The role of organisational resilience in maintaining long term performance, especially after undergoing major organisational changes: a consideration of the critical success factors involved

A lot has been said about change. For example, it is widely recognised that the only constant is change (Heraclitus, 470 BC). As such, no sensible decision can be made any longer without taking into account not only the world as it is, but the world as it will be (Isaac Asimov). As regards this, a bulk of existing researches have been aimed at understanding the triggers for change and the extent or degree to which individuals, organisations, systems or entities have to change. Generally, results from such studies vary. With specific relations to organisations, organisations are advised of the need to develop added adaptive and dynamic capabilities. One of such added adaptive and dynamic capabilities is organisational resilience. In the literature, organisational resilience has been successful linked with organisations ability to maintain long term performance. Hence, the research is not about re-examining the relationship between organisational resilience and organisations ability to maintain long term performance. This research focuses on exploring the critical success factors required to maintain long term performance and building adequate resilience into systems undergoing changes. The investigation was conducted in three phases, namely: (a) the exploratory phase; (b) the descriptive phase; and the empirical phase. The exploratory phase involved identifying the critical factors essential to maintain long term performance and at the same time build resilience into their systems after undergoing organisation-wide changes. In order to make out these critical, a pilot study was conducted. 21 persons occupying senior managerial positions in different organisations were interviewed. The interview data were transcribed, coded and analysed using coding and thematic analysis to identify five common themes, namely (a) employees readiness to support ongoing organisation-wide changes; (b) development of targeted organisational adaptive capacity; (c) the provision of individualised and social support; (d) the use of stress coping mechanisms; and (e) the existence of organisational resilience strategies. The second phase of the research entailed conducting case study research with the intention of describing the identified critical success factors. The final phase entailed conducting empirical analyses and cross case analysis. Results from the cross case study analyses indicated that both resilience building at the individual level and organisational level is needed for organisations to build in resilience into their systems especially after undergoing organisation-wide changes. Three factors (i.e. employees readiness to support ongoing organisation-wide changes, the provision of individualised and social support and the use of stress coping mechanisms) were found to be more pronounced at the individual level. The remaining two factors namely development of targeted organisational adaptive capacity and the existence of organisational resilience strategies are essentially carried out at the organisational level. The research has contributed to the current body of knowledge on how organisations can strive to maintain long term performance, especially for a country like Nigeria where there still remains a dearth of such related studies. Each of the research hypotheses were either confirmed or non confirmed. This will give the practitioners, academicians and managers of Nigerian organisations the opportunity to understand how each of the sub factors of the five critical success factors can influence on attempts to build organisational resilience. In addition, specific actions that managers can follow over the life of an organisation-wide change project that will improve the resilience of systems undergoing change. In addition, differences in how varied control factors can influence resilience building in organisations were explored and validated based on the results of the Mann Whitney test results. At the end of the thesis, recommendations for future practice and research were made. One of such is that resilience building at both levels be done concurrently and given equal prominence

Chalazion, a Benign Eyelid Tumour – The Sagamu Experience

Aim: To study the demographic characteristics, pattern of presentation and type of treatment of chalazion in Sagamu, Nigeria.Materials and Methods: A retrospective hospital-based study was conducted to review all the cases seen and diagnosed as chalazion in the eye clinic of Olabisi Onabanjo University Teaching Hospital [OOUTH], Sagamu between January 1997 and December 2007. Data was obtained from the clinic attendance register, the register of minor office procedure and the case files. The age, sex, pattern of presentation and type oftreatment given were recorded.Result: Ninety-seven cases (0.7%) out of a total of 13,605 new cases seen during the period under review were diagnosed as chalazion although 59 case records were available for review. There were 46 males and 51 females with a mean age of 25.3 years. Thirty-nine cases (40.2%) were between the ages of 21 and 30 years. Twenty-one cases (42.9%) presented with multiple chalazia while 32 cases (65.3%) had chalazion onlyin their upper eyelids. Forty-four cases (74.6%) were treated with incision and curettage.Conclusion: Chalazion is not a common ocular problem. Youngage at presentation and multiple lesions are significant findings. Surgery is the standard method of treatment

Unilateral Idiopathic Dilated Episcleral Vein with Secondary Open Angle Glaucoma (Radius–Maumenee Syndrome) in an African – A case report and literature review

A 69-year-old woman was seen in the eye clinic of the Olabisi Onabanjo University Teaching Hospital [OOUTH], Sagamu, south-west Nigeria, with irritation in the right eye due to a vascular nasal pterygium, but asymptomatic in her left eye. Examination revealed dilated and tortuous conjunctival and episcleral vessels in her left eye with no apparent cause. She later developed secondary glaucoma in that eye. A diagnosis of left idiopathic dilated episcleral vein with secondary open angle glaucoma [Radius Maumenee syndrome] was made. She was treated both medically and surgically. This rare case in an African woman is presented in order to highlight the possibility of secondary vascular glaucoma in a patient with chronic redness of the eye without symptoms of discomfort or allergy. Keywords: idiopathic, dilated episcleral veins, secondary glaucoma, NigeriaNigerian Journal of Ophthalmology Vol. 16 (1) 2008: pp. 20-2

Gastroprotective Activities of the n-Hexane Fraction of Heliotropium indicum on Gastric Ulceration

Heliotropium indicum has been established to possess gastroprotective properties. We evaluated the gastroprotective properties of the non-polar (n-hexane) fraction of H. indicum to establish its anti-ulcer activities. Rats of Groups I and II received physiological saline and 80 mg/kg/body weight (bw) of Indomethacin respectively. Rats of Groups III – VI received orally 100, 200 and 400 mg/kg/bw of the n – hexane fraction of methanolic extracts of dried leaves of H. indicum and 50 mg/kg/bw of Ranitidine respectively before the induction of gastric ulceration. One hour after administration of extract doses and Ranitidine, 80 mg/kg/bw of Indomethacin (an ulcerogen) was administered orally to rats of Groups III – VI. Morphological analyses show that administrations of 100, 200 and 400 mg/kg/bw of extract and Ranitidine resulted in percentage ulcer reductions of 45%, 50%, 75% and 95% respectively. Histological analyses of the stomach in rats of Groups II and III show erosion of mucus-secreting cells, parietal cells, gastric pit and glands. Erosion of few mucus-secreting cells, gastric pit and parietal cells were observed in rats of Group IV. Normal cytoarchitectures of the mucosa layer were observed in rats of Groups I, V and VI. Our findings show that the n-hexane fraction of H. indicum possessed gastroprotective properties.Keywords: Heliotropium indicum, Indomethacin, Ulceration

Eye Injuries among Road Traffic Accident Victims in Ogun State, Nigeria

Aim: To investigate the types of eye injuries seen among road traffic accident (RTA) victims managed at a referral hospital in Ogun State, Nigeria.Materials and Method: All RTA victims who presented at Olabisi Onabanjo University Teaching Hospital (OOUTH) between July 2004 and June 2005; their eyes were examined by an ophthalmologist for any form of injury. The biodata, cause and type of eye injury, cause of accident, position ofvictim in the vehicle, use of seat belt by victim, and treatment offered were documented using a questionnaire.Results: Thirty-five (2.7%) of the RTA victims (1314) during the study period had various forms of eye injury. The majority were male (65.7%); 80% were between 20 and 40 years. The victims included 7 technical workers (20%); 6 students (17.1%); 5 traders (14.3%); 5 office workers (14.3%); and 5 drivers (14.3%). Only 24% of the drivers and 8% of frontseat passengers had used a seat belt. The majority of the victims, 23 (65.7%), had a combination of extraocular and anterior segment injuries . Lid injury was the most common extraocular injury 29 (90.6%), followed by laceration (34.4%), oedema (30.2%) and bruising (25%); while themost common injury of the anterior segment was subconjunctival haemorrhage 23 (85.2%). Most of the patients, 28(80%), presented within 24 hours of injury.Conclusions: The majority of eye injuries from RTAs seen at OOUTH, Sagamu were mild and mainly found in the extraocular and anterior segments of the eye.Key words: eye injury, road traffic accidents, anterior segment, extraocular segment, posterior segmen

Vestibular disorders in elderly patients: characteristics, causes and consequences

Introduction: this study assessed vestibular disorders in elderly patients, describing the causes,  clinical characteristics, therapies and treatment outcomes. Methods: five-year hospital-based  prospective study, conducted at the ENT clinic of a tertiary referral center. Subjects were consecutive elderly patients with dizziness, treated and followed-up for a minimum of six months. Data was  generated using structured questionnaire and case record files. Analyzed results were presented in  simple descriptive forms as graphs and tables.Results: among the elderly patients, prevalence of vestibular disorders was 18.6%, 49.1% were retired, 71.9% were married, M:F was 1:1.1. Mean age ±SD were 69.4±1.1 and 69.0±0.8 years for males and females respectively. 56.9% of the patients presented early on experiencing the vestibular symptoms.  The symptoms were associated with nausea or vomiting in 26.3%, with an aura in 12.3%. While 50.9% of the patients experienced intermittent symptoms, laterality of the symptoms was not clear in 45.6%. Positional vertigo was diagnosed in 33.3% while in 17.5%, the symptoms could be attributable to  previous trauma or assaults. 31.6% of the elderly were referred to ENT surgeons by other specialties, 45.6% were managed with multidisciplinary approach, while 82.5% had the vestibular symptoms initially controlled with labyrinthine sedatives. At follow-up, 43.9% had intermittent periods of recurrence of symptoms. Conclusion: prevalence of vestibular disorders in elderly patients is high, most patients present early with intermittent, relatively innocuous symptoms which may be difficult to lateralize. Positional vertigo was the most common cause, it is frequently relieved with labyrinthine sedatives but tends to recur  intermittently.Key words: Dizziness, elderly, vertigo, causes, characteristics, Nigeri

Orbital Loiasis Masquerading as Orbital Cellulitis: A Case Series

Background: Orbital loiasis is a rare ocular disease which is sparsely reported in the literature. It is caused by the human filarial parasite, Loa loa, which is rarely found in other continents except in Africa and among African immigrants. The ocular presentation of orbital loiasis is similar to orbital cellulitis, thus, a high index of suspicion is required to make a diagnosis. Methods: A retrospective description of the patients diagnosed and treated for orbital loiasis in a tertiary health facility in Ogun State, Nigeria between 1998 and 2013 was done. Data on the demographic characteristics, place of residence of the patients, symptoms, signs, and results of ancillary investigations were retrieved from the records. Result: Three cases of presumed orbital loiasis were seen within the study period. All the patients presented with sudden onset of ocular pain with proptosis without the history of shifting body or facial swellings or visible worm in their eyes. Other features recorded in all the three patients included severe axial proptosis, eyelid oedema with mechanical ptosis, conjunctival injection with chemosis and restriction of ocular motility in all positions of gaze. Full blood count revealed eosinophilia while the radiological investigation was neither in keeping with sinusitis, thyroid-related orbital disease or orbital pseudotumor. Treatment was switched to Diethylcarbamazine when there was no satisfactory clinical response to the initial antibiotics and all the patients had a good outcome. Conclusion: Orbital loiasis should be suspected when orbital cellulitis cases appear to be recalcitrant to treatment with antibiotics, particularly when there is eosinophilia on peripheral blood film

The Epidemiology, Possible Risk Factors and Clinical Presentation of Pterygium at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria

development of pterygium. This is a hospital based retrospective review of patients diagnosed to have pterygium at the Olabisi Onabanjo University Teaching Hospital in Sagamu, Ogun State, Nigeria between January 2006 and December 2009. Data was obtained from the case files of patients. The age, sex, place of abode, occupation, level of education, pattern of presentation and type of treatment offered were recorded and analyzed. Two hundred and thirty-three patients were diagnosed to have pterygium within the 3 years study period but only 178 case notes were retrieved. Age range was between 8 years and 85years with a mean of 50.9years ±15.6 standard deviation. Pterygium was most common in the age group 41-60years. There was a male: female ratio of 1:1.8. Ninety-four (52.8%) of the patients were traders, 10 were students, 8 were teachers while 4 were farmers. Sixty (33.7%) patients presented because there was growth in their eyes while 44 complained of redness. One hundred and twenty-nine (72.5%) patients had bilateral pterygia while 49 (27.5%) were unilateral cases. One hundred and eight (60.7%) had bilateral nasal lesion and same number (129) of patients came with a presenting visual acuity of 6/18 and better. Seventy-eight patients (43.8%) were treated conservatively with eye drops while 39 (21.9%) had excision with adjuvant 5 fluorouracil [FU]. Bilaterality and preponderance of female gender are important findings in this study. The perceived presence of pterygium was a predominant reason for seeking eye care.Keywords: Epidemiology, Risk factors, Clinical presentation, pterygium, NigeriaNigerian Medical Practitioner Vol. 63 No 1-2, 201

Autosomal Dominant Aniridia in A Nigerian Family: A Case Report.

A 54year old man brought his son to our clinic because of large eyeballs and poor vision from birth. Family history revealed that father and another child had poor vision and used to squeeze their faces especially in bright light. Examination of the boy revealed bilateral aniridia with congenital glaucoma. The father, the other child and his grand child all had bilateral aniridia with microcorneae. This is a rare case of autosomal dominant aniridia in threegenerations of a Nigerian family. Recognition of a child with aniridia should draw the attention of the ophthalmologist to the possibility of a familial disorder.Key words: Aniridia, Autosomal dominant, Alternate family members, Nigerian family