Globalising employee engagement: myths and reality; a Middle East perspective.

The purpose of this research was to investigate if selected cultural and national aspects had an effect on employee engagement drivers. Another aim was to find out if applying global engagement tools in different cultures would provide an accurate engagement report. Finally, a new tool was proposed and examined in this study by companies operating in the Middle and Near East regions. Employee engagement has been of growing concern to business leaders as well as occupational psychologists, since it was claimed to relate to organisational productivity and long term success. Despite this growing concern and various consultancy solutions provided, few academic researches tackled cross cultural employee engagement aspects. In this research, both qualitative and quantitative research methodologies were used. The qualitative research data consisted of two in-depth interviews with employees working in the Middle and Near East regions. The quantitative research data was gathered with the aid of two questionnaires. One hundred and eighty nine responses were received out of two hundred and seventeen questionnaires sent. The response rate was eighty seven per cent. This research produced a number of key findings: (a) Cultural, national and organisational factors affect engagement drivers. (b) Engagement drivers change over time, at least in priority. (c) Measuring engagement through a globally designed fixed tool is not likely to produce accurate results that management can use to plan for actions. The main conclusion drawn from this research was that current approaches to measuring employee engagement are taking engagement drivers as common for granted, and this concept should be revised. The author recommends that leaders should investigate and run an analysis of engagement drivers before any engagement survey is undertaken. A new tool has been presented by the research and was tested by a number of organisations. This tool takes into account building engagement questionnaires based on key drivers analysed from specific work cultures

MR exponential image in ischemic stroke: A preliminary evaluation

AbstractBackground and purposeMagnetic resonance (MR) diffusion images, including both the diffusion-weighted image (DWI) and the apparent diffusion coefficient (ADC), allow detection of cerebral ischemic lesions within minutes of onset, and the contrast within the image is based on microscopic motion of the water. A third type of diffusion image can be created, “the exponential image”. Our goals were to evaluate the ability of exponential image in reflecting the changes in both DWI and ADC and whether it can replace these two sets of images in cerebral infarction patients.Patients and methodsA total of 51 patients were enrolled in the study, 47 were included in the analysis, and four were excluded from the study. Conventional and DW MRI were performed in 47 patients. For each patient DWI, ADC maps, and exponential images were reviewed and the change in signal intensity of the lesion compared with the contralateral normal side was measured (rSI) as well as the changes in (rADC).ResultsThere was a significant change in the rSIDW and rSIExp in late subacute and chronic stages (p<.001), however, rADC showed a significant decrease (p<.001) in hyperacute and acute stages, followed by a significant increase (p<.001) in the late subacute and chronic stages. rSIExp was highly correlated with the change in the rADC values in different stages of infarction (r=.72, p<.001). However, the changes in the rSIDW correlated less closely with the change in the rADC values (r=.35, (p<.05)).ConclusionExponential image offers a simple, more accurate replacement for both sets (DWI and ADC), by combining the advantages of both sets

Anatomic variations of intrahepatic bile ducts in the general adult Egyptian population: 3.0-T MR cholangiography and clinical importance

AbstractObjectiveTo describe the anatomical variations occurring in intrahepatic bile ducts (IHDs) and their frequencies in general adult Egyptian population using 3.0-T MR cholangiography (MRC) as well as its clinical importance to reduce the biliary complications of hepatobiliary surgery.Materials and methodsMRC was applied to a study group of 106 subjects (26 potential liver donors and 80 volunteers). Anatomical variations in IHDs were classified based on the variable insertion of right posterior hepatic bile duct (RPHD) using Huang classification.ResultsAccording to this classification, the frequencies of each type were as follows: Huang A1 (typical pattern): 63.2% (n=67), Huang A2: 10.4% (n=11), Huang A3: 17% (n=18), Huang A4, 7.5% (n=8), and Huang A5: 1.9% (n=2). Total frequency for atypical types (i.e. A2, A3, A4 and A5) was 36.8%. No significant difference was detected in the distance between RPHD insertion to the junction of right and left hepatic duct in-between these Huang types. This distance was short (<1cm) in 21 of subjects under Huang A classification. Twenty-one donors underwent intraoperative cholangiograms, of which twenty (95.2%) had similar classification in both intraoperative and MRC findings.ConclusionThe incidence of variant biliary anatomy in general Egyptian population (36.8%) as well as the presence of Huang type A with short distance (<1cm) between RPHD insertion and junction of right and left hepatic duct (19.8%) enhance the importance of MRC as a pre-operative tool before hepato-biliary surgical procedures to reduce post-operative biliary complications

Diffusion-weighted MRI in liver fibrosis staging: Added value of normalized ADC using spleen and renal cortex as reference organs

AbstractAimTo evaluate the potential value of the spleen and renal cortex as a reference organ to improve the performance of DWI in the assessment of liver fibrosis.Material and methods44 subjects were included: 30 patients with chronic viral hepatitis and 14 age matched volunteers. They were subjected to diffusion weighted MRI (DWI). Liver ADC, normalized ADC (ratio between ADC of liver to spleen (S-ADC) and renal cortex (R-ADC)) was calculated. Data was analyzed and ROC was used to evaluate the performance of ADC, S-ADC and R-ADC.ResultsNo significant difference between spleen ADC and renal ADC values between patient group and control group or in-betweens different fibrosis stages. The mean liver ADC was significantly lower in cirrhotic patients than control group (1.59±0.024 versus 1.55±0.036×10−3mm2/s, P=0.009) with some overlap in different fibrosis grades.With exception to stage 1 fibrosis, the mean S-ADC value was significantly lower in patients with different hepatic fibrosis stages in comparison to control group (P 0.02–<0.001). Significant negative correlation was noted between S-ADC value and fibrosis stage (r=−0.75, p<0.001). It had significant difference between stage 0 compared to stage 2, 3, and 4 as well as between stage 4 in comparison to stage 1, 2 and 3. S-ADC had a significant ability to differentiate between stages 0–1 Vs stage 2–4, stage 0–2 Vs stage 3–4 as well as stage 0–3 Vs stage 4.Significant negative correlation was noted between R-ADC value and fibrosis stage (r=−0.68, p<0.001). The mean R-ADC value was lower in patients with liver fibrosis compared to volunteers with significant difference between stage 0 and 3 and between stage 0 and 4 (P<0.001). It had significant difference between stage 0 compared to stage 3, and 4 as well as in stage 4 in comparison to stage 1 and 2. R-ADC has a significant ability to differentiate between stages 0–1 Vs stage 2–4, stage 0–2 Vs stage 3–4 as well as stage 0–3 Vs stage 4.ROC analysis showed higher performance using S-ADC in comparison to liver ADC and R-ADC while R-ADC had higher performance in comparison to liver ADC. The AUC, sensitivity, specificity, PPV, NPV and k-value for detection of fibrotic stages ⩾2 (0.85, 95.8%, 60%, 74%, 92% and 0.85 for S-ADC Vs 0.68, 66.7%, 60%, 66%, 60% and 0.28 for ADC and 0.85, 95.8%, 50%, 69%, 91% and 0.47 for R-ADC). and in detection of fibrotic stages ⩾3 was (0.86, 100%, 52%, 61%, 100% and 0.48 for S-ADC Vs 0.63, 63%, 52%, 50%, 65% and 0.14 for ADC and 0.88, 100%, 44%, 57%, 100% and 0.40 for R-ADC) while for fibrosis stage 4, the corresponding values was (1, 100%, 100%, 100%, 100% and 1 for S-ADC Vs 0.7, 81%, 54%, 37%, 90% and 0.26 for ADC and 0.65, 100%, 65%, 45%, 100% and 0.43 for R-ADC) respectively.ConclusionNormalized liver ADC using the spleen and kidney increases the performance of ADC in the evaluation of liver fibrosis which is highest in spleen normalized ADC

Determinants and Motivational Factors of Healthcare Staff: A Comparison between Governmental and Non-Governmental Hospitals in the South of West Bank / Palestine

Background: Palestine is a low-income country with very limited resources. Human resources are the most valuable resource for the country. Human resource management determines how to use other resources in order to achieve organizational goals. Aim: To identify and compare the motivational factors of healthcare workers and its determinants in the Palestinian hospitals in the South of West Bank. Methods: A quantitative cross sectional study design was used. Data collection was through self-administered questionnaire. A total of 297 healthcare workers participated in this crosssectional survey from four major hospitals in Bethlehem and Hebron. The study was conducted between June and October, 2015. Data collection tool included 18 motivational factors that were found in the literature. Other demographic characteristics were also collected. Descriptive and inferential statistics were used for data analysis by using SPSS version 16. Findings: Working according to ethics, helping people, recognition, reward and appreciation, ensuring job security, continuous education and opportunities for growth were major motivational factors for choosing work place (P<0.01). On the other hand, ensuring jobsecurity, full/part-time positions, sharing creativity and leadership, continuous education, working and living conditions and opportunities for advancement were major motivational factors to do work properly (P<0.01). Regarding place of work, healthcare workers in nongovernmental hospitals have experienced significantly higher motivational factors for choosing work place than those in governmental hospitals (P<0.05). Moreover, duration of work was an important motivational factor for choosing work place (P<0.05). Conclusion: Improving healthcare workers’ motivation is a vital process towards having better quality of health services. It requires support from managers and enhancing good management practices. The findings of this study suggests that further efforts should be extended in some aspects such as job security, continuous education, recognition, reward and appreciation, working and living conditions and opportunities for growth. Keywords: Motivational factors, healthcare workers, Palestine

Triple-Pulse Integrated Path Differential Absorption Lidar for Carbon Dioxide Measurement - Novel Lidar Technologies and Techniques with Path to Space

The societal benefits of understanding climate change through identification of global carbon dioxide sources and sinks led to the desired NASA's active sensing of carbon dioxide emissions over nights, days, and seasons (ASCENDS) space-based missions of global carbon dioxide measurements. For more than 15 years, NASA Langley Research Center (LaRC) have developed several carbon dioxide active remote sensors using the differential absorption lidar (DIAL) technique operating at the two-micron wavelength. Currently, an airborne two-micron triple-pulse integrated path differential absorption (IPDA) lidar is under development. This IPDA lidar measures carbon dioxide as well as water vapor, the dominant interfering molecule on carbon dioxide remote sensing. Advancement of this triple-pulse IPDA lidar development is presented