Leadership and Top Management Influence on Total Quality Management Implementation in the Ghanaian Construction Industry

This study aims to determine the key and underlying Leadership and Top Management (LTM) factors that have a significant impact on sustaining the implementation of Total Quality Management (TQM) within the construction industry in Ghana. The research methodology employed in this study was a quantitative technique. Questionnaires were distributed to 641 participants within construction industry in Ghana. Questionnaires retrieved for the analysis were 536. Three steps approached were used for the data analysis. These include Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and Structural Equation Modeling (SEM) analysis. After conducting the EFA and CFA, SEM was also used to analyze the construct validity. The SEM analysis helps to determine four key indicator variables for the leadership and top management construct. These include Leadership/Top Management approach to employees’ management, Leadership/Top Management understanding of TQM, Leadership/Top Management empowerment of employees to resolve quality issues, and Leadership/Top Management endorsement of TQM. All the four indicator variables were found to be good of fit and closely associated with the dependent variable. The study adds to the body of knowledge by using EFA, CFA and SEM techniques to establish key leadership and top management factors affecting TQM implementation in Ghana’s construction industry. The findings in general suggested that leadership and top Management factors identified have a direct positive impact on sustaining TQM implementation in the Ghanaian construction industry. Consequently, the leadership and top management factors identified in this study can help improve TQM in the Ghanaian construction industry.

A Blockchain-Based Life-Cycle Environmental Management Framework for Hospitals in the COVID-19 Context

During the coronavirus disease 2019 (COVID-19) emergency, many hospitals were built or renovated around the world to meet the challenges posed by the rising number of infected cases. Environmental management in the hospital life cycle is vital in preventing nosocomial infection and includes many infection control procedures. In certain urgent situations, a hospital must be completed quickly, and work process approval and supervision must therefore be accelerated. Thus, many works cannot be checked in detail. This results in a lack of work liability control and increases the difficulty of ensuring the fulfillment of key infection prevention measures. This study investigates how blockchain technology can transform the work quality inspection workflow to assist in nosocomial infection control under a fast delivery requirement. A blockchain-based life-cycle environmental management framework is proposed to track the fulfillment of crucial infection control measures in the design, construction, and operation stages of hospitals. The proposed framework allows for work quality checking after the work is completed, when some work cannot be checked on time. Illustrative use cases are selected to demonstrate the capabilities of the developed solution. This study provides new insights into applying blockchain technology to address the challenge of environmental management brought by rapid delivery requirements.

Optimizing pain management in elderly patients post-knee surgery:A novel collaborative strategy

Total knee replacement,a common surgery among the elderly primarily necessitated by osteoarthritis,replaces the damaged knee joint with an artificial one.Given the aging population and the increasing prevalence of such surgeries,the article highlights the critical need for effective postoperative care strategies.This editorial provides an overview of rehabilitation care for pain in elderly knee replacement patients,emphasizing the importance of a multimodal approach to postoperative recovery.Furthermore,the article advocates for a patient-centered,comprehensive rehabilitation regimen that enhances recovery and quality of life in elderly patients undergoing knee replacement surgery.

Management of lateral pelvic lymph nodes in rectal cancer:Is it time to reach an Agreement?

In this editorial,we proceed to comment on the article by Chua et al,addressing the management of metastatic lateral pelvic lymph nodes(mLLN)in stage II/III rectal cancer patients below the peritoneal reflection.The treatment of this nodal area sparks significant controversy due to the strategic differences followed by Eastern and Western physicians,albeit with a higher degree of convergence in recent years.The dissection of lateral pelvic lymph nodes without neoadjuvant therapy is a standard practice in Eastern countries.In contrast,in the West,preference leans towards opting for neoadjuvant therapy with chemoradiotherapy or radiotherapy,that would cover the treatment of this area without the need to add the dissection of these nodes to the total mesorectal excision.In the presence of high-risk nodal characteristics for mLLN related to radiological imaging and lack of response to neoadjuvant therapy,the risk of lateral local recurrence increases,suggesting the appropriate selection of strategies to reduce the risk of recurrence in each patient profile.Despite the heterogeneous and retrospective nature of studies addressing this area,an international consensus is necessary to approach this clinical scenario uniformly.

Study on life-cycle risk management of high earth-rock dam project

Based on advanced computer technology, internet of things （lOT） technology, project management con- cept and professional technology and combined with the innovative theories, methods and techniques in earlier hy- dropower projects, the life-cycle risk management system of high earth-rock dam project for Nuozhadu project was developed. The system mainly includes digital dam, three-dimensional design, construction quality monito- ring, safety assessment and warning, etc, to integrally manage and analyze the dam design, constructional quality and safety monitoring information. It realized the dynamic updates of the comprehensive information and the safe- ty quality monitoring in the project life cycle, and provided the basic platform for the scientific management of the construction and operation safety of high earth-rock dam. Application in Nuozhadu earth-rock dam showed that construction safety monitoring and warning greatly helped accelerate the construction progress and improve project quality, and provided a new way for the quality safety control of high earth-rock dam.

Perioperative blood management strategies for patients undergoing total knee replacement:Where do we stand now?

Total knee replacement(TKR) is one of the most common surgeries over the last decade. Patients undergoing TKR are at high risk for postoperative anemia and furthermore for allogeneic blood transfusions(ABT). Complications associated with ABT including chills, rigor, fever, dyspnea, light-headedness should be early recognized in order to lead to a better prognosis. Therefore, perioperative blood management program should be adopted with main aim to reduce the risk of blood transfusion while maximizing hemoglobin simultaneously. Many blood conservation strategies have been attempted including preoperative autologous blood donation, acute normovolemic haemodilution, autologous blood transfusion, intraoperative cell saver, drain clamping, pneumatic tourniquet application, and the use of tranexamic acid. For practical and clinical reasons we will try to classify these strategies in three main stages/pillars: Pre-operative optimization, intra-operative and post-operative protocols. The aim of this work is review the strategies currently in use and reports our experience regarding the perioperative blood management strategies in TKR.

Three-Dimensional Water Quality Model Based on FVCOM for Total Load Control Management in Guan River Estuary,Northern Jiangsu Province

Guan River Estuary and adjacent coastal area(GREC) suffer from serious pollution and eutrophicational problems over the recent years.Thus,reducing the land-based load through the national pollutant total load control program and developing hydrodynamic and water quality models that can simulate the complex circulation and water quality kinetics within the system,including longitudinal and lateral variations in nutrient and COD concentrations,is a matter of urgency.In this study,a three-dimensional,hydrodynamic,water quality model was developed in GREC,Northern Jiangsu Province.The complex three-dimensional hydrodynamics of GREC were modeled using the unstructured-grid,finite-volume,free-surface,primitive equation coastal ocean circulation model(FVCOM).The water quality model was adapted from the mesocosm nutrients dynamic model in the south Yellow Sea and considers eight compartments:dissolved inorganic nitrogen,soluble reactive phosphorus(SRP),phytoplankton,zooplankton,detritus,dissolved organic nitrogen(DON),dissolved organic phosphorus(DOP),and chemical oxygen demand.The hydrodynamic and water quality models were calibrated and confirmed for 2012 and 2013.A comparison of the model simulations with extensive dataset shows that the models accurately simulate the longitudinal distribution of the hydrodynamics and water quality.The model can be used for total load control management to improve water quality in this area.

Developing a matrix to explore the relationship between partnering and total quality management in construction

Recently, there has been an increasing awareness and implementation of practices associated with Partnering and Total Quality Management (TQM) in the construction industry. Partnering and TQM both seek to enhance construction outcomes, yet rigorous studies of Partnering and TQM have been conducted separately and have not carefully examined common or unique practices associated with these techniques. This paper presents the findings of a theoretical analysis of an integrated approach for the use of Partnering and TQM. A matrix approach has been used to explore the extent to which Partnering may improve TQM implementation in construction. The matrix is based around 3 indexes, namely; the Degree of Partnering, the Degree of TQM and the Project Success Index and enables the relationship between Partnering and TQM to be analysed quantitatively. It also assists in understanding the trends of Partnering and TQM and their relationship to project performance. The results of a case study using this matrix are also presented. It has been concluded that the integrated use of Partnering can facilitate improvements in the way TQM is implemented in construction.

A Study on the Feasibility of Total Quality Management Model and the Awareness and Attitude of the Managers of Health Care

Total Quality Management is not just an admirable phenomenon but it is any client’s right and can be done through contribution of the staff and the managers as well as the client’s of an organization. The purpose of the present study is to investigate the feasibility of TQM model and the attitude of the managers of health field of Yazd medical sciences university towards it. The present study was a descriptive and analytical one which was cross-section ally conducted from 2010 to 2011. The population under study consisted of the managers of the unit of staff vice-chancellor for health and treatment, the managers of health system and centers of cities and also the managers of Yazd’s public hospitals. 64 people were chosen using the formula for calculating the number of samples. A questionnaire with 48 questions was used. The questionnaire’s validity was approved by the faculty members whose major is management and its reliability by using α-cronbach 87%. To analyze the data, the software SPSS V.17 was used. Scoring method was based on likert. The findings of the study show that, considering feasibility of TQM, there is a significant relation between the awareness and attitude of the managers of health and treatment field on one side and the variables, age and University degree, on the other side p = 0.001. Considering binary logistic regression and the results obtained in the form of inter and backward stepwise, the most important factors affecting the feasibility of TQM among the managers of health and treatment field are the level of awareness and attitude with the predicted accuracy 79.3% and 87.9% respectively.

Total Quality Management in the Hospital Area and Its Contribution to Patient Safety

Objective： This study deals with the emergence of Total Quality Management and its start in the hospital area, as well as its connection to the patient safety issue, introducing the use of quality tools as the ＂cause and effect diagram＂, brainstorming, flowcharts for analysis of adverse events and a financial analysis of the impact that adverse events cause in an institution. Methods： We used a literature review through consultation with research sources as Scielo, Medline, Fiocruz - Proqualis, as well as access to books and websites on the subject. Conclusion： With the increasing need to provide hospital care quality, Total Quality Management in the hospital area has much to contribute to reach an even better service and safe, helping to mitigate the adverse events through use of tools such as ＂cause and effect diagram＂, brainstorming and flowcharts, where the occurrence of events involving patient safety resulted in large losses of hospital costs.

The 360-Degree Feedback Model as a Tool of Total Quality Management

The 360-degree feedback,also known as“multifaceted feedback”,is a management tool,according to which an employee receives feedback(comments)from peers,subordinates,supervisors and in some cases may include external feedback such as customers,suppliers or other interested parties.It is a process of systematic data collection from many sources regarding the skills,abilities and behavior of employees.In most cases the subject of the feedback is a senior executive.In contrast to the traditional approach,this method collects information from a set of individuals who form a“circle”around the feeder,hence the name of the tool.

The Impact of Total Quality Management on Health Services Improvement, Sana’a Hospitals, Yemen (2017-2020)

Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the nature of the relationship between the application of TQM and improving the quality of health services in Sana’a Governorate. Method: This applied research is a descriptive cross-sectional study in which the TQM of 13 affiliated Sana’a Governorate hospitals during “2017-2020”, were evaluated based on self-administered questionnaires. Data were collected by questionnaires including demographical variables, TQM dimensions variables. Data were analyzed by using SPSS version 16. Results: A total of 281 users 98.6% had responded. The employee’s responses for sixth study dimensions were the top manager’s commitment (TMC) 80.46%, customers focusing CF 81.55%, continuous improvement (CI) 82.32%, training (T) 71.51%, and strategic planning of the quality (SPQ) 74.76%, health services quality improvement (HSQI) 74.25%. There is a strong relationship between TQM and HSQI. There is no relationship between demographic factors gender, profession, years of experience, except age with TMC, T, HSQI, qualification with the TMC, CI, T, HSQI and job with all study variables. Conclusion: The application of TQM at hospitals in quality of health services improvement has several challenges, lacking staff experience and lacking leadership support, weakness of the training, customers focusing, continuous improvement, and strategic planning of the quality. Therefore, benefiting from the experiences of leading hospitals in implementing total quality management programs by sending some cadres to these hospitals for training and gaining experience or by hosting experienced cadres to conduct training courses is recommended.

A Study of the Relationships Among Total Quality Management, Executive Ability, and Sustainable Competitive Advantage

It is very important for organization to deal with and balance the challenge of environmental complexity and inner resources scarcity. This study considers total quality management (TQM) as a factor linking internal and external of organization and executive ability as linkage to promote and coordinate internal-external elements and then organization obtains its sustainable competitive advantage. The research surveyed effective samples 252 and used Structural Equation Model (SEM) and discriminated analysis for analysis and testing. The results indicate that TQM positively affects executive ability and firm sustainable competitive advantage. Executive ability affects firm sustainable competitive advantage and has the mediating effect between TQM and firm sustainable competitive advantage. Managerial practice implications, limitations, and future research directions have been discussed.

Total colectomy in a colon cancer patient with patent foramen ovale:a case of surgical and anesthetic challenges

A patent foramen ovale(PFO)is a clinical condition linked to ischemic stroke,aura migraine,and other pathologies.Current medical consensus posits that PFO closure may mitigate the risk of recurrent strokes.This case report details the management of a 61-year-old female diagnosed with colon cancer for one month.Preoperative transthoracic echocardiography indicated a potential left-to-right shunt through the foramen ovale and mild regurgitation of both the mitral and aortic valves.The patient’s history revealed previous left-sided migraines,and a review of her medical records disclosed multifocal cerebral infarctions identified by a head CT.A pulmonary artery computed tomography angiography suggested embolization in the anterior branch of the right upper pulmonary artery and several branches of the right lower lung’s posterior and lateral basilar artery,along with thickening of the trunk canals of the pulmonary arteries.After a thorough assessment and extensive consultation with the surgical team,the procedure was transitioned from a laparoscopic radical resection to an open total colectomy.Anesthesia induction required careful avoidance of hypoxia,breath-holding,and coughing.Vigilant management of respiratory and circulatory functions was crucial during periods prone to intraoperative embolism formation.Postoperatively,attention was given to the stabilization of respiratory and circulatory functions during extubation,ensuring adequate sputum suction to prevent choking and close monitoring of breathing to avert airway obstruction post-extubation.Additionally,the patient was closely monitored for postoperative nausea and vomiting,a high-risk condition for this patient cohort.Strategies were implemented to minimize the risk of right-to-left shunting,ensuring the patient’s vital signs remained stable throughout the perioperative period.The patient was discharged safely after a 10-day recovery.For patients with cancer and PFO,comprehensive risk assessment and meticulous safety management are paramount.This case confirms the patient’s history of patent foramen ovale through the association between some atypical symptoms such as migraine,pulmonary embolism and cerebral infarction,which provides guidance for the management of anesthesia in the perioperative period,offering significant clinical implications.

Total Quality Management at Algerian Higher Education Institutions to Promote Our Roles in Comprehensive Development

The aims this study to know the reality of the role for Total Quality Management(TQM)to need of Algerian Higher Education Institutions(AHEI)in apply the Total Quality Management(TQM)to promote the Comprehensive Development(CD),and this approach to enhance their roles in the comprehensive development,the efficiency of the training process,global changes and their needs to adopt a new educational policy in line with the global transformation competition,and the requirements of sustainable development,in this study was used a questionnaire composed of(75)items distributed on(08)areas,This is for confirmation the need to adopt philosophy of Total Quality Management(TQM)as a strategy imposed by the nature and the stage experienced for Algerian Higher Education Institutions(AHEI),And deal with the nature of the changes and challenges imposed by certain factors such as Globalization and the knowledge revolution,through all this inevitably to apply the Total Quality Management(TQM)in our Algerian Higher Education Institutions(AHEI).

Study on the Teaching Total Quality Management of Management Postgraduate

With the rapid development of postgraduate education in management in China, the traditional teaching quality management mode can not meet the diversity demands to the high-level management talents in nowadays society. In this paper, the total quality management is introduced into the quality management of postgraduate education in colleges and universities, capacity requirements of management postgraduate is investigated from two perspectives of enterprises and students, the whole operating model is explored as well.

Soil Carbon Pool Management Index under Different Straw Retention Regimes

[Objective] To clarify the effects of different straw retention regimes on soil fertility in double cropping paddy field. [Method] The effects of different straw reten- tion regimes on total organic carbon （CToc）, active carbon （CA） and mineralized carbon （CM） were analyzed, and carbon pool active （A）, carbon pool active index （A/）, carbon pool index （CPI） and carbon pool management index （CPMi） for each treat- ment were calculated. [Result] Compared with the unfertilized treatment （CK）, CToc, CA, CM and the available ratio of soil carbon were increased in the treatment of re- turning early season and late season rice straws to field. With the same nutrient application, CToc, CA and the available ratio of soil carbon in the field with straw re- turned to field were higher than that of straw incineration and no straw returning, and the change in soil CA content was more significant. The difference in CPMI be- tween different treatments reached significant or very significant level, and the value was in the order of straw directly returned to field 〉 straw returned to field after in- cineration 〉 no straw returned to field. [Conclusion] This study provided theoretical bases for the increase of soil CA content and soil fertility in double rice fields.

Management of proximal humerus fractures in adults

The majority of proximal humerus fractures are lowenergy osteoporotic injuries in the elderly and their incidence is increasing in the light of an ageing population. The diversity of fracture patterns encountered renders objective classification of prognostic value challenging. Non-operative management has been associated with good functional outcomes in stable, minimally displaced and certain types of displaced fractures.Absolute indications for surgery are infrequent and comprise compound, pathological, multi-fragmentary head-splitting fractures and fracture dislocations, as well as those associated with neurovascular injury. A constantly expanding range of reconstructive and replacement options however has been extending the indications for surgical management of complex proximal humerus fractures. As a result, management decisions are becoming increasingly complicated, in an attempt to provide the best possible treatment for each indi-vidual patient, that will successfully address their specific fracture configuration, comorbidities and functional expectations. Our aim was to review the management options available for the full range of proximal humerus fractures in adults, along with their specific advantages, disadvantages and outcomes.