An analysis of organisational culture in a restaurant in Grahamstown, South Africa

This study investigates organisational culture and shared values that currently exist at Saint’s Bistro in Grahamstown along with the desired organisational culture and desired values. In particular it explores possible discrepancies between the two using the reliable and valid Competing Values Framework (CVF) and its matched scale, the Organisational Culture Assessment Instrument (OCAI) and the Shared Values Survey. McDonald and Gandz (1992: 64-67) discovered 24 shared values that correlate with modern business and where each value ties in with one of the four quadrants of the CVF. The researcher found a study conducted by Burchell and Saele (2011: 512) which is a cultural study based on the CVF working in conjunction with shared values survey to analyse a situation and it presented an improved means of investigating culture and values related facets within an organisation. The aim of this study is to examine the existing culture and subsequently make recommendations that can create alignment between what is currently experienced and what is desired in the organisation, if it is found that misalignment exists. This research presents a study using a paper based survey conducted in a restaurant in Grahamstown, South Africa. The results are based on the use of the OCAI in conjunction with organisational shared values profiles. The study revealed that there is no significant gap between the current organisational culture and the desired organisational culture within the organisation. Due to these findings, the research established that a structured strategy for maintaining the organisational culture should be developed in order to sustain the existing organisational culture that can be used when recruiting and on-boarding new employees in the future. The research is significant in that it highlighted a link between the competing values framework and the shared values survey and this will contribute to the effective analysis of organisational culture in future culture research

The role of verbal and non-verbal working memory in the comprehension of subject and object relative clauses in Greek high-functioning children with ASD: a theoretical approach on underconnectivity theory

Η Διαταραχή Αυτιστικού Φάσματος (ΔΑΦ) αποτελεί μία διάχυτη νευροαναπτυξιακή διαταραχή η οποία χαρακτηρίζεται κυρίως από περιορισμένες κοινωνικές και επικοινωνιακές δεξιότητες καθώς και από στερεοτυπικές και περιορισμένες συμπεριφορές και ενδιαφέροντα (DSM-V). Εκτός από τη θεωρία της Αδύναμης Κεντρικής Συνοχής και την απώλεια της Θεωρίας του Νου (Frith and Happé, 1994), ελλείμματα έχουν παρατηρηθεί και στις επιτελικές λειτουργίες σε παιδιά με ΔΑΦ (Hughes et al. 1994; Pennington and Ozonoff, 1996; Hill, 2004). Η εργαζόμενη μνήμη επιτρέπει την προσωρινή αποθήκευση και επεξεργασία πληροφοριών και εδρεύει κυρίως στα μετωπιαία-βρεγματικά δίκτυα του εγκεφάλου. Τα αποτελέσματα ερευνών σχετικά με την εργαζόμενη μνήμη των παιδιών με ΔΑΦ είναι αμφιλεγόμενα, καθώς οι ερευνητές υποστηρίζουν τόσο την ύπαρξη όσο και την απώλεια ελλειμμάτων σε διάφορες πτυχές της (Bennetto, Pennington, & Rogers, 1996). Ωστόσο, ένα από τα βασικότερα ευρήματα αναφορικά με τα ελλείμματα στην εργαζόμενη μνήμη σχετίζεται με το φορτίο και την πολυπλοκότητα της πληροφορίας προς επεξεργασία. Όσο πιο περίπλοκη είναι η πληροφορία που τίθεται σε επεξεργασία, τόσο πιο δύσκολη καθίσταται η επεξεργασία της από τα παιδιά με ΔΑΦ. Επιπλέον, η αναχαίτιση -ή αλλιώς ο ανασταλτικός έλεγχος- δηλαδή η ικανότητα του ατόμου να ελέγχει τη συμπεριφορά του αποκλείοντας εξωτερικά ερεθίσματα, αποτελεί μία από τις επιτελικές λειτουργίες που έχουν μελετηθεί σε παιδιά με ΔΑΦ. Εντούτοις, ελάχιστες έρευνες έχουν μελετήσει τη συσχέτιση μεταξύ των ελλειμμάτων στην εργαζόμενη μνήμη και την αναχαίτιση και των γλωσσικών ελλειμμάτων που μπορεί να παρουσιάζουν τα παιδιά με ΔΑΦ. Η παρούσα έρευνα θα μελετήσει τα πιθανά ελλείμματα στη λεκτική εργαζόμενη μνήμη μέσω μίας δοκιμασίας αντίστροφης ανάκλησης ψηφίων, όπως και στην αναχαίτιση μέσω δύο αντίστοιχων δοκιμασιών σε ελληνόφωνα παιδιά υψηλής λειτουργικότητας με ΔΑΦ (ηλικίες 7 – 11 ετών), καθώς και σε παιδιά τυπικής ανάπτυξης της ίδιας ηλικίας. Επίσης, η εν λόγω έρευνα θα μελετήσει την κατανόηση των αναφορικών προτάσεων Υποκειμένου και Αντικειμένου στους ίδιους συμμετέχοντες μέσω μίας δοκιμασίας επιλογής εικόνας. Τέλος, θα παρουσιαστεί σε θεωρητικό επίπεδο η νευρωνική βάση του ελλείμματος στην εργαζόμενη μνήμη και στη γλώσσα, η οποία βασίζεται στη θεωρία της υποσυνδεσιμότητας που παρατηρείται στα άτομα με ΔΑΦ (Just et al., 2004).Autism Spectrum Disorder (ASD) is a pervasive neurodevelopmental disorder characterized mainly by diminished social and communicational skills and the presence of stereotyped and restricted behaviors and interests (DSM-V). Apart from a weak central coherence account and an absence of Theory of Mind (Frith and Happé, 1994), executive function impairments are also common in ASD (Hughes et al. 1994; Pennington and Ozonoff, 1996; Hill, 2004). Working memory allows for temporary storage and manipulation of information and relies heavily on frontal-parietal networks of the brain. Research on the deficit in working memory in children with ASD is controversial, as there are suggestions about either intact or impaired aspects of working memory (Bennetto, Pennington, & Rogers, 1996). However, one of the main findings is that deficits in working memory might be associated with the load and complexity of information that needs to be processed. The more complex the information is, the more difficult it is to be processed by children with ASD. Also, inhibitory control, the ability to delay a behavioral response, has been studied in children with ASD. Little research has shown the correlation of working memory and inhibition deficits with language difficulties that children with ASD might present. This study will try to shed light on verbal working memory deficits through a digit backward task along with two inhibition tasks in high-functioning children with ASD (aged 7-11 years old) and typically developing children matched on chronological age, combined with a language task based on the comprehension of subject and object relative clauses in Greek. Moreover, the present study will try to provide a theoretical background of the neural basis of disordered working memory and language, related to neurobiological foundations of underconnectivity in ASD (Just et al., 2004)

Urban vs rural STEMI patients; is there a difference?

Background: Timely access to reperfusion therapy for ST elevation myocardial infarction (STEMI) is vital. Every minute of delay costs 10 days of patient's life. Patients living in the rural Scottish highlands face a lot of challenges to optimum reperfusion therapy (ORT), due to geographical and environmental barriers that influence receiving pharmacological or interventional therapy timeously. Aims: looking at ORT comparing remote vs urban patients. Methods: Patients admitted, between March 2014 and April 2015, were selected from Raigmore hospital STEMI electronic database. A data collection form was developed by the research team and piloted. Clinical details were collected retrospectively from patient's discharge letters. 132 patients who suffered STEMI were included. Data collected included; patients' treatment location, date of admission, distance to the nearest cardiac-unit (CU), MI location, route of access to health, LV function and reperfusion therapy received. Results: 132 patients were identified, 73% received percutaneous coronary intervention, 31.7% received pre-hospital thrombolysis, 24.8% received in-hospital thrombolysis while 13% didn't receive any treatment. From this cohort 51% lived more than 50 miles from the nearest CU. Further analysis is ongoing to identify who received ORT and in the remaining cases what barriers limited ORT. These barriers will be divided into modifiable and non-modifiable. Conclusion: From initial analysis of the results it seems that there is a differential in patients' care, with more rural patients potentially receiving sub-optimal reperfusion therapy. This is likely to have an adverse mortality outcome. More research required to determine if addressing barriers to ORT is achievable and cost effective

Pulmonary Hyalinising Granuloma: A report of two cases

ABSTRACT: Pulmonary hyalinising granuloma (PHG) is a rare fibrosclerosing inflammatory lung condition of unknown aetiology. It is characterised by solitary or multiple pulmonary nodules that are usually found incidentally while imaging the chest for other reasons. We report two cases of histologically proven PHG diagnosed at the Royal Hospital, Muscat, Oman. The first case was a 71-year-old male patient who presented in 2010 with a dry cough, weight loss and bilateral pulmonary nodules. The second case was a 58-year-old male patient who presented in 2012 and was found to have incidental bilateral pulmonary nodules on chest X-ray. Both patients were started on prednisolone and on follow-up the PHG nodules remained stable. Although there is no definitive treatment, PHG generally has an excellent prognosis.Keywords: Granuloma; X-Ray Computed Tomography; Multiple Pulmonary Nodules; Lung; Case Report; Oman

Facteurs de risque de mortalité chez les nouveaux-nés transférés au service de néonatologie de l’Hôpital Jason Sendwe de Lubumbashi, République Démocratique du Congo

Introduction: la mortalité néonatale reste préoccupante dans notre milieu et plusieurs facteurs dont ceux liés à l’organisation du transfert de nouveau-nés au niveau des structures de prise en charge y  contribuent. Les objectifs de notre étude sont de déterminer la fréquence du transfert néonatal  extrahospitalier à l’unité de néonatologie et identifier les facteurs de risque de mortalité dans notre  milieu. Méthodes: il s’agit d’une étude prospective et analytique menée sur une période de douze mois allant du 1er Janvier 2012 au 31 décembre 2012 ayant ciblé tous les nouveau-nés transférés des  maternités extérieurs, traités et suivis dans le service de néonatologie de l’hôpital Sendwe. Les caractéristiques maternelles (âge, parité, état-civil, profession, niveau d’étude, antécédents médicaux et toxicologiques) et perpartales (âge gestationnel, état de la poche des eaux, voie d’accouchement) et néonataux (âge lors du transfert, sexe, poids de naissance, moyen de transfert, motif de transfert et évolution (guérison ou décès)) ont été étudiés. La saisie et l’analyse des données ont été faites sur le logiciel Epi Info 2011 (version 7.0.8.3) et le seuil de signification de 5%. Résultats: la fréquence du transfert néonatal extrahospitalier est de 12,9%. La mortalité était significativement liée à la profession (vendeuse ou travailleuse) de la mère (OR=7,43 (1,38-39,97)), au niveau d’étude élevé (OR=4,22  (1,18-15,10)), à l’âge gestationnel <37 SA (OR=3,21 (1,46-7,06)), à l’accouchement par voie basse de manière dystocique (OR=6,50 (1,54-27,38)), au sexe masculin du nouveau-né (OR=2,43 (1,08-5,46)), au poids de naissance <1500 grammes (OR=15,3 (5,73-40,78)) et à la prématurité comme motif de  transfert (OR=5,56 (1,47-20,98)). Conclusion: le bilan de la mortalité néonatale est lourd dans les pays en développement où les  nouveau-nés continuent de mourir pour des causes souvent évitables. La  réduction de la morbidité et la mortalité néonatales passe par une amélioration du système de référence  des nouveau-nés dans notre milieu.Key words: Transfert extrahospitalier, nouveau-né, facteurs de risque, Lubumbash

Comparing ST-segment elevation myocardial infarction care between patients residing in central and remote locations: a retrospective case series.

People who experience an ST-elevation myocardial infarction (STEMI) due to an occluded coronary artery require prompt treatment. Treatments to open a blocked artery are called reperfusion therapies (RTs), and can include intravenous pharmacological thrombolysis (TL) or primary percutaneous coronary intervention (pPCI) in a cardiac catheterisation laboratory (cath lab). Optimal RT (ORT) with pPCI or TL reduces morbidity and mortality. In remote areas, a number of geographical and organisational barriers may influence access to ORT. These are not well understood, and the exact proportion of patients who receive ORT - and the relationship to time of day and remoteness from the cardiac cath lab - is unknown. The aim of this retrospective study was to compare the characteristics of ORT delivery in central and remote locations in the north of Scotland, and to identify potential barriers to optimal care with a view to service redesign. The study was set in the north of Scotland. All patients who attended hospital with a STEMI between March 2014 and April 2015 were identified from national coding data. A data collection form was developed by the research team in several iterative stages. Clinical details were collected retrospectively from patients' discharge letters. Data included treatment location, date of admission, distance of patient from the cath lab, route of access to health care, left ventricular function and RT received. Distance of patients from the cath lab was described as remote if they were more than ninety minutes of driving time from the cardiac cath lab, and described as central if they were ninety minutes or less of driving time from the regional centre. For patients who made contact in a pre-hospital setting, ORT was defined as pre-hospital TL (PHT) or pPCI. For patients who self-presented to the hospital first, ORT was defined as in-hospital TL or pPCI. Data were described as mean (standard deviation) as appropriate. Chi-squared and student's t-test were used as appropriate. Each case was reviewed to determine if ORT was received; if ORT was not received, the reasons for this were recorded to identify potentially modifiable barriers. Of the 627 acute myocardial infarction patients initially identified, 131 had a STEMI, and the others were non-STEMI. From this STEMI cohort, 82 (62%) patients were classed as central and 49 (38%) were remote. In terms of initial therapy, 26 (20%) received pPCI, 19 (15%) received PHTs, 52 (40%) received in-hospital TL, while 33 (25%) received no initial RT. ORT was received by 53 (65%) central and 20 (41%) remote patients; chi-squared = 7.05, degrees of freedom = 130, p < 0.01).Several recurring barriers were identified. This study has therefore demonstrated a significant health inequality between the treatment of STEMI in remote locations compared to central locations. Potential barriers identified include staffing availability and training, public awareness and inter-hospital communication. This suggests that there remain significant opportunities to improve STEMI care for people living in the north of Scotland