Managing an Acute Pain Unit Based on the Balanced Scorecard

The Balanced Scorecard (BSC) is a continuous strategic monitoring model focused not only on financial issues but also on internal processes, patients/users, and learning and growth. Initially dedicated to business management, it currently serves organizations of other natures - such as hospitals. This paper presents a BSC designed for a Portuguese Acute Pain Unit (APU). This study is qualitative and based on the experience of collaborators at the APU. The management of APU is based on four perspectives – users, internal processes, learning and growth, and financial and legal. For each perspective, there were identified strategic objectives, critical factors, lead indicators and initiatives. The strategic map of the APU outlining sustained strategic relations among strategic objectives. This study contributes to the development of research in the health management area as it explores how organizational insufficiencies and inconsistencies in this particular case can be addressed, through the identification of critical factors, to clearly establish core outcomes and initiatives to set up.

Sustainable Ecosystem of Regional Development, Infrastructure and Tourism in Major Countries and Cities in Asia

In view of the global population is increasing; it is the prime concern of government and community to diversify the dense population to regional area and maintain a healthy and sustained economic growth. This paper is to outline the interaction of different attributes which critically affect regional development, infrastructure and tourism. This research not only focused on the relation and interaction of regional development and associated infrastructure but also provides a holistic study and review of the ecosystem of regional development, infrastructure and tourism development. In this study, we will review the three aspects development and their interaction in different cities in Asia. The finding will demonstrate how those factors affect the ecosystem and sustainability and provide some insight and material for further review and discussion.

Impact of Fiscal Policy on Economic Growth under the Contributions of Level of External Debt in Developing Countries

This study investigates the fiscal policy impact on countries’ economic growth in developing countries with a different external debt level. The fiscal policy effectiveness has been re-emphasized in the global financial crisis of 2008 with the external debt as its new contemporary driver. Different theories have proposed the economic consequence of fiscal policy, specifically for developing countries. However, fiscal policy literature is lacking research regarding the fiscal policy’s effectiveness with the external debt’s contributions through comprehensive study. Also, high levels of external debt will influence economic growth. Through foreign resources and channel of investment in which high level of debt decreases the amount of foreign investment in the developing countries. The finding of this study suggests that only countries with a low external debt level and appropriate fiscal policies and good quality institutions can gain the proper quantity and quality of foreign investors in which will help the economic growth. For this, this research is examining the impact of fiscal policy on developing countries' economic growth in the situation of different external debt levels.

Farming Production in Brazil: Innovation and Land-Sparing Effect

Innovation and technology can be determinant factors to ensure agricultural and sustainable growth, as well as productivity gains. Technical change has contributed considerably to supply agricultural expansion in Brazil. This agricultural growth could be achieved by incorporating more land or capital. If capital is the main source of agricultural growth, it is possible to increase production per unit of land. The objective of this paper is to estimate: 1) total factor productivity (TFP), which is measured in terms of the rate of output per unit of input; and 2) the land-saving effect (LSE) that is the amount of land required in the case that yield rate is constant over time. According to this study, from 1990 to 2019, it appears that 87% of Brazilian agriculture product growth comes from the gains of productivity; the remaining 13% comes from input growth. In the same period, the total LSE was roughly 400 Mha, which corresponds to 47% of the national territory. These effects reflect the greater efficiency of using productive factors, whose technical change has allowed an increase in the agricultural production based on productivity gains.

The Impact of ISO 9001 Certification on Brazilian Firms’ Performance: Insights from Multiple Case Studies

The evolution of quality management by companies was strongly enabled by, among others, ISO 9001 certification, which is considered a crucial requirement for several customers. Likewise, performance measurement provides useful insights for companies to identify the reflection of their decision-making process on their improvement. One of the most used performance measurement models is the balanced scorecard (BSC), which uses four perspectives to address a firm’s performance: financial, internal process, customer satisfaction, and learning and growth. Since ISO 9001 certified firms are likely to measure their performance through BSC approach, it is important to verify whether the certificate influences the firm performance or not. Therefore, this paper aims to verify the impact of ISO 9001:2015 on Brazilian firms’ performance based on the BSC perspective. Hence, nine certified companies located in the Southeast region of Brazil were studied through a multiple case study approach. Within this study, it was possible to identify the positive impact of ISO 9001 on firms’ overall performance, and four Critical Success Factors (CSFs) were identified as relevant on the linkage among ISO 9001 and firms’ performance: employee involvement, top management, process management, and customer focus. Due to the COVID-19 pandemic, the number of interviews was limited to the quality manager specialist, and the sample was limited since several companies were closed during the period of the study. This study presents an in-depth analysis of how the relationship between ISO 9001 certification and firms’ performance in a developing country is.

Strategic Investment in Infrastructure Development to Facilitate Economic Growth in the United States

The COVID-19 pandemic is unprecedented in terms of its global reach and economic impacts. Historically, investment in infrastructure development projects has been touted to boost the economic growth of a nation. The State and Local governments responsible for delivering infrastructure assets work under tight budgets. Therefore, it is important to understand which infrastructure projects have the highest potential of boosting economic growth in the post-pandemic era. This paper presents relationships between infrastructure projects and economic growth. Statistical relationships between investment in different types of infrastructure projects (transit, water and wastewater, highways, power, manufacturing etc.) and indicators of economic growth are presented using historic data between 2002 and 2020 from the U.S. Census Bureau and U.S. Bureau of Economic Analysis (BEA). The outcome of the paper is the comparison of statistical correlations between investment in different types of infrastructure projects and indicators of economic growth. The comparison of the statistical correlations is useful in ranking the types of infrastructure projects based on their ability to influence economic prosperity. Therefore, investment in the infrastructures with the higher rank will have a better chance of boosting the economic growth. Once, the ranks are derived, they can be used by the decision-makers in infrastructure investment related decision-making process.

Induced Affectivity and Impact on Creativity: Personal Growth and Perceived Adjustment when Narrating an Intense Emotional Experience

We examine the causal role of positive affect on creativity, the association of creativity or innovation in the ideation phase with functional emotional regulation, successful adjustment to stress and dispositional emotional creativity, as well as the predictive role of creativity for positive emotions and social adjustment. The study examines the effects of modification of positive affect on creativity. Participants write three poems, narrate an infatuation episode, answer a scale of personal growth after this episode and perform a creativity task, answer a flow scale after creativity task and fill a dispositional emotional creativity scale. High and low positive effect was induced by asking subjects to write three poems about high and low positive connotation stimuli. In a neutral condition, tasks were performed without previous affect induction. Subjects on the condition of high positive affect report more positive and less negative emotions, more personal growth (effect size r = .24) and their last poem was rated as more original by judges (effect size r = .33). Mediational analysis showed that positive emotions explain the influence of the manipulation on personal growth - positive affect correlates r = .33 to personal growth. The emotional creativity scale correlated to creativity scores of the creative task (r = .14), to the creativity of the narration of the infatuation episode (r = .21). Emotional creativity was also associated, during performing the creativity task, with flow (r = .27) and with affect balance (r = .26). The mediational analysis showed that emotional creativity predicts flow through positive affect. Results suggest that innovation in the phase of ideation is associated with a positive affect balance and satisfactory performance, as well as dispositional emotional creativity is adaptive.

Modeling Exponential Growth Activity Using Technology: A Research with Bachelor of Business Administration Students

Understanding the concept of function has been important in mathematics education for many years. In this study, the models built by a group of five business administration and accounting undergraduate students when carrying out a population growth activity are analyzed. The theoretical framework is the Models and Modeling Perspective. The results show how the students included tables, graphics, and algebraic representations in their models. Using technology was useful to interpret, describe, and predict the situation. The first model, the students built to describe the situation, was linear. After that, they modified and refined their ways of thinking; finally, they created exponential growth. Modeling the activity was useful to deep on mathematical concepts such as covariation, rate of change, and exponential function also to differentiate between linear and exponential growth.

The Experience of Middle Grade Teachers in a Culture of Collaboration

Collaboration is a powerful tool for professional development and central for creating opportunities for teachers to reflect on their practice. However, school districts continue to have difficulty both implementing and sustaining collaboration. The purpose of this research was to investigate the experience of the teacher in a creative, instructional collaboration. The teachers in this study found that teacher-initiated collaboration offered them trust and they were more open with their partners. An interpretative phenomenological analysis was used for this study as it told the story of the teacher’s experience. Interpretative Phenomenological Analysis was chosen for this study to capture the complex and contextual nature of the teacher experience from a creative, instructional collaborative experience. This study sought to answer the question of how teachers in a private, faith-based school experience collaboration. In particular, the researcher engaged the study’s participants in interviews where they shared their unique perspectives on their experiences in relation to this phenomenon. Through the use of interpretative phenomenological analysis, the researcher interpreted the experiences of each participant in an attempt to gain deeper insight into how teachers made sense of their understanding of collaboration. In addition to the researcher’s interpreting the meaning of this construct for each research participant, this study gave a voice to the individual experiences and positionality of each participant at the research site. Moreover, the key findings presented in this study shed light on how teachers within this particular context participated in and made sense of their experience of creating an instructional collaborative. The research presented the findings that speak to the meaning that each research participant experienced in their relation to participating in building a collaborative culture and its effect on professional and personal growth. The researcher provided recommendations for future practice and research possibilities. The research findings demonstrated the unique experiences of each participant as well as a connection to the literature within the field of teacher professional development. The results also supported the claim that teacher collaboration can facilitate school reform. Participating teachers felt less isolation and developed more teacher knowledge.

Maternal Health Outcome and Economic Growth in Sub-Saharan Africa: A Dynamic Panel Analysis

Maternal health outcome is one of the major population development challenges in Sub-Saharan Africa. The region has the highest maternal mortality ratio, despite the progressive economic growth in the region during the global economic crisis. It has been hypothesized that increase in economic growth will reduce the level of maternal mortality. The purpose of this study is to investigate the existence of the negative relationship between health outcome proxy by maternal mortality ratio and economic growth in Sub-Saharan Africa. The study used the Pooled Mean Group estimator of ARDL Autoregressive Distributed Lag (ARDL) and the Kao test for cointegration to examine the short-run and long-run relationship between maternal mortality and economic growth. The results of the cointegration test showed the existence of a long-run relationship between the variables considered for the study. The long-run result of the Pooled Mean group estimates confirmed the hypothesis of an inverse relationship between maternal health outcome proxy by maternal mortality ratio and economic growth proxy by Gross Domestic Product (GDP) per capita. Thus increasing economic growth by investing in the health care systems to reduce pregnancy and childbirth complications will help reduce maternal mortality in the sub-region.

Effect of Plant Nutrients on Anthocyanin Content and Yield Component of Black Glutinous Rice Plants

The cultivation of black glutinous rice rich in anthocyanins can provide great benefits to both farmers and consumers. Total anthocyanins content and yield component data of black glutinous rice cultivar (KHHK) grown with the addition of mineral elements (Ca, Mg, Cu, Cr, Fe and Se) under soilless conditions were studied. Ca application increased seed anthocyanins content by three-folds compared to controls. Cu application to rice plants obtained the highest number of grains panicle, panicle length and subsequently high panicle weight. Se application had the largest effect on leaf anthocyanins content, the number of tillers, number of panicles and 100-grain weight. These findings showed that the addition of mineral elements had a positive effect on increasing anthocyanins content in black rice plants and seeds as well as the heightened development of black glutinous rice plant growth.

Cutting Propagation Studies in Pennisetum divisum and Tamarix aucheriana as Native Plant Species of Kuwait

Native plants are better adapted to the local environment providing a more natural effect on landscape projects; their use will both conserve natural resources and produce sustainable greenery. Continuation of evaluation of additional native plants is essential to increase diversity of plant resources for greenery projects. Therefore, in this project an effort was made to study the mass multiplication of further native plants for greenery applications. Standardization of vegetative propagation methods is essential for conservation and sustainable utilization of native plants in restoration projects. Moreover, these simple propagation methods can be readily adapted by the local nursery sector in Kuwait. In the present study, various treatments were used to mass multiply selected plants using vegetative parts to secure maximum rooting and initial growth. Soft or semi-hardwood cuttings of selected native plants were collected from mother plants and subjected to different treatments. Pennisetum divisum can be vegetatively propagated by cuttings/off-shoots. However, Tamarix aucheriana showed maximum number of rooted cuttings and stronger vigor seedlings with the lowest growth hormone concentration. Standardizing the propagation techniques for the native plant species will add to the rehabilitation and landscape revegetation projects in Kuwait.

Microbial Assessment of Dairy Byproducts in Albania as a Basis for Consumer Safety

Dairy by-products are a fairly good environment for microorganisms due to their composition for their growth. Microbial populations have a significant impact in the production of cheese, butter, yogurt, etc. in terms of their organoleptic quality and at the same time some also cause their breakdown. In this paper, the microbiological contamination of soft cheese, butter and yogurt produced in the country (domestic) and imported is assessed, as an indicator of hygiene with impact on public health. The study was extended during September 2018-June 2019 and was divided into three periods, September-December, January-March, and April-June. During this study, a total of 120 samples were analyzed, of which 60 samples of cheese and butter locally produced, and 60 samples of imported soft cheese and butter productions. The microbial indicators analyzed are Staphylococcus aureus and E. coli. Analyzes have been conducted at the Food Safety Laboratory (FSIV) in Tirana in accordance with EU Regulation 2073/2005. Sampling was performed according to the specific international standards for these products (ISO 6887 and ISO 8261). Sampling and transport of samples were done under sterile conditions. Also, coding of samples was done to preserve the anonymity of subjects. After the analysis, the country's soft cheese products compared to imports were more contaminated with S. aureus and E. coli. Meanwhile, the imported butter samples that were analyzed, resulted within norms compared to domestic ones. Based on the results, it was concluded that the microbial quality of samples of cheese, butter and yogurt analyzed remains a real problem for hygiene in Albania. The study will also serve business operators in Albania to improve their work to ensure good hygiene on the basis of the HACCP plan and to provide a guarantee of consumer health.

Micropropagation and in vitro Conservation via Slow Growth Techniques of Prunus webbii (Spach) Vierh: An Endangered Plant Species in Albania

Wild almond is a woody species, which is difficult to propagate either generatively by seed or by vegetative methods (grafting or cuttings) and also considered as Endangered (EN) in Albania based on IUCN criteria. As a wild relative of cultivated fruit trees, this species represents a source of genetic variability and can be very important in breeding programs and cultivation. For this reason, it would be of interest to use an effective method of in vitro mid-term conservation, which involves strategies to slow plant growth through physicochemical alterations of in vitro growth conditions. Multiplication of wild almond was carried out using zygotic embryos, as primary explants, with the purpose to develop a successful propagation protocol. Results showed that zygotic embryos can proliferate through direct or indirect organogenesis. During subculture, stage was obtained a great number of new plantlets identical to mother plants derived from the zygotic embryos. All in vitro plantlets obtained from subcultures underwent in vitro conservation by minimal growth in low temperature (4ºC) and darkness. The efficiency of this technique was evaluated for 3, 6, and 10 months of conservation period. Maintenance in these conditions reduced micro cuttings growth. Survival and regeneration rates for each period were evaluated and resulted that the maximal time of conservation without subculture on 4ºC was 10 months, but survival and regeneration rates were significantly reduced, specifically 15.6% and 7.6%. An optimal period of conservation in these conditions can be considered the 5-6 months storage, which can lead to 60-50% of survival and regeneration rates. This protocol may be beneficial for mass propagation, mid-term conservation, and for genetic manipulation of wild almond.

Social Interaction Dynamics Exploration: The Case Study of El Sherouk City

In Egypt, there is continuous housing demand as a result of rapid population growth. In 1979, this forced the government to establish new urban communities in order to decrease stress around delta. New Urban Communities Authority (NUCA) was formulated to take the responsibly of this new policy. These communities suffer from social life deficiency due to their typology, which is separated island with barriers. New urban communities’ typology results from the influence of neoliberalism movement and modern city planning forms. The lack of social interaction in these communities at present should be enhanced in the future. On a global perspective, sustainable development calls for creating more sustainable communities which include social, economic and environmental aspects. From 1960, planners were highly focusing on the promotion of the social dimension in urban development plans. The research hypothesis states: “It is possible to promote social interaction in new urban communities through a set of socio-spatial recommended strategies that are tailored for Greater Cairo Region context”. In order to test this hypothesis, the case of El-Sherouk city is selected, which represents the typical NUCA development plans. Social interaction indicators were derived from literature and used to explore different social dynamics in the selected case. The tools used for exploring case study are online questionnaires, face to face questionnaires, interviews, and observations. These investigations were analyzed, conclusions and recommendations were set to improve social interaction.

The Keys to Innovation: Defining and Evaluating Attributes that Measure Innovation Capabilities

Innovation is a key driver for companies, society, and economic growth. However, assessing and measuring innovation for individuals as well as organizations remains difficult. Our i5-Score presented in this study will help to overcome this difficulty and facilitate measuring the innovation potential. The score is based on a framework we call the 5Gs of innovation which defines specific innovation attributes. Those are 1) the drive for long-term goals 2) the audacity to generate new ideas, 3) the openness to share ideas with others, 4) the ability to grow, and 5) the ability to maintain high levels of optimism. To validate the i5-Score, we conducted a study at Florida Polytechnic University. The results show that the i5-Score is a good measure reflecting the innovative mindset of an individual or a group. Thus, the score can be utilized for evaluating, refining and enhancing innovation capabilities.

Analytical Solution of the Boundary Value Problem of Delaminated Doubly-Curved Composite Shells

Delamination is one of the major failure modes in laminated composite structures. Delamination tips are mostly captured by spatial numerical models in order to predict crack growth. This paper presents some mechanical models of delaminated composite shells based on shallow shell theories. The mechanical fields are based on a third-order displacement field in terms of the through-thickness coordinate of the laminated shell. The undelaminated and delaminated parts are captured by separate models and the continuity and boundary conditions are also formulated in a general way providing a large size boundary value problem. The system of differential equations is solved by the state space method for an elliptic delaminated shell having simply supported edges. The comparison of the proposed and a numerical model indicates that the primary indicator of the model is the deflection, the secondary is the widthwise distribution of the energy release rate. The model is promising and suitable to determine accurately the J-integral distribution along the delamination front. Based on the proposed model it is also possible to develop finite elements which are able to replace the computationally expensive spatial models of delaminated structures.

Effect of Different Salts on Pseudomonas taetrolens’ Ability to Lactobionic Acid Production

Lactobionic acid is a disaccharide formed from gluconic acid and galactose, and produced by oxidation of lactose. Productivity of lactobionic acid by microbial synthesis can be affected by various factors, and one of them is a presence of potassium, magnesium and manganese ions. In order to extend lactobionic acid production efficiency, it is necessary to increase the yield of lactobionic acid by optimising the fermentation conditions and available substrates for Pseudomonas taetrolens growth. The object of the research was to determinate the application of K2HPO4, MnSO4, MgSO4 × 7H2O salts in different concentration for effective lactose oxidation to lactobionic acid by Pseudomonas taetrolens. Pseudomonas taetrolens NCIB 9396 (NCTC, England) and Pseudomonas taetrolens DSM 21104 (DSMZ, Germany) were used for the study. The acid whey was used as the study object. The content of lactose in whey samples was determined using MilcoScanTM Mars (Foss, Denmark) and high performance liquid chromatography (Shimadzu LC 20 Prominence, Japan). The content of lactobionic acid in whey samples was determined using the high performance liquid chromatography. The impact of studied salts differs, Mn2+ and Mg2+ ions enhanced fermentation instead of K+ ions. Results approved that Mn2+ and Mg2+ ions are necessary for Pseudomonas taetrolens growth. The study results will help to improve the effectiveness of lactobionic acid production with Pseudomonas taetrolens NCIB 9396 and DSM 21104.

Application of Thermoplastic Microbioreactor to the Single Cell Study of Budding Yeast to Decipher the Effect of 5-Hydroxymethylfurfural on Growth

Yeast cells are generally used as a model system of eukaryotes due to their complex genetic structure, rapid growth ability in optimum conditions, easy replication and well-defined genetic system properties. Thus, yeast cells increased the knowledge of the principal pathways in humans. During fermentation, carbohydrates (hexoses and pentoses) degrade into some toxic by-products such as 5-hydroxymethylfurfural (5-HMF or HMF) and furfural. HMF influences the ethanol yield, and ethanol productivity; it interferes with microbial growth and is considered as a potent inhibitor of bioethanol production. In this study, yeast single cell behavior under HMF application was monitored by using a continuous flow single phase microfluidic platform. Microfluidic device in operation is fabricated by hot embossing and thermo-compression techniques from cyclo-olefin polymer (COP). COP is biocompatible, transparent and rigid material and it is suitable for observing fluorescence of cells considering its low auto-fluorescence characteristic. The response of yeast cells was recorded through Red Fluorescent Protein (RFP) tagged Nop56 gene product, which is an essential evolutionary-conserved nucleolar protein, and also a member of the box C/D snoRNP complexes. With the application of HMF, yeast cell proliferation continued but HMF slowed down the cell growth, and after HMF treatment the cell proliferation stopped. By the addition of fresh nutrient medium, the yeast cells recovered after 6 hours of HMF exposure. Thus, HMF application suppresses normal functioning of cell cycle but it does not cause cells to die. The monitoring of Nop56 expression phases of the individual cells shed light on the protein and ribosome synthesis cycles along with their link to growth. Further computational study revealed that the mechanisms underlying the inhibitory or inductive effects of HMF on growth are enriched in functional categories of protein degradation, protein processing, DNA repair and multidrug resistance. The present microfluidic device can successfully be used for studying the effects of inhibitory agents on growth by single cell tracking, thus capturing cell to cell variations. By metabolic engineering techniques, engineered strains can be developed, and the metabolic network of the microorganism can thus be manipulated such that chemical overproduction of target metabolite is achieved along with the maximum growth/biomass yield.  

Effects of Ophiocordyceps dipterigena BCC 2073 β-Glucan as a Prebiotic on the in vitro Growth of Probiotic and Pathogenic Bacteria

The  β-glucan produced by Ophiocordyceps dipterigena BCC 2073 is a (1, 3)-β-D-glucan with highly branching O-6-linkedside chains that is resistant to acid hydrolysis (by hydrochloric acid and porcine pancreatic alpha-amylase). This β-glucan can be utilized as a prebiotic due to its advantageous structural and biological properties. The effects of using this β-glucan as the sole carbon source for the in vitro growth of two probiotic bacteria (L. acidophilus BCC 13938 and B. animalis ATCC 25527) were investigated. Compared with the effect of using 1% glucose or fructo-oligosaccharide (FOS) as the sole carbon source, using 1% β-glucan for this purpose showed that this prebiotic supported and stimulated the growth of both types of probiotic bacteria and induced them to produce the highest levels of metabolites during their growth. The highest levels of lactic and acetic acid, 10.04 g·L-1 and 2.82 g·L-1, respectively, were observed at 2 h of cultivation using glucose as the sole carbon source. Furthermore, the fermentation broth obtained using 1% β-glucan as the sole carbon source had greater antibacterial activity against selected pathogenic bacteria (B. subtilis TISTR 008, E. coli TISTR 780, and S. typhimurium TISTR 292) than did the broths prepared using glucose or FOS as the sole carbon source. The fermentation broth obtained by growing L. acidophilus BCC 13938 in the presence of β-glucan inhibited the growth of B. subtilis TISTR 008 by more than 70% and inhibited the growth of both S. typhimurium TISTR 292 and E. coli TISTR 780 by more than 90%. In conclusion, O. dipterigena BCC 2073 is a potential source of a β-glucan prebiotic that could be used for commercial production in the near future.