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Strategies for improving the sustainability of SMEs in the construction industry in Malawi
Get PDFThe Structural Adjustment Programme (SAPs) during the period 1980 to 2000
encouraged Governments to privatise non-strategic commercial activities, leading to the
emergence of Small and Medium Enterprise (SME) sector, taking 95% of all trading
entities and employing up to 40% of workforce in Sub-Saharan Africa.
However, majority of SMEs in Africa fail within five years of starting and few last beyond
15 years and have no capacity to compete with International SMEs particularly in the
construction industry. This research was to identify the leading factor in causing failure
of SMEs in construction Industry in Africa; case of Malawi and develop a strategic legal
framework to enhance sustainability of local SMEs. Literature reviewed confirmed a
high frequency of failure and revealed twelve factors which cause negative impact on
sustainability of SMEs generally. The National Construction Industry Council (NCIC)
registers and regulates SMEs in the construction Industry and from their records there
were 5,000 SMEs in 2015.
Mixed methods was adopted collecting qualitative and quantitative data in three stages.
A survey by questionnaire administered to a random representative sample of 800No,
and data analysed with Statistical Package for the Social Sciences (SPSS) established
payment paralysis the leading factor in failure. 20SME failure cases were reached and
responded to a questionnaire and interviews revealing the events and circumstances
leading to payment paralysis. They posited that major drivers of payment paralysis are
Corruption, Weak Contract laws, PEs skewing risks in their favour, poor bid evaluation
and high bank interests. Interviews were then conducted with 5policy/opinion leaders
who confirmed the major drivers of payment paralysis stated by the 20failed SMEs and
gave their suggestions on contract and legal steps required to support the SMEs which
were adopted in the design of the legal framework. The research findings were shared
widely in awareness presentations in Malawi, Kenya and Zambia to Government,
Academia, Legal Societies, SMEs MABCATA, MIE, IEK. . In 2015 Civil Engineering
Contractors Association, (RACECA) appointed a team of lawyers and the author to seek
solutions. In 2018 the author published these findings in the Kenya Engineer Journal.
The concerted efforts of stakeholders resulted in 5No. Bills tabled in Kenya Parliament
between May 2019 and October 2020 and happily, Bill No.5 was the Prompt Payment
Bill sponsored by the Government. To date two of the five drivers were targeted
SVBE: searchable and verifiable blockchain-based electronic medical records system.
Get PDFCentral management of electronic medical systems faces a major challenge because it requires trust in a single entity that
cannot effectively protect files from unauthorized access or attacks. This challenge makes it difficult to provide some services
in central electronic medical systems, such as file search and verification, although they are needed. This gap motivated us to
develop a system based on blockchain that has several characteristics: decentralization, security, anonymity, immutability, and
tamper-proof. The proposed system provides several services: storage, verification, and search. The system consists of a
smart contract that connects to a decentralized user application through which users can transact with the system. In addition,
the system uses an interplanetary file system (IPFS) and cloud computing to store patients’ data and files. Experimental results
and system security analysis show that the system performs search and verification tasks securely and quickly through the
network
Evaluation of neuro image for the diagnosis of Alzheimer's Disease using deep learning neural network
Get PDFAlzheimer’s Disease (AD) is a progressive, neurodegenerative brain disease and is an
incurable ailment. No drug exists for AD, but its progression can be delayed if the
disorder is identified at its initial stage. Therefore, an early analysis of AD is of fundamental
importance for patient care and efficient treatment. Neuroimaging techniques aim to
assist the physician in the diagnosis of brain disorders by using images. Positron emission
tomography (PET) is a kind of neuroimaging technique employed to create 3D images of
the brain. Due to many PET images, researchers attempted to develop computer-aided
diagnosis (CAD) to differentiate normal control from AD. Most of the earlier methods
used image processing techniques for preprocessing and attributes extraction and then
developed a model or classifier to classify the brain images. As a result, the retrieved
features had a significant impact on the recognition rate of previous techniques. A novel
and enhanced CAD system based on a convolutional neural network (CNN) is formulated
to address this issue, capable of discriminating normal control from Alzheimer’s disease
patients. The proposed approach is evaluated using the 18FDG-PET images of 855
patients, including 635 normal control and 220 Alzheimer’s disease patients from the
ADNI database. The result showed that the proposed CAD system yields an accuracy
of 96%, a sensitivity of 96%, and a specificity of 94%, leading to splendid performance
when related to the methods already in use that are specified in the literature
Critical Commentary. The development of integrated clinical pathways and plurality training: Personal contributions to forensic mental health nursing from an autoethnographic perspective.
Get PDFThe research area of this study examines the impact of the author’s contribution
to the development of Forensic Mental Health Nursing (FMHN) over a 40-year
career. This retrospective analysis hopes to capture the impact of the author upon
the role development of a distinct FMHN role, including a range of skills,
knowledge and areas of practice undertaken by such nurses. However, the word
count limitations of this study and specific advice from the University of Bolton
have necessitated an approach that focuses upon only two case studies to be
illustrative of the contribution to this specialist role. These case studies include the
implementation of an integrated clinical pathway (ICP) into mental health, and the
development of a programme of multi-professional plurality training in the very
specialist forensic field to support its operation. Historically there has been a gap
in knowledge and function of forensic teams. The development and use of ICPs
in mental health care is rare, and the associated need for a shared understanding of
the approach by multi-professional teams is essential for success in the nursing care
and treatment of mentally disordered offenders. Additional contributions made by
the author to Forensic Mental Health Nursing are detailed in the accompanying
Portfolio of Evidence.
The aim was specifically to investigate how the contribution of the author
positively impacted upon the implementation, operation and success of the model
used, with particular attention to the development of the role of FMHNs. The
methods used to investigate and evidence this, were the use of an evocative
autoethnographic study in the form of a Critical Commentary. This used reflection
from a 40-year career to review and evaluate the success of efforts to enhance the
role and skill set of FMHNs and integrate them fully into multi-professional teams.
The paper contains a selective review of the general FMHN literature, followed by
more specific literature, to support the evidence provided in the two illustrative case
studies. These are presented as chapters and include a retrospective evaluation of
Forensic Plurality Training (a multi-professional training and development
programme for new and existing staff in the forensic field), and the use of an
Integrated Clinical Pathway model in forensic mental health to co-ordinate and
enhance teamwork and patient recovery. This is supported by a Portfolio of
Evidence, which contains additional work by the author. This includes research to
measure and reduce clinical violence. The implementation of nurse independent
prescribing. Initiatives to improve the clinical environment of forensic hospitals and
other material, such as professional testimonies from colleagues and significant
leaders in the field.
The key findings were the increased impact of FMHNs within the speciality and
the teams that they were part of. The FMHN role has been transformed from that of
‘passive custodians and deliverers of others’ instructions’, into modern and fully
integrated clinical professionals with a unique identity and function. The exemplar
case studies are demonstrative of the impact such initiatives play in the
enhancement of the nursing contribution to the wider team, thus reflecting ways to
promote and facilitate this. The significance of these findings is that since the
closure of the large Victorian era asylums, FMHNs have risen to the challenge of
de-institutionalisation, and adapted their role into more diverse modes of care
delivery. As a result, they have extended and expanded their skills and operational
functioning into new and exciting areas of multi-professional practice and have
become a key feature of contemporary forensic practice
What is a psychology degree
Get PDFThis chapter aims to:
• Assist students with understanding psychology as a science and inform them about the British Psychological Society, which is the representative body for students, graduates and chartered members.
• Prepare students for the type of content they should expect to receive across their degree course and
how this links in with the core requirements of the British Psychological Society.
• Encourage thought and reflection around the study skills required at each level of study and the gradual shift to autonomous learning as students progress through their psychology degre
Nurse staffing levels within acute care: results of a national day of care survey
Get PDFIntroduction: The relationship between nurse staffing levels and patient safety is well recognised. Inadequate provision of nursing staff is associated with increased medical error, as well as higher morbidity and mortality. Defining
what constitutes safe nurse staffing levels is complex. A range of guidance and planning tools are available to inform
staffing decisions. The Society for Acute Medicine (SAM) recommend a ‘nurse-to-bed‘ ratio of greater than 1:6. Whether this standard accurately reflects the pattern and intensity of work on the Acute Medical Unit (AMU) is unclear.
Methods: Nurse staffing levels in AMUs were explored using the Society for Acute Medicine Benchmarking Audit
2019 (SAMBA19). Data from 122 acute hospitals were analysed. Nurse-to-bed ratios were calculated and compared.
Estimates of the total nursing time available within the acute care system were compared to estimates of the time
required to perform nursing activities.
Results: The total number of AMU beds across all 122units was 4997. The mean daytime nurse-to-bed ratio was 1:4.3
and the mean night time nurse-to-bed ratio was 1:5.2. The SAM standard of a nurse to bed ratio of greater than 1:6
was achieved in 99units (81.9%) during daytime hours and achieved by 74units (60.6%) at night.
The estimated time required to deliver direct clinical care was 35,698h. A deficit of 4128h (11.5% of time required) was
estimated, representing the time difference between the total number of nursing hours available with current staffing
and the estimated time needed for direct clinical care across all participating units.
Conclusion: This UK-wide study suggests a significant proportion of AMUs do not meet the recommenced SAM
staffing levels, particularly at night. A difference was observed between the total number of nursing hours within
the acute care system and the estimated time required to perform direct nursing activities. This suggests a workforce
shortage of nurses within acute care at the system level
Using medical education as a tool to train doctors as social innovators
Get PDFCurrent medical education prepares doctors to diagnose, assess and treat individual patients yet lacks the expectation to be responsible for the care of the wider community. Learning the skills to recognise and redress the social determinants of health are increasingly being recognised as an essential part of medical education.
Objectives: The goal of this research was (1) to investigate how medical education can be leveraged to reduce health inequalities through the role and practice of doctors and (2) to elucidate how key innovations in medical education are a necessity that can support doctors as ‘change agents.’ Methods: Two international multidisciplinary roundtable focus groups with 23 healthcare leaders from various backgrounds were facilitated. The discussions were audio recorded, transcribed and then thematically analysed with the qualitative analysis software QDA Miner.
Results: Eight themes emerged: (1) Social innovation training in medical education; (2) Linking community working with social innovation; (3) Future curricula development; (4) Settings, context, environment and leaving the classroom; (5) Developing links with third sector organisations and community, including low-income and middle-income countries; (6) Including learners’ perspectives and lived experience; (7) Medical roles are political and need political support and (8) The need to address power imbalances and impact of discrimination.
Conclusions: Medical education needs to fundamentally widen its focus from the individual doctor–patient relationship to the doctor–community relationship. Doctors’ training needs to help them become social innovators who can balance interventions with prevention, promote good health on a community and societal scale and tailor their treatments to the individuals’ contexts
Developing an online practicum in professional education: a case study from UK teacher education
No full textA ‘practicum’, ‘clinical experience’ or ‘internship’ is an established component of professional preparation in education, health, social work, law, accountancy and engineering. Across diverse occupational fields, employability and work readiness are gaining prominence in college marketing strategies. The disruption to work placements during the Covid-19 pandemic in programmes linked to licensure rapidly increased the pace and scale of virtualisation and the need for systematic evaluation of curriculum re-design. This chapter presents a case study of the transition to a fully online practicum for UK university students training to be teachers during 2020/21. Drawing on interviews with students, university tutors and school partners, the chapter outlines key learning about partnership formation and innovation. The evaluation suggests that online supervision requires participants to work harder to establish a positive working alliance and sense of belonging across time–space-digital media. The study highlights the importance of iterative review to promote reciprocity, transparency and voice
A high secured Steganalysis using QVDHC model
No full textData compression plays a vital role in data security as it saves memory, transfer speed is high, easy to handle and
secure. Mainly the compression techniques are categorized into two types. They are lossless, lossy data compression. The data
format will be an audio, image, text or video. The main objective is to save memory of using these techniques is to save memory
and to preserve data confidentiality, integrity. In this paper, a hybrid approach was proposed which combines Quotient Value
Difference (QVD) with Huffman coding. These two methods are more efficient, simple to implement and provides better security
to the data. The secret message is encoded using Huffman coding, while the cover image is compressed using QVD. Then the
encoded data is embedded into cover image and transferred over the network to receiver. At the receiver end, the data is
decompressed to obtain original message. The proposed method shows high level performance when compared to other existing
methods with better quality and minimum erro