gaining momentum with potential applications in businesses, government, and social context with some impressive applications for storing information, eliminating intermediaries, and enabling greater coordination between entities in issues such as in maintaining data standards (Higginson, Nadeau, and Rajgopal, 2019). While there are aspects of this technology that are still not settled such as the question of whether it is a disruptor or foundational technology, there is an agreement that it has the capability to increase security and transparency of transactions to all parties. Smart contracts using blockchain are theorized to be manifested using machine-to-machine coordination within IoT or with decentralized digital marketplaces (Beck, Müller-Bloch, and King, 2018). However, even though the blockchain technology has the potential towards decentralization of authority decision-making, current research indicates that so far that has not transpired and blockchain applications mostly operate in the environment of centralization mimicking notion of “benevolent dictatorship” (Beck, Müller-Bloch, and King, 2018). The main purpose of this work is to understand the gaps in application of blockchain technology in supply chain with domain focus on the supply chains involving dual use products

Anesthetic Management of a Patient with Reactive Thrombocytosis due to Post-Trauma Splenectomy in a Patient Requiring Further Corrective Surgeries: A Case Report

Thrombocytosis poses hemostatic and bleeding risks, especially in the perioperative period and in the presence of other risk factors. There is no defined upper cut-off limit for platelet count for elective surgeries and ideal mode of anesthesia in these patients, especially in reactive thrombocytosis. A 22-year-old male will be described with thrombocytosis post-splenectomy after trauma and was scheduled to undergo an open reduction and internal fixation (ORIF) procedure for the shaft of a femur fracture. Hematology evaluation was sought and the decision to go ahead with the surgery was taken since the patient had no symptoms or signs of thrombosis or bleeding and the surgery was urgent which would help the patient to mobilize early and prevent further risk. Informed written risk consent was obtained from the patient about the risk of thromboembolism perioperatively. Perioperative measures for thromboprophylaxis were taken and the procedure was done uneventfully under spinal anesthesia. Postoperatively Hydroxyurea was started and after an uneventful hospital course, he was discharged and asked to follow up in the hematology outpatient department (OPD). There are conflicts on the use of neuraxial anesthesia in patients with thrombocytosis. The risk of bleeding and thrombosis is considerably less in reactive etiology and hence we decided to go ahead with spinal anesthesia. Also, none of the studies have defined the upper safe limit of platelet count that is to be accepted for elective surgeries. Further studies are needed in patients with thrombocytosis undergoing urgent or emergent surgeries where deferring surgeries for optimizing platelet count is not an option to understand the risks associated and the suitable method of anesthesia