The state-sangha relations in the countries of Theravada Buddhism has often been described as a mutually dependent patron-client relation in which the state and the sangha support each other by performing their due roles. Yet this theory involves a normative dimension that prescribes such a relation as the ideal in the Buddhist world. The explanatory power of this theory hence is hampered in a country where the ideal is not fully realized. In the wake of tumultuous political upheaval where political rivals vie for the state the ideal as well as the theory are put into a trial. The tragic history of modern Cambodia is a history of ceaseless conflict in which multiple contenders for the state had to define their relations with the sangha. The relations defined turned out less mutual than supposed. The state-sangha relations were rather unilaterally dependent. More often than not the sangha was subject to state control with no power to confront the state or coopted only to become a tool for political propaganda and manipulation. The sangha always played the role of client, waiting for the state to define the relation and to be benevolent. Even when the monks were forced to disrobe and when the sangha itself was annihilated, all they did was to wait for another patron state that would put the sangha back in place. The state-sangha relations the Cambodian history reveals were not close to one in which the two parties benefit each other on an equal basis. It was a patron-client relationship in which the client sangha had to be heavily dependent on the patron state. Such a unilaterally dependent relationship is the one that has prevailed in Cambodia.
Purpose: In-hospital cardiac arrest is rare, but often results in high mortality rates. Early and effective cardiopulmonary resuscitation (CPR) is crucial for survival and nurses are often the first responders. This study aimed to investigate how inter-professional attitudes and educational burdens affect self-efficacy related to CPR performance following team-based CPR simulation training. Methods: This retrospective observational study analyzed data from a satisfaction survey conducted after team-based CPR training sessions between January and November 2022. Of the 454 nurses surveyed, 238 were included in the study after excluding those with ambiguous responses. Multiple regression analysis was performed to assess factors influencing CPR self-efficacy. The factors examined included inter-professional attitudes and educational burden. Results: Higher levels of inter-professional attitudes, particularly regarding teamwork roles and responsibilities, lower educational burden, and a positive perception of CPR competence were all associated with improved CPR-related self-efficacy. Participants who reported higher engagement in teamwork, lower task load, and greater confidence in their CPR abilities demonstrated higher self-efficacy in performing CPR. Conclusion: Enhancing the competencies of nurses who may act as initial responders in CPR situations within or outside hospital settings can help save lives and support public health.
Exosomes are nano-sized membrane-bound extracellular vesicles containing various biological molecules, such as nucleic acids, proteins, and lipids, which can be used to modulate physiological processes. The exosomal molecules secreted by cells can be extensively used as tools for diagnosis and therapy. Exosomes carry specific molecules released by the cells they originate from, which can be transferred to surrounding cells or tissues by the exosome. For these reasons, exosomes can be exploited as biomarkers for diagnosis, carriers for drug delivery, as well as therapeutics. In stem cell technology, exosomes have been an attractive option because they can be used as safer therapeutic agents for stem cell-based cell-free therapy. Recently, studies have demonstrated the safety and efficacy of mesenchymal stem cell-derived exosomes in alleviating symptoms associated with coronavirus disease 2019 as they have anti-inflammatory and immunomodulatory potential. Performing multiple studies on exosomes would provide innovative next-generation options for clinical diagnostics and therapy. This review summarizes the use of exosomes focusing on their diverse roles. In addition, the potential of exosomes is illustrated with a focus on how exosomes can be exploited as powerful tools in the days to come.
Curcumin has diverse anticancer activities that lead to tumor growth inhibition of cancer cells and induction of apoptosis. Curcumin is involved in the regulation of multiple genes via transcription factors including NF-${\kappa}B$, STATs, AP1, and SP. Notch signaling plays critical roles in maintaining the balance between cell proliferation, differentiation and apoptosis, and thereby may contribute to the development of various cancers involving breast cancer. This study was to investigate the effects of curcumin on Notch1 gene expression and to explore the underlying mechanism. Here, we found that curcumin decreased the levels of Notch1 mRNA and protein in MDA-MB-231 human breast cancer cells, along with the downregulation of Sp family genes (Sp1, Sp2, Sp3, and Sp4). The repressive effect of curcumin on Notch1 gene transcription was confirmed by performing Notch1 promoter-driven reporter assay and three Sp-binding sites were identified on Notch1 promoter that may act as curcumin-respose elements. Moreover, treatment with mitramycin A, a specific Sp inhibitor, decreased the levels of Notch1 mRNA and protein in human breast cancer cells. Taken together, our results indicate that Notch1 gene expression is downregulated by curcumin, at least in part, through the suppression of Sp family, which may lead to apoptosis in human breast cancer cells.
Even the teachers who agree with the necessity of effective mathematical discussions find it difficult to orchestrate such discussions in the actual lessons. This study focused on analyzing the difficulties 15 elementary school teachers faced in applying "the five practices for orchestrating productive mathematics discussions" to their lessons. Specifically, this study analyzed the process of planning, implementing, and reflecting on the lessons to which three or four teachers as a teacher community applied the five practices. The results of this study showed that the teachers experienced difficulties in selecting and presenting tasks tailored to the student levels and class environment, monitoring all students' solutions, and identifying the core mathematical ideas in student solutions. In addition, this study revealed practical and specific difficulties that had not been described in the previous studies, such as writing a lesson plan for effective use, simultaneously performing multiple teacher roles, and visually sharing student presentations. This study is expected to provide practical tips for elementary school teachers who are eager to promote effective mathematical discussions and to provoke professional discourse for teacher educators through specific examples.
Every country in the world has been trying to expand the basic health right for the peoples as W.H.O has established the goal 'health for AU' by the year of 2000. Related to this goal, our government authority has establish the policy 'the insurance of health for all' into effect from July 198\). Recently hospitalshave been making a ceaseless effort for the plan for the rationalization of its management the academic World is making it a subject of discussion by doing the secure of manpower at a resonable level and the increase of productivity by the manpower. As a result of the efforts the study was established to secure the numbers of nursing manpower at a resonable level and use the unskilled persons at the utilizing field and seek the possible area of their activity for more efficient service through the investigation of ablity of simple nursing activities of regiestered nurses and nurse aides for rational function according to the educational levels and talents. The method of study was established by the registered nurses and nurse and nurse aides(R.N 229, N.A 226) who are working in 15 hospitals with over 200 beds. This surrey was conducted from Mar 29, 1989 to April 8, 1989. The method to test the degree of importance, difficulties, and the abillity of performance of a simple nursing activities was classified into 35 activities on the basis of references on this field. The degree of importance was composed from point l(Not so important) to 5(Very important). the degree of difficulties. was composed as follows; very easy - Point 1 very difficult and complicated - Point 5. and the ability of performance was composed from point 1 to 5. The materials gathered through the survey were analyzed with frequency, mean standard deviation, percentage. t-test, Anova, pearson's coefficient of correlation, stepwise multiple regression. factor analysis, discriminant analysis. The obtained results are summarized as follows: 1. The recognition values of the simple nursing activities of each group of registered nurse and nurse aides show; The degree of importance; 4.04 and 4.26 The degree of difficulties; 2.72 and 2.94 The ability of performance; 2.07 and 2.38 The brief summary shows there are little differences between who two groups the simple nursing activities turned out to be easy and simple work. 2. Regardless of the degree of importance, and difficulties, the ability of performance the important in fluencing of the degree of the simple nursing activities between the registered nurses and nurse aides was the order of educational level, hospital career, working career in wards and ages of the registered nurses and ages and hospital creer of nurse aides. The result was that the simple nursing activities could easily be familiar through the training of their working environment and period of experience. 3. Among the 35 simple nursing activities the items capable of resonable entrusting to the nurse aides are 5 that is helping bed-bathing, 8itz Bath, using bed pan, care while delivering patient, accompaying patient when visitor's check. There wasn't and differences between RN and nurse aides in performing the above 5 items. In anywhere. so we can say obviosuly that this nursing activities should be performed under the nursing system of which chief of nurse are supposed to supervise nurse aides as a possible function to be entrusted. In view of the above mentioned results, therefore, this partial functional job of the simple nursing activities can able be entrusted to the nurse aides through the regular training course. In case of these functional activities could be entrusted under, the responsibility of registered nurse, we can able suggest to for that there are the following advantages: 1.. In the nursing activities-affairs, the qualified guarantee of the nursing services can be kept and increased or promotoed with accommodation of the required nursing service and roles being expanded presently. 2. In the productivity of the hospital manpower, therefore, we have comt to view and consider in favourly that when an automational administration times would be come in the near future time to hospital affairs as a reality, to utilize the existing nures aides is better rather than investing so as to develop the other source manpowers or seek its for the efficient business management in the operational strategy or its policy.
Customer Relationship Management(CRM) has been a sustainable competitive edge of many companies. CRM analyzes customer data for designing and executing targeted marketing analysing customer behavior in order to make decisions relating to products and services including management information system. It is critical for companies to get and maintain profitable customers. How to manage relationships with customers effectively has become an important issue for both academicians and practitioners in recent years. However, the existing academic literature and the practical applications of customer relationship management(CRM) strategies have been focused on the technical process and organizational structure about the implementation of CRM. These limited focus on CRM lead to the result of numerous reports of failed implementations of various types of CRM projects. Many of these failures are also related to the absence of marketing approach. Identifying successful factors and outcomes focused on marketing concept before introducing a CRM project are a pre-implementation requirements. Many researchers have attempted to find the factors that contribute to the success of CRM. However, these research have some limitations in terms of marketing approach without explaining how the marketing based factors contribute to the CRM success. An understanding of how to manage relationship with crucial customers effectively based marketing approach has become an important topic for both academicians and practitioners. However, the existing papers did not provide a clear antecedent and outcomes factors focused on marketing approach. This paper attempt to validate whether or not such various marketing factors would impact on relational quality and CRM performance in terms of marketing oriented perceptivity. More specifically, marketing oriented factors involving market orientation, customer orientation, customer information orientation, and core customer orientation can influence relationship quality(satisfaction and trust) and CRM outcome(customer retention and customer share). Another major goals of this research are to identify the effect of relationship quality on CRM outcomes consisted of customer retention and share to show the relationship strength between two factors. Based on meta analysis for conventional studies, I can construct the following research model. An empirical study was undertaken to test the hypotheses with data from various companies. Multiple regression analysis and t-test were employed to test the hypotheses. The reliability and validity of our measurements were tested by using Cronbach's alpha coefficient and principal factor analysis respectively, and seven hypotheses were tested through performing correlation test and multiple regression analysis. The first key outcome is a theoretically and empirically sound CRM factors(marketing orientation, customer orientation, customer information orientation, and core customer orientation.) in the perceptive of marketing. The intensification of ${\beta}$coefficient among antecedents factors in terms of marketing was not same. In particular, The effects on customer trust of marketing based CRM antecedents were significantly confirmed excluding core customer orientation. It was notable that the direct effects of core customer orientation on customer trust were not exist. This means that customer trust which is firmly formed by long term tasks will not be directly linked to the core customer orientation. the enduring management concerned with this interactions is probably more important for the successful implementation of CRM. The second key result is that the implementation and operation of successful CRM process in terms of marketing approach have a strong positive association with both relationship quality(customer trust/customer satisfaction) and CRM performance(customer retention and customer possession). The final key fact that relationship quality has a strong positive effect on customer retention and customer share confirms that improvements in customer satisfaction and trust improve accessibility to customers, provide more consistent service and ensure value-for-money within the front office which result in growth of customer retention and customer share. Particularly, customer satisfaction and trust which is main components of relationship quality are found to be positively related to the customer retention and customer share. Interactive managements of these main variables play key roles in connecting the successful antecedent of CRM with final outcome involving customer retention and share. Based on research results, This paper suggest managerial implications concerned with constructions and executions of CRM focusing on the marketing perceptivity. I can conclude in general the CRM can be achieved by the recognition of antecedents and outcomes based on marketing concept. The implementation of marketing concept oriented CRM will be connected with finding out about customers' purchasing habits, opinions and preferences profiling individuals and groups to market more effectively and increase sales changing the way you operate to improve customer service and marketing. Benefiting from CRM is not just a question of investing the right software, but adapt CRM users to the concept of marketing including marketing orientation, customer orientation, and customer information orientation. No one deny that CRM is a process or methodology used to develop stronger relationships being composed of many technological components, but thinking about CRM in primarily technological terms is a big mistake. We can infer from this paper that the more useful way to think and implement about CRM is as a process that will help bring together lots of pieces of marketing concept about customers, marketing effectiveness, and market trends. Finally, a real situation we conducted our research may enable academics and practitioners to understand the antecedents and outcomes in the perceptive of marketing more clearly.
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