Understanding power in relation to voice and silence on patient safety among surgical professionals in Ghanaian teaching hospitals

Employee voice is essential in positive work outcomes and harm prevention. However, there is a dearth of research on how power influences voice and silence in organisations (e.g Morrison et al., 2015). This study aims at understanding the implication of upward and interdisciplinary power relationships on voice and silence among Healthcare Professionals (HCPs) on patient safety in surgery. Sixty-seven (67) interviews and policy documents were analysed from two teaching hospitals in Ghana. The study found that formal power inequality is often reinforced by sociocultural authority. This enables superiors to take unilateral decisions and disregard inputs of team members resulting in preventable harm as well as apathy and silence on patient safety. Likewise, authority gradient creates a psychological barrier in hierarchy and undermine voice at interpersonal and broad surgical levels. The unequal power relationships coupled with lack of organisational support exposes those who speak up to risk. Beyond these, military authority often reinforces power or overrides healthcare authority and undermine voice in the military hospital. In terms of interdisciplinary power relationships, doctors’ authority often undermines nurses’ voice and compel them to undertake perceived harmful practices. However, a sense of equal interdisciplinary power relationship between surgeons and anaesthesiologists give rise to power struggles that promote voice in their respective speciality but undermine voice across speciality. Finally, HCPs adopt ingenious voice strategies to avoid appearing offensive and enhance receptivity to voice. Although sociocultural values generally reinforce formal power and silence, these equally provide unique interpersonal access that occasionally permeates power barriers for effective voice. Findings imply the need to empower HCPs, especially nurses, and shift surgical responsibility from individuals such as surgeons to teams as a way of mitigating unequal power and promoting a sense of involvement to encourage voice. Surgery may also consider ‘transdisciplinary approach’ as a creative solution to interdisciplinary power challenges to voice. Further implications for management and practice are presented in the conclusion of the study

POSTCOLONIALITY AND RESISTANCE IN EARLLOVELACE’S: The Wine of Astonishment and The Dragon Can’t Dance

É relativamente “seguro”, neste século 21, opinar que nenhum povo existiu sem uma história, mesmo em sociedades pré-industriais e predominantemente orais, ou que nenhuma cultura é estática. Mas não há muito tempo tempo atrás, dois terços do mundo estavam, de alguma forma, sob controle de outras pessoas, “os edificadores de impérios”, que pensavam de modo diferente e tentaram dominar o “Outro”. Como em qualquer parte no mundo pós-colonial, a resistência a essa episteme hegemônica — um pensamento que gerou a escravidão, o colonialismo e o neo-colonialismo na África e na sua Diáspora — tomou muitas formas: tradições orais, práticas marciais, o sincretismo nas religiões africanas e a militância, que, entre outras coisas, são parte integral dessa tradição de resistência à tirania. Essa história de resistência coincide com o que foi referido como o “momento pós-colonial”, um espaço de transição, onde as culturas se encontram e divergem, onde as identidades são continuamente criadas e contestadas, atestando o dinamismo das culturas da Diáspora Africana. Este artigo visa mostrar como as obras The Wine of Astonishment e The Dragon Can’t Dance, de Earl Lovelace, criaram aquele momento de pós-colonialidade e resistência, desafiando qualquer noção preconcebida de uma cultura caribenha estática, e redefinem o sujeito pós-colonial em seus próprios termos. Palavras-chave: Literatura Caribenha. Identidade. Pós-colonialidade. Descolonização. Carnaval. Igreja Batista. Folclore. ResistênciaResumenEs relativamente “seguro”, en este siglo 21, opinar que ningún pueblo existió sin historia. Todos tienen historia hasta las sociedades pre-industriales y predominantemente orales, también las culturas no son estáticas. Mas, em los tiempos pasados, dos tercios del mundo se encontraban, de alguna forma, bajo el control de otras personas, “los edificadores de imperios”, que pensaban de modo diferente e intentaron dominar el “Otro”. Como en cualquier parte en el mundo pós-colonial, la resistencia a ese pensamento hegemónico, un pensamiento que generó la esclavitud, el colonialismo y el neo-colonialismo en el Caribe, tomó muchas formas: tradiciones orales, prácticas marciales, el sincretismo en las religiones africanas y la militancia, que, entre otras cosas, son parte integral de esa tradición de resistência a la tiranía. Esa historia de resistência coincide con lo que fue referido como el “momento pós-colonial”, un espacio de transición, donde las culturas se encuentran y desencuentran, donde las identidades son contínuamente creadas y contestadas, testando el dinamismo de las culturas de la Diáspora Africana. Este artículo intenta mostrar como las obras The Wine of Astonishment e The Dragon Can’t Dance, de Earl Lovelace, crearon ese momento de pós-colonialidad y resistencia, desafiando cualquier noción preconcebida de una cultura caribeña estática, y redefinen el sujeto pós-colonial en sus propios términos. Palavras claves: Literatura Caribeña. Identidad. Pos-colonialidad. Descolonización. Carnaval. Iglesia Bautista. FolkloreAbstract It is relatively ‘safe’, in this 21st century, to opine that no people ever existed without a history, even in predominantly oral and pre-industrial societies, or that no culture is static. But not too long ago, two-thirds of the world was once under some form of control of a people, “the empire builders,” who thought differently and sought to dominate the “Other.” As elsewhere in the postcolonial world, resistance to this hegemonic thinking, a thinking that gave birth to slavery, colonialism, and neo-colonialism in the Caribbean, took many forms: oral traditions, martial practices, syncretic African religions, and militancy, among other things, form an integral part of this tradition of resistance to tyranny. This history of resistance coincides with what has been referred to as a “postcolonial moment,” a liminal space, where cultures meet and diverge and where identities are continually created and contested, attesting to the dynamism of African Diasporic cultures. This paper endeavors to show how Lovelace’s The Wine of Astonishment and The Dragon Can’t Dance create that moment of postcoloniality and resistance that defies any preconceived notion of a static Caribbean culture, and redefine the postcolonial subject in his/her own terms. Key Words: Caribbean Literature. Identity. Postcoloniality. Decolonization. Carnival. Baptist Church. Folklor

ENTRY AND EARLY INFECTION OF NON-SEGMENTED NEGATIVE SENSE RNA VIRUSES

Paramyxoviruses, pneumoviruses, and other non-segmented negative sense (NNS) RNA viruses have historically been of public health concern. Although their genomes are typically small (up to 19kbs) they are able to inflict large-scale detrimental pathologies on host cells. Human metapneumovirus (HMPV) is a widespread pathogen and is a NNS RNA virus. HMPV results respiratory tract infections and is particularly dangerous for preterm infants, the elderly, and immunocompromised individuals. Other viruses within the NNS RNA virus order include the deadly Ebola, Hendra, and Nipah viruses (EBOV, HeV, and NiV), as well as the re-emerging measles virus (MeV). Despite their public impact, there are currently very limited available FDA-approved therapeutics and antivirals against NNS RNA viruses. During the infectious cycle, viral surface glycoproteins play critical roles in establishing infection. For most NNS RNA viruses, the attachment protein is important for the tethering of a viral membrane to host cells, while the fusion protein is responsible for the membrane merger of the virus and host. The fusion protein of paramyxo-and pneumovirus proteins are class I proteins that are folded into trimers, must be proteolytically cleaved to be functional, and are held in a metastable prefusion conformation until the signal for fusion occurs. Upon being signaled, the fusion protein undergoes dramatic essentially irreversible conformational changes for membrane mixing. Because of its important role in starting infection, F has garnered interest as a potentially powerful target against infection. For paramyxoviruses, the ectodomain regions of F have been well-studied; however, the hydrophobic nature of the transmembrane domain (TMD) of the protein has resulted in difficulties in crystallization. To address this, several biochemical assays have been utilized to address the function of the TMDs of paramyxo-and pneumovirus fusion proteins. Although initially thought to be solely a membrane anchor, the transmembrane domains of several viruses have been shown to be important for the functionality of fusion proteins. For some paramyxoviruses, replacement of the proteinaceous TMD resulted in the premature triggering. Further studies showed that the TMDs of paramyxoviruses and several other viral F proteins exist in isolation as trimers, and these trimeric associations in turn drive trimeric associations of the full protein. Studies of the HeV F TMD in isolation identified a leucine/isoleucine (L/I) zipper as an important motif for TMD-TMD trimerization. Mutations to this L/I zipper motif in the context of the full protein resulted in reduced surface expression, and a loss of functionality. The L/I zipper was found to be present in 140 paramyxo- and pneumovirus fusion protein TMDs. This work examines whether wh iimporether the importance of the L/I zipper in the context of another paramyxvovirus. We used the model system, PIV5 F to dissect the role of the TMD L/I zipper in expression and fusogenic activity. We found that the (L/I) zipper plays important roles in functionality of the PIV5 F protein, but not surface expression of the protein. Following membrane merging, a series of events occur that facilitate the release of viral contents into the host cell. The NNS RNA carried by the virus into the cell is used as a template for viral replication and transcription; two important steps in generation of viral progeny. In the life cycle of NNS viruses, viral proteins assume multi-functional roles to optimize their replication and spread. One of the key players during the course of infection is the matrix protein (M). The matrix protein has been identified as a master regulator of viral infection with most studies focusing on its roles in late-stage infection, during assembly and budding of viral progeny. The matrix proteins of many enveloped viruses have been shown to associate in high order oligomers to form a grid- like array underneath the plasma membrane, where they can induce membrane curvature to allow for the budding of viral particles. Not surprisingly, the absence of M in some NNS RNA viruses results in a significant viral titer decrease. Interestingly, some recent studies show that the matrix protein has other critical roles in viral infection such as immune modulation and host cell translation antagonism. One of these newly uncovered roles for viral matrix proteins involves the regulation of viral RNA synthesis. Studies with EBOV and MeV demonstrate that the matrix protein is involved in early infection events, as inhibits viral replication. To study the roles of the HMPV M protein in early infection, we performed a spatiotemporal analysis of M in HMPV-infected cells. We noted the presence of HMPV M within the nucleus during early infection. Our knockdown studies of HMPV M indicate that HMPV M is a positive regulator of viral replication and transcription, as in its absence, the rates of mRNA and viral genomic RNA synthesis are dramatically reduced. Additionally, within the NNS RNA virus order, HMPV M is the only matrix protein found to bind calcium. We created alanine mutants to the calcium coordinating residues of HMPV M and found that these residues were important in properly folding the protein. Together, these findings contribute to our understanding of the mechanisms of NNS RNA viral infection

ECOWAS' Role as a Security Organization: The Case of Sierra Leone

In 1975, ECOWAS was formed primarily as a regional economic bloc. Through a careful remaking of the original treaty and the addition of new Protocols, it managed to metamorphose into a security organization that ultimately intervened in the humanitarian crisis then unfolding in the West African nation of Sierra Leone. This thesis argued the premise that the intervention was justified for two basic reasons. First, that ECOWAS’ founding treaty (including the Protocols) to which all 16 member countries are signatories, gave it the right to do so. Second, the doctrine of Responsibility to Protect provided the legal, moral and diplomatic basis for the intervention. The utility of this study lies in the idea that it brings to the fore the concept of African solutions for African problems. The ECOWAS mission in Sierra Leone was the first of its kind anywhere in Africa, and it just may be the impetus needed for Africans to come up with novel ideas to resolve some of the myriad issues confronting the continent

Eye eye

The output is a creative project called ‘Eye Eye’ consisting of a series of largescale printed textile and paper works. The project was a collaboration between textile designer Slater and visual artist, Mawuena Kattah. Both artists responded to shared connections in their practices, of pattern and textiles, image making, and narrative found in family and personal iconography. Research process: Initial inquiry was undertaken at The Whitworth Wallpaper and Textile Collection. Ideas were developed using textile and print as accessible and democratic processes. Slater and Kattah questioned the nuances between artist and designer, drawing upon their shared methods and tools. Their collaborative approach to making, drawing and image development challenged the function of the studio and the factory. Research insights: The notion of collaboration was questioned in relation to the roles of artist and designer. The dichotomy of studio and commercial practice was challenged within the context of textiles. Collaboration is important in keeping work relevant and innovative whilst sustaining the longevity of the creative economy. Through the project, Slater and Kattah argue that the design industry needs to acknowledge practitioners that come through alternative routes to practice. Dissemination: The project was disseminated at the following: Exhibition: ‘Eye Eye’ - Colours May Vary, Leeds, 15-30 November 2019. Seminar: ‘PROCESS I PATTERN I PRINT I PURPOSE’ The Whitworth Study Centre, Design Manchester, 16 November 2019. Seminar: ‘Archives and Collections- Design in a Gallery Context’, The Hepworth Wakefield- 14th December 2019. Editorial: ‘Together in Print’ by Jake Kennedy, Editorial Pressing Matters Magazine, November 2019. Exhibition: Collect, Crafts Council, Somerset House, 25th February- 1st March 2020. Acquisition: V&A Textile Collection, ‘Eyes’ (Pink) and Screen-Printed Linen, November 2019, Laura Slater & Mawuena Kattah

Establishing a decentralized maintenance system

Establishing a decentralized maintenance syste

An effective location strategy and design of goods and services strategy to improve customer satisfaction and market share for Dough Man Foods

Applied project submitted to the Department of Business Administration, Ashesi University, in partial fulfillment of Bachelor of Science degree in Business Administration, May 2020Dough Man Foods is a Ghanaian-owned food company that provides fresh, quality snacks. Established in 2016, Dough Man Foods is no longer a ‘start up’ and seeks to provide its customers with improved satisfaction. They also seek to increase their market share and be the market leaders in their industry. In this project, the researcher sought to find out how the company would be able to do this by adopting new operational strategies. Assessing the current state of the business was done through qualitative research by conducting semi-structured interviews with the Chief Executive Officer, Chief Operating Officer, surveys for customers and employees and online reviews. Through the research process, it was observed that the key areas of concern relate significantly to Dough Man Foods’ location and design of goods and services. Specifically, they were interested in siting a permanent production and sales location and modifying the design of their goods and services. The solution addresses the issues identified by proposing a partial operations management plan with the aim of improving customer satisfaction and increasing market share by focusing on location and product development.Ashesi Universit

“It was a bit my fault and a bit his fault": Mothers' and Early School-aged Children’s Blame Attributions in Conversations about Peer Conflicts

In a sample of 36 dyads, this study investigated mothers’ and their 6-7-year-old children’s blaming strategies when engaged in conversations about the children’s peer conflicts. Each dyad discussed two conflicts in which the child was hurt, one to which they felt they contributed (shared fault) and the other in which they felt they did not contribute to the conflict (no fault). We specifically examined: (1) how conversations about the two events differed in terms of maximizing and mitigating blame attributions across three contexts (the peer’s harm against the child, child’s harm to the peer, and the child’s self-protection from harm) (2) variations between mothers and children’s maximizing and mitigating blame strategies (3) the specific dimensions that mothers and children considered in making blame attributions. Results revealed that families maximized responsibility more in the no fault conversations in the context of harm to the child and self-protection from harm, whereas they maximized blame concerning the child’s harm to his/her peer more in the shared fault conversations. Comparing mothers and children, findings indicated that mothers maximized blame more in self-protection contexts, whereas children maximized blame for the peers’ harm to child and mitigated responsibility across all contexts. Regarding dimensions of blame attribution, avoidability and consequences of harm were used most often by families. Mothers referenced avoidability and act evaluations most frequently whereas children more often discussed presence of harmful acts and subsequent responses to one’s own harm. Findings suggest that maternal socialization of blame is context-sensitive as mother-child dyads are listening to and largely agreeing with each other. Mothers’ emphasis on self-protection raises questions about parental concerns for children’s responsibility and agency in the context of victimization. Implications for children’s moral development are discussed

Taking people to water instead of taking water to people: changes in Ghana's rural water sector

The paper highlights key issues emerging from a “conversion programme”, the Accompanying Measures Eastern Region (AMER) Project, during which over 150 hand-pumps previously centrally-managed and maintained by government (the 3000 Wells Project), were transferred to rural communities for ownership and management (COM). Implementation was carried out in the Eastern Region of Ghana between 1996 and 2001. To ease the burden on communities to make the transition “transfer-friendly”, communities could pay 50% of arrears owed over six months for the rest to be written off, local residents were trained for maintenance of facilities and there was free rehabilitation of the hand-pumps. Even though some challenges were encountered, there were interesting findings such as the long time it takes for COM to take root in rural communities towards sustainability, the need to make alternative arrangements for maintenance of facilities and the complex relationships between socio-cultural configurations and payment of arrears