Clinical Leadership in Jordanian Hospitals: The Clinicians' Perspective

The main aim of this study is to explore the nature of leadership in Jordanian hospitals. This study consists of four objectives; the first objective is to identify the extent to which clinicians perform their role of managing and leading Jordanian hospitals .The second objective for this study is to explore the source of power and authority being adopted in Jordanian hospitals. Then the third objective is to differentiate between doctors and other clinicians from nurses and AHPS in practicing leadership. While the fourth objective to explore the obstacles in developing CL in Jordanian hospitals. The methodology of a qualitative approach was adopted through analyzing the contents, thus, semi-structured interview was conducted with 38 participants from managers who have a clinical mission besides managerial and supervising ones. The study has found out that there is a lack of administrative qualifications for clinicians, and seems difficult to apply the transformational style in Jordanian hospitals due the fear of responsibility and bad distribution of power and authority among clinicians and doctors in particular. Furthermore, there is a lack cultural diversity and this weakens the provided medical services in matching globalization and international criteria. Communication channels in Jordanian hospitals are acceptable; because both technical and personal settings among clinicians are emerged. Unfortunately, there was no specific and clear agenda for both quality and ethical considerations .Doctors are dominated by the concept of bureaucracy and centralism. Accordingly, some obstacles have been revealed in Jordanian hospitals; doctors are the biggest obstacle because they are holding the whole power. Also, communication channels with other departments and among colleagues are weak. Furthermore, the clinical culture did not reach the creation of cultural system .This is due to the weak coordination among academic faculties and governmental departments to shape the meaningful concept of health care management and leadership. The researcher recommends that both quality and ethical considerations should be involved in more practical sense and doctors need to be trained to carry out the administrative responsibilities by involving nurses and AHPS to ensure the distribution of power and diversity. This study has added the academic contribution by presenting a new mass of knowledge, and considering clinical team members in Jordanian hospitals as a uniform by creating the comprehensiveness of work culture. Finally, the study proved that both experience and knowledge are additional authorities beside position, law and work that may enrich performance

Development of Gulf Cooperation Council human resources: an evidence-based review of workforce nationalization

Purpose – This study aimed to contribute to the field of Human Resource Management (HRM) by providing a critical review of existing scholarly research and a thematic analysis of the workforce nationalization domain in the Gulf Cooperation Council (GCC) countries. To strengthen the literature on this topic, it seeks to identify key gaps and areas for further exploration. Design/methodology/approach – A two-step systematic research methodology (qualitative and quantitative) and a thematic analysis of empirical and theoretical studies were used in this study. The quantitative review was conducted using a predesigned coding framework. Findings – The study identified and discussed four perspectives of workforce nationalization in the GCC countries. These were (1) the conceptualization of workforce nationalization; (2) the role of institutional policies in achieving it; (3) the practices and outcomes of nationalization efforts and (4) the impact of gender and women in the nationalization process. Research limitations/implications – This study has several limitations, which the authors have addressed by proposing several future research avenues. For example, the reviewed studies are skewed toward certain countries (e.g. UAE and Saudi Arabia), which limits the generalizability of their findings. Practical implications – A more comprehensive definition of nationalization, development of qualitative and quantitative measures to enhance HRM practices and outcomes, and the identification of alternative approaches to improve the employment of locals are emphasized as needs. Additionally, revised measures and mechanisms to rectify negative perceptions about entitlement and the revision of policies to integrate females in the national labor force are suggested. Originality/value – Workforce nationalization initiatives in the GCC region offer a unique and rich research phenomenon replete with managerial, organizational, economic and political dilemmas. The investigation of this phenomenon would profoundly enlighten employers, policymakers and scholars. Keywords GCC countries, Workforce nationalization, Localization, Human resource management Paper type Literature revie

Effective Light Source for Illuminating Overhead Guide Signs and Improving Roadway Safety

Driver safety is considered an important issue to departments of transportation. One way to increase highway safety is to improve the visibility of overhead guide signs for drivers. Visibility improving methods include the use of sign illumination or retroreflective sheeting materials. This paper focuses on sign illumination by comparing five light sources including high pressure sodium (HPS), metal halide (MH), mercury vapor (MV), induction lighting, and light emitting diode (LED). A laboratory experiment was conducted to compare effective light distribution of each light source and a cost analysis was performed to compare initial, maintenance, and operating cost components of the light sources. Results of the light distribution experiment indicated that HPS was the optimum light source followed by MH, induction lighting, MV, and LED. Induction lighting is a promising lighting technology which features good efficiency and long life. According to cost analysis, induction lighting was the most effective source, followed by the LED, HPS, MV, and MH. Of the five light sources considered, induction lighting provided the best overall performance when considering initial cost, operating cost, expected maintenance, and sign illuminance. Environmentally, LED does not contain mercury, and for those agencies that prefer using sources that are friendlier with the environment, the LED can be their best choice

A weighted companion of Ostrowski's inequality using three step weighted kernel

There are numerous works suggesting linking SSM models to information systems (IS) models for information systems development. In these works links between SSM and IS models are established at the conceptual level i.e. they provide ways to utilise SSM models to identify or to derive IS models. However, most of them have not provided a method for representing the links explicitly in the combined model. Consequently, the links become subtle and untraceable, looking at the combined model only at the representation level. This paper proposes an approach based on meta modelling to achieve a uniform and formalised representation of models that combine SSM and IS models. The approach allows one to represent not only SSM and IS modelling concepts but also relationships between the concepts in a meta model using the conceptual modelling language Telos. Telos supports meta models to be flexibly specified and extended to meet specific modelling requirements of a particular project. An exemplary application is presented to demonstrate the operationalisation of the proposed approach and to illustrate the uniform representation of combined models. The example also shows benefits of the formalised representation in terms of computer support for managing and retrieving a combined model's meta data

Prescribing Antibiotics for pediatric dental patients in Jordan; knowledge and attitudes of dentists

Objective: The inappropriate use of antibiotic in treating children has been observedin the treatment of dental infections. Recent surveys reported that dentistsin several countries have modest knowledge about antibiotic prescribing. The aimof this study was to investigate the knowledge and attitude of a group of Jordaniandentists treating children towards antibiotic prescribing.Methods: A written questionnaire was distributed during a meeting of the JordanianSociety of Paediatric Dentistry. The questionnaire included questions aboutthe knowledge and attitudes of dentists toward dental antibiotic prescribing tochildren.Results: Amoxicillin was the most popular antibiotic (62.9%) to be prescribed bydentists treating children. A lesser percentage (29.7%) prescribe combination ofantibiotics, and around 37% prescribe antibiotics for duration longer than 5 days.Erythromycin was the most popular alternative to amoxicillin (77.8%) followed byclindamycin (22.2%). A number of antibiotics were prescribed for non-indicatedclinical conditions like pulpitis and gingivitis. More than 50% of the sample prescribedantibiotics for non-scientific reasons like the “need to delay treatment†and“sterilization not guaranteedâ€.Conclusion: There is a need to improve awareness of Jordanian dentists regardingantibiotic prescribing to children particularly in the aspects of type of antibiotic tobe used for patients allergic and non-allergic to penicillin, duration of prescribing,and clinical indications. Dentists also should be discouraged to prescribe antibioticsbased on non-scientific/social factors

PIV study of the effect of piston position on the in-cylinder swirling flow during the scavenging process in large two-stroke marine diesel engines

A simplified model of a low speed large two-stroke marine diesel engine cylinder is developed. The effect of piston position on the in-cylinder swirling flow during the scavenging process is studied using the stereoscopic particle image velocimetry technique. The measurements are conducted at different cross-sectional planes along the cylinder length and at piston positions covering the air intake port by 0, 25, 50 and 75%. When the intake port is fully open, the tangential velocity profile is similar to a Burgers vortex, whereas the axial velocity has a wake-like profile. Due to internal wall friction, the swirl decays downstream, and the size of the vortex core increases. For increasing port closures, the tangential velocity profile changes from a Burgers vortex to a forced vortex, and the axial velocity changes correspondingly from a wake-like profile to a jet-like profile. For piston position with 75% intake port closure, the jet-like axial velocity profile at a cross-sectional plane close to the intake port changes back to a wake-like profile at the adjacent downstream cross-sectional plane. This is characteristic of a vortex breakdown. The non-dimensional velocity profiles show no significant variation with the variation in Reynolds numbe

Treated Olive Cake as a Non-forage Fiber Source for Growing Awassi Lambs: Effects on Nutrient Intake, Rumen and Urine pH, Performance, and Carcass Yield

The objective of this study was to investigate the effects of partial replacement of wheat hay with sun-dried (SOC) or acid-treated SOC (ASOC) olive cake on nutrient intake and performance of Awassi lambs. An additional objective was to study the effects of acid treatment of olive cake (OC) on its chemical composition and nutritive value. On DM basis, sun-drying of OC did not dramatically affect its chemical composition. On the other hand, treating SOC with phosphoric acid decreased (p<0.05) SOC contents of neutral detergent fiber. Twenty seven male lambs (17.6±0.75 kg body weight) individually housed in shaded pens were randomly assigned to one of three dietary treatments (9 lambs/treatment). Dietary treatments were formulated to be isocaloric and isonitrogenous by replacing 50% of wheat hay in the control diet (CTL) with SOC or ASOC and to meet all nutrient requirements. Dietary treatments had no effects on nutrient intake or digestibility except for ether extract. Lambs fed the SOC diet had (p = 0.05) faster growth rate, greater final body weight, and greater total body weight gain in comparison with the CTL diet, but not different from the ASOC diet. Additionally, lambs fed the SOC diet had greater (p = 0.03) hot and cold carcass weights than the ASOC diet, but not different from the CTL diet. However, feed conversion ratios and dressing percentages were similar among dietary treatments. In conclusion, replacing half of dietary wheat hay with SOC improved performance of Awassi lambs with no detrimental effects on nutrients intake or digestibility. No further improvements in the nutritive value of SOC and lambs performance were detected when SOC was treated with acid

Thermal injury in tonsils and its relation to postoperative pain—a histopathological and clinical study

Objectives: The aim of this study was to compare thermal injury and depth of necrosis of using different monopolar power settings in partial tonsillectomy and correlate the results with the postoperative pain score. Results: The study included a total of 15 patients with mean of age of 5.7 ± 2.57 years. The mean depth of injury was significantly higher for the 25 W side (0.973 ± 0.613) versus the 15 W side (0.553 ± 0.218) (p = 0.023). The postoperative pain score showed no significant differences between both sides. Conclusion: The histopathologic depth of thermal injury is significantly higher with the 25 W monopolar microdissection in comparison to the 15 W; however, it does not seem to correlate with the postoperative pain level. Apparently, power settings of 25 W can be safely used for pediatric intracapsular tonsillectomies, without added postoperative morbidity despite the deeper tissue injury observed in the tonsil.The authors are grateful to the Histology and Electron Microscopy Service (HEMS) team at the i3S (Institute for Research and Innovation in Health, University of Porto) for providing the necessary equipment and the technical support for the electron microscopic analysis

Application of smooth particle hydrodynamics method for modelling blood flow with thrombus formation

Thrombosis plays a crucial role in atherosclerosis or in haemostasis when a blood vessel is injured. This article focuses on using a meshless particle-based Lagrangian numerical technique, the smoothed particles hydrodynamic (SPH) method, to study the flow behaviour of blood and to explore the flow parameters that induce formation of a thrombus in a blood vessel. Due to its simplicity and effectiveness, the SPH method is employed here to simulate the process of thrombogenesis and to study the effect of various blood flow parameters. In the present SPH simulation, blood is modelled by two sets of particles that have the characteristics of plasma and of platelet, respectively. To simulate coagulation of platelets which leads to a thrombus, the so-called adhesion and aggregation mechanisms of the platelets during this process are modelled by an inter-particle force model. The transport of platelets in the flowing blood, platelet adhesion and aggregation processes are coupled with viscous blood flow for various low Reynolds number scenarios. The numerical results are compared with the experimental observations and a good agreement is found between the simulated and experimental results