Exploring the contribution of a leadership development program on the implementation of improvement projects at a South African central hospital

Background It is recognized that healthcare leaders of today would need to not only be responsive to the rapid changes around them, but also plan for the future of healthcare by creating a climate that is sensitive to the context of the organization while responding to the service needs. In the South African public healthcare context, where the service demands outweigh the ability to satisfy these needs with limited resources, leadership and leadership development is required to create more adaptive and resilient leaders and leadership. This PhD therefore aimed to study the implementation of a strategy to improve the leadership of the executive team at the hospital through a leadership development program, specifically analysing whether and how the program facilitated their capacity as leaders and their continuing work, with their respective multidisciplinary teams to implement improvement processes across the hospital. Methodology Given the limited knowledge on implementing a leadership development program (LDP) at a large South African central hospital, this study was comprised of two phases. Phase one of the study used a qualitative exploratory design, to explore the experiences and perspectives of the thirteen executive leaders on the LDP and whether these learnings played any role in developing their capacity. This was done by reviewing 242 documents and 13 one on one interviews with the hospital executive leaders, using purposive sampling. The second phase of this study used the insights of phase one to guide the analysis of four improvement processes initiated at the hospital. This phase explored which factors contributed to the success or failure of the implementation of the improvement processes in the executive leaders' respective areas and how their leadership of the process contributed to these factors. This was done by conducting in-depth case studies through focus group interviews with a total number of 36 participants in the respective teams and six one-on-one interviews with key informants (members of the team who had retired, but were integral to the process) that were involved in the improvement processes. Results The results of the study indicated the need for a context specific, practical LDP that provided benefit to the executive leaders, both as individuals and as team leaders. The executives reflected on their growth as leaders through building relationships, developing themselves through self-awareness and developing multidisciplinary teams. The analysis of the case studies in turn showed that leaders who engaged and supported their teams were more successful in their improvement processes. Concluding remarks This research summarized eight major conclusions drawn from the study as a contribution to what is possible in the public sector. Both the leadership development program and the case studies provided a broad conceptual framework of the Individual, the Team and the System as components that can be used to develop leaders, develop teams and improve overall leadership at a hospital. Based on the study learnings, the bottom-up approach and specific tools developed could serve as a basis for other hospitals to implement a leadership development program (LDP) and improvement processes in similar contexts. Further research on LDPs in a South African context could test the findings of this study and assist in enhancing the development of leaders at public sector hospitals

ISOLATION AND CHARACTERIZATION OF SHATAVARIN IV FROM ROOT OF ASPARAGUS RACEMOSUS WILLD

Objective: To develop a method for the isolation of the steroidal saponin Shatavarin IV from the root of Asparagus racemosus Willd.Methods: Powder of Asparagus racemosus dried roots were defatted with hexane and extracted with methanol. The methanolic extract was used for isolation of pure compound by column chromatography. Isolated compound was identified by melting point analysis, IR and Mass spectroscopic analysis. Purity was checked by High-performance thin layer chromatography (HPTLC).Results: The highest yield of Shatavarin IV was obtained 401.1 mg from 250 g crude powder and highest purity was achieved 66% of lower atmospheric temperature (17-22 °C).Conclusion: Shatavarin IV isolation using column chromatography was affected with the change in atmospheric temperature. Maximum yield was obtained at the lower temperature i.e. 17-22 °C, whereas at higher temperature the Shatavarin IV showed degradation in purity and yield.Â

The Effect of Risk Return Analysis of Pharmaceutical Companies on Indian Stock Market

Each individual endeavors to stop his/her well deserved funds in different venture roads relying on his/her targets. Among the different venture options, securities exchange is viewed as a standout amongst the most compensating roads of speculation. At the point when the normal return is high, the hazard related with such return is additionally high. So before putting resources into value advertise one should come to realize the hazard return attributes of those stocks and those ventures in which he/she plans to contribute. In this viewpoint, an examination has been embraced to break down the hazard return relationship of chose organizations in pharmaceutical industry of Indian securities exchange. The pharmaceutical business of India positions third on the planet regarding volume and fourteenth as far as esteem. The business is said to be the ideal part for parcel of speculators. The financial specialists must know about the hazard and return associated with the speculation. This investigation encourages the potential financial specialists to settle on educated and reasonable venture choice. The example time of this examination is five years from 2013 to 2018. The investigation has endeavored to discover the hazard return attributes of chosen 10 pharmaceutical organizations in Indian securities exchange. The information has been gathered and examined utilizing MS exceed expectations. The examination inferred that from the chose pharmaceutical organizations Sun Pharmaceutical Industries Ltd gives exceptional yield yet the market danger of the offers is much high. So the value offers of Divi's Laboratories Ltd are increasingly great to potential speculators since it gives exceptional yield and the hazard related with those offers less

A review of the ethical and legal principles used in the decision making process for feticides at seven sites in South Africa

M.Sc. (Med.) (Bioethics and Health Law), Faculty of Health Sciences, University of the Witwatersrand, 2009This study set out to perform an ethical-legal analysis of the current practices across the seven public health centres in South Africa that perform feticide for congenital abnormalities. Ideally, such decisions need to be guided by multidisciplinary discussions with the parent(s) and the parties included in the team, e.g. Obstetricians, Neonatologists, Nursing, Genetics counsellors and Social Workers and following the ethical principles of beneficence and respect for autonomy. Prior to the study, it was unknown as to whether all seven centres were using multidisciplinary groups in the decision-making process and on what basis approvals were being granted for feticide. The objectives of the review were to assess the number of feticides performed, who made the decision to offer the feticide and for what ethical or clinical indications. The results showed that all public health facilities in South Africa differed in the criteria that were used in making the decision to offer feticide. The clinicians varied in terms of who was represented in the team that reviewed the cases of congenital abnormalities. An analysis of the literature, together with a review of the data received on the current practices, guided the development of an ethical guideline for this service as well as making recommendations as to how the law could be strengthened in order to protect both health workers and patients

Fine needle aspiration cytology as a first line investigation in cervical swellings of 470 cases

Background: Fine needle aspiration cytology (FNAC) is a first line investigation in cervical swellings. The etiology varies from an inflammatory process to a malignant condition.Methods: The study was carried out in department of Pathology, Government Medical College, affiliated with government hospital in Gujarat. There were 470 patients with cervical swelling in a period from January 2017 to December 2017. Patients with thyroid swelling (swelling moves with deglutition) were excluded from the study. FNAC procedure was performed, smears prepared, stained with haematoxylin and eosin (H and E), May Grunwald Giemsa (MGG) and Pap stain. Zeihl Neelsen stain was carried out when required. Patient history, local examination findings and microscopic findings were recorded.Results: Total 470 patients, age ranged from 2 months to 90 years were studied. There were 286 males and 184 females. There were 449 cases in which conclusive opinion given. 111 cases were neoplastic and 338 cases were non-neoplastic. Various cytological diagnosis were; 207 cases of granulomatous lymphadenitis (tuberculosis), 1 case of filarial lymphadenitis, 72 cases of chronic reactive hyperplasia, 25 cases of acute suppurative inflammation, 1 case of sialadenitis, 10 cases of keratinous cyst, 6 cases of benign cystic lesion, 12 cases of lipoma, 4 cases of lymphoproliferative lesion, 1 cases of benign appendage tumor, 2 cases of mucoepidermoid carcinoma, 103 cases of metastasis and 5 cases of non Hodgkin lymphoma.Conclusions: FNAC is a simple, quick, inexpensive and minimally invasive technique to diagnose cervical swellings. It can differentiate the infective process from neoplastic one and avoids unnecessary surgeries

Reporting of thyroid fine needle aspiration cytology with the use of the Bethesda System (TBS) of 150 cases

Background: Fine needle aspiration cytology (FNAC) is very simple, rapid, cost effective diagnostic test to evaluate thyroid swelling. The Bethesda system for reporting thyroid cytopathology gives guidelines which remains the same while reporting the thyroid FNAC. There are six diagnostic categories of lesions: (I) Non-diagnostic/Unsatisfactory, (II) Benign, (III) Atypical follicular lesion of undetermined significance (AFLUS), (IV) Suspicious for follicular neoplasm (SFN), (V) Suspicious for malignancy (SM), (VI) Malignant.Methods: The study was carried out in Department of Pathology, Government Medical College affiliated with a Government hospital, Gujarat. It includes 150 patients, coming to the outpatient departments with a complaint of thyroid swelling from January 2017 to December 2017. The patients age ranges from 7 years to 75 years (Male-20, Female-130). The procedure was done with the patient in a supine position without a pillow. Patients were instructed not to speak or swallow during the procedure to avoid movement of the gland. The reporting was done with the current Bethesda nomenclature.Results: There were 150 cases of thyroid FNAC, 3 cases (2 %) were non-diagnostic (TBS-I), 133 cases (88.7 %) were benign (TBS-II), 6 cases (4 %) were atypical follicular lesion of undetermined significance (AFLUS) (TBS-III), 5 cases (3.4 %) were suspicious for follicular neoplasm (TBS-IV), 2 cases (1.3 %) were suspicious for malignancy (TBS-V), and 1 case (0.6 %) was malignancy (TBS-VI).Conclusions: The Bethesda system is very useful standardized system for reporting thyroid cytopathology, improving communication between cyto-pathologists and clinicians, inter-laboratory agreement, leading to more consistent management approaches.

Organisational change : The assimilation of software technology in the higher education environment

Organizational change- its mechanisms, and its outcomes - is a topic of increasing interest and study in both business and education. The external environment, including the economic, political, and cultural dimensions of society is rapidly changing, growing in complexity and posing numerous challenges. The creation of the learning organisation is one of the responses to these challenges. During the 1990s the concept of the “learning organisation” attracted much attention and generated a significant amount of research. The central tenent of a learning organisation is that it is able to learn and therefore able to adapt better to both external and internal challenges. The study of how learning takes place in organisations has therefore become important in understanding organisational change. In the current research study, the implementation of an Enterprise Resource Planning (ERP) system meant that organisational change would be inevitable. New information technology software would result in changes in business processes, changes in work groups, changes in terminology and changes in how work is processed. The implication was that there would be a need for learning to take place in order for organisational change to take place. The Guttman’s Stage of Assimilation Model formed the theoretical basis for the research. A key assumption is that the assimilation of technology is best characterised as a process of organisational learning. The research findings indicated that learning did take place and Guttman’s model provided interesting insights into the different types of assimilation that took place at different level of the organisation. Interesting differences were found between academic and support staff and useful lessons were learned about how ERP systems can be introduced into higher education organisations. The current research findings also provided evidence that training and communication were crucial during a change process. These two elements are also vital in enabling organisational learning to take place