Search results for: towards quality healthcare

Authors: T. M. Al Muhareb

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Any organization should take into consideration the customers’ satisfaction while providing any service to their customers. The quality of services is always considered as the main aspect that attracts the customers’ attention and helps the airports to develop their services and operations. King Khalid International Airport is considered as the gateway of the Kingdom of Saudi Arabia. Therefore, the aim of this paper was to identify the quality service in the departure area at in King Khalid Airport. The SERVQUAL questionnaire was distributed among the passengers in King Khalid International Airport and the respondents have reached to 500 passengers. The results that are obtained from the SERVQUAL questionnaire showed that the quality of airport’s services is low.

Keywords: service quality, SERVQUAL methodology, King Khalid International Airport (KKIA), customers’ satisfaction

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Authors: Hassan Y. Kikhia, Jin P. Zhang, Khaldoon G. Albiatr

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The Enron and Arthur Andersen scandal has raised concerns internationally about auditor independence and audit quality. Furthermore, the debate continues about the relationship between audit fees, auditor tenure and audit quality in spite of extensive empirical evidence examining audit failures and earnings management. Therefore, the purpose of current research is to determine the effect of audit fee and audit tenure both partially and simultaneously on the audit quality. Using a sample of Chinese firms, an environment where we believe it provides us with an opportunity to test whether the development of market and legal institutions affects the impact of audit fees and auditor tenure on audit quality. We employ the standard deviation of residuals from regressions relating current accruals to cash flows as proxy for audit quality. The paper documents statistically significant negative association between audit fees and audit quality. These findings are consistent with economic bonding being a determinant of auditor behavior rather than auditor reputational concerns. Further, the current paper shows a positive association between auditor tenure and audit quality in the earlier years of audit tenure. These results support the proposition that when the Learning Effect dominates the Bonding Effect in the earlier years of tenure, then audit quality is likely to be higher. Taken audit fees and audit tenure together, the results suggest that there is positive association between audit fees and audit quality in the earlier years of auditor tenure. Interestingly, the findings of our study have important implications for auditors, policymakers, multinational firms, and users of financial reports. As the rapid growth of China's economy gains global recognition, the Chinese stock market is capturing the attention of international investors. To a lesser extent, our paper also differs from the prior studies in methodology and findings in the investigation of audit quality.

Keywords: audit quality, accruals quality, audit fees, auditor tenure

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Authors: Andhiani Sharfina Arnellya, Mochammad Indra Permana, Dika Pramita Destiani, Ellin Febrina

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Health Research Data, Ministry of Health of Indonesia in 2007, showed coronary heart disease (CHD) or coronary artery disease (CAD) was the third leading cause of death in Indonesia after hypertension and stroke with 7.2% incidence rate. Antiplatelet is one of the important therapy in management of patients with CHD. In addition to therapeutic effect on patients, quality of life is one aspect of another assessment to see the success of antiplatelet therapy. The purpose of this study was to determine the quality of life of patients on oral antiplatelet therapy in outpatient cardiac department Dr. Hasan Sadikin central general hospital, Bandung, Indonesia. This research is a cross sectional by collecting data through quality of life questionnaire of patients which performed prospectively as primary data and secondary data from medical record of patients. The results of this study showed that 54.3% of patients had a good quality of life, 45% had a moderate quality of life, and 0.7% had a poor quality of life. There are no significant differences in quality of life-based on age, gender, diagnosis, and duration of drug use.

Keywords: antiplatelet, quality of life, coronary artery disease, coronary heart disease

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Authors: Aykut Bedük, Kemalettin Eryeşil, Osman Eşmen

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The aim of this study is to examine the relationship between organizational commitment which is defined as a strong belief in and acceptance of the organization’s goals and values, and burnout syndrome and organizational cynicism. Accordingly, a field research based on survey method was conducted on the employees of a health institution operating in the province of Konya. The findings of the research show that there is a positive statistically significant relationship between organizational cynicism and burnout while there is a negative statistically significant relationship between organizational commitment and burnout. Furthermore, it has been also realized that there is a negative and statistically significant relationship between organizational commitment and organizational cynicism.

Keywords: burnout, organizational commitment, organizational cynicism, healthcare management

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Authors: Shu-Ching Chiu, Shu-Fang Chang

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The World Health Organization (WHO) has been actively developing intervention programs to deal with geriatric frailty. In its White Paper on Healthcare Policy 2020, the Department of Health, Bureau of Health Promotion proposed that active aging and the prevention of disability are essential for elderly people to maintain good health. The paper recommended five main policies relevant to this objective, one of which is the prevention of frailty and disability. Scholars have proposed a number of different criteria to diagnose and assess frailty; no consistent or normative standard of measurement is currently available. In addition, many methods of assessment are recursive, which can easily result in recall bias. Due to the relationship between frailty and physical fitness with regard to co-morbidity, it is important that academics optimize the criteria used to assess frailty by objectively evaluating the physical fitness of senior citizens. This study used a review of the literature to identify fitness indicators suitable for measuring frailty in the elderly. This study recommends that measurement criteria be integrated to produce an optimized predictive value for frailty score. Healthcare professionals could use this data to detect frailty at an early stage and provide appropriate care to prevent further debilitation and increase longevity.

Keywords: frailty, aging, physical fitness, optimized criteria, healthcare

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Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

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Authors: Aman Kaur, Colin Ribton, Wamadeva Balachandaran

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Electron beam welding due to its inherent advantages is being extensively used for material processing where high precision is required. Especially in aerospace or nuclear industries, there are high quality requirements and the cost of materials and processes is very high which makes it very important to ensure the beam quality is maintained and checked prior to carrying out the welds. Although the processes in these industries are highly controlled, however, even the minor changes in the operating parameters of the electron gun can make large enough variations in the beam quality that can result in poor welding. To measure the beam quality a simple device has been designed that can be used at high powers. The device consists of two slits in x and y axis which collects a small portion of the beam current when the beam is deflected over the slits. The signals received from the device are processed in data acquisition hardware and the dedicated software developed for the device. The device has been used in controlled laboratory environments to analyse the signals and the weld quality relationships by varying the focus current. The results showed matching trends in the weld dimensions and the beam characteristics. Further experimental work is being carried out to determine the ability of the device and signal processing software to detect subtle changes in the beam quality and to relate these to the physical weld quality indicators.

Keywords: electron beam welding, beam quality, high power, weld quality indicators

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Authors: Sami Alanazi

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Teamwork practices have been recognized as a significant strategy to improve patient safety, quality of care, and staff and patient satisfaction in healthcare settings, particularly within the emergency department (ED). The EDs depend heavily on teams of interdisciplinary healthcare staff to carry out their operational goals and core business of providing care to the serious illness and injured. The ED is also recognized as a high-risk area in relation to service demand and the potential for human error. Few studies have considered the perceptions and experiences of the ED staff (physicians, nurses, allied health professionals, and administration staff) about the practice of teamwork, especially in Saudi Arabia (SA), and no studies have been conducted to explore the practices of teamwork in the EDs. Aim: To explore the practices of teamwork from the perspectives and experiences of staff (physicians, nurses, allied health professionals, and administration staff) when interacting with each other in the admission areas in the ED of a public hospital in the Northern Border region of SA. Method: A qualitative case study design was utilized, drawing on two methods for the data collection, comprising of semi-structured interviews (n=22) with physicians (6), nurses (10), allied health professionals (3), and administrative members (3) working in the ED of a hospital in the Northern Border region of SA. The second method is non-participant direct observation. All data were analyzed using thematic analysis. Findings: The main themes that emerged from the analysis were as follows: the meaningful of teamwork, reasons of teamwork, the ED environmental factors, the organizational factors, the value of communication, leadership, teamwork skills in the ED, team members' behaviors, multicultural teamwork, and patients and families behaviors theme. Discussion: Working in the ED environment played a major role in affecting work performance as well as team dynamics. However, Communication, time management, fast-paced performance, multitasking, motivation, leadership, and stress management were highlighted by the participants as fundamental skills that have a major impact on team members and patients in the ED. It was found that the behaviors of the team members impacted the team dynamics as well as ED health services. Behaviors such as disputes among team members, conflict, cooperation, uncooperative members, neglect, and emotions of the members. Besides that, the behaviors of the patients and their accompanies had a direct impact on the team and the quality of the services. In addition, the differences in the cultures have separated the team members and created undesirable gaps such the gender segregation, national origin discrimination, and similarity and different in interests. Conclusion: Effective teamwork, in the context of the emergency department, was recognized as an essential element to obtain the quality of care as well as improve staff satisfaction.

Keywords: teamwork, barrier, facilitator, emergencydepartment

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Authors: Rizwan Ali, Hammad Zafar

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The purpose of this research is to investigate the mediation effect of customer satisfaction in the relationship between service quality, corporate image to customer loyalty, in Pakistan banking sector. The population of this research is banking customers and sample size of 210 respondents. This research uses the SPSS, Correlation, ANOVA and regression analysis techniques along with AMOS methods. The service quality and corporate image applied by the banks are not all variables can directly affect customer loyalty, but must first going through satisfaction. Which means that banks must first need to understand what the customer basic needs through variable service quality and corporate image so that the customers feel loyal when the level of satisfaction is resolved. The service quality provided by the banking industry needs to be improved in order to improve customer satisfaction and loyalty of banking services, especially for banks in Pakistan.

Keywords: customer loyalty, service quality, corporate image, customer satisfaction

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Authors: Ayala Kobo-Greenhut, Amos Notea, Izhar Ben-Shlomo

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In R&D projects, there is no doubt about the need to change a current concept to an alternative one over time (i.e., concept leaping). Concept leaping is required since with most R&D projects uncertainty is present as they take place in dynamic environments. Despite the importance of concept leaping when needed, R&D teams may fail to do so (i.e., frozen concept). This research suggests a possible reason why frozen concept happens in the framework of quality engineering and control engineering. We suggest that frozen concept occurs since concept determines the derived plan and its implementation may be considered as equivalent to a closed-loop process, and is subject to the problem of not recognizing gaps as failures. We suggest that although implementing quality practices into an R&D project’s routine has many advantages, it intensifies the frozen concept problem since working according to quality practices relates to exploitation of learning behavior, while leaping to a new concept relates to exploring learning behavior.

Keywords: closed loop, control engineering, design, leaping, frozen concept, quality engineering, quality practices

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Authors: Hsin-Hung Lai, Wei Lo

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Whether it is in virtue or vice for a construction quality of public construction project, it is one of the important indicators for national economic development and overall construction, the impact on the quality of national life is very deep. In recent years, a number of scandal of public construction project occurred, the requirements of the government agencies and the public require the quality of construction of public construction project are getting stricter than ever, the three-level public construction project construction quality of quality control system implemented by the government has a profound impact. This study mainly aggregated the evolution of ISO 9000 quality control system, the difference between the practice of implementing management of construction quality by many countries and three-level quality control of our country, so we explored and found that almost all projects of enhancing construction quality are dominated by civil organizations in foreign countries, whereas, it is induced by the national power in our country and develop our three-level quality control system and audit mechanism based on IOS system and implement the works by legislation, we also explored its enhancement and relevance with construction quality of public construction project that are intervened by such system and national power, and it really presents the effectiveness of construction quality been enhanced by the audited result. The three-level quality control system of our country to promote the policy of public construction project is almost same with the quality control system of many developed countries; however our country mainly implements such system on public construction project only, we promote the three-level quality control system is for enhancing the quality of public construction project, for establishing effective quality management system, so as to urge, correct and prevent the defects of quality management by manufacturers, whereas, those developed countries is comprehensively promoting (both public construction project and civil construction) such system. Therefore, this study is to explore the scope for public construction project only; the most important is the quality recognition by the executor, either good quality or deterioration is not a single event, there is a certain procedure extends from the demand and feasibility analysis, design, tendering, contracting, construction performance, inspection, continuous improvement, completion and acceptance, transferring and meeting the needs of the users, all of mentioned above have a causal relationship and it is a systemic problems. So the best construction quality would be manufactured and managed by reasonable cost if it is by extensive thinking and be preventive. We aggregated the implemented results in the past 10 years (2005 to 2015), the audited results of both in central units and local ones were slightly increased in A-grade while those listed in B-grade were decreased, although the levels were not evidently upgraded, yet, such result presents that the construction quality of concept of manufacturers are improving, and the construction quality has been established in the design stage, thus it is relatively beneficial to the enhancement of construction quality of overall public construction project.

Keywords: ISO 9000, three-level quality control system, audit and review mechanism for construction implementation, quality of construction implementation

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Authors: Roghayeh Karami, Ahmad Gharaei

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Backgrounds and objectives: This study was undertaken at four different sites (north polluted, south polluted, south healthy and north healthy) in Tehran, in order to examine whether there was a relationship between publicly available air quality data and the public’s perception of air quality and to suggest some guidelines for reducing air pollution. Materials and Methods: A total of 200 people were accidentally filled out the research questionnaires at mentioned sites and air quality data were obtained simultaneously from the Air Quality Control Department. Data was analyzed in Excel and SPSS software. Results: Clean air and secure job were of great importance to people comparing to other pleasant aspect of life. Also air pollution and fear of dangerous diseases were the most important of people concerns. The Indies bored /news paper services on air quality were little used by the public as a means of obtaining information on air pollution. Using public transportation and avoid unessential journeys are the most important ways for reducing air pollution. Conclusion: The results reveal that the public’s perception of air quality is not a reliable indicator of the actual levels of air pollution. Current earths to down actions are not effective and enough in reducing air pollution, therefore it seems participatory management and public participation is suitable guideline.

Keywords: air pollution, quality of life, opinion poll, public participation

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Authors: Christian Neunzig, Simon Fahle, Jürgen Schulz, Matthias Möller, Bernd Kuhlenkötter

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The increasing use of deep learning applications in production is becoming a competitive advantage. Predictive quality enables the assurance of product quality by using data-driven forecasts via machine learning models as a basis for decisions on test results. The use of real Bosch production data along the value chain of hydraulic valves is a promising approach to classifying the leakage of directional valves.

Keywords: artificial neural networks, classification, hydraulics, predictive quality, deep learning

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Authors: Fateme Hadadian, Behnam Khaledi Paveh, Hosein Feizi

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Background: High number of patients with end-stage renal disease worldwide, and Iran and the patients required hemodialysis, As well as symptoms and treatment process and its impact on quality of life The researcher had to take a step towards solving these problems. Methods: In randomized clinical trial in 60 hemodialysis patients admitted to hospital hemodialysis Imam Reza (AS) were studied. Using questionnaires dialysis patients' QOL, quality of life was measured in patients and controls were divided randomly into two groups. Benson's relaxation method for the experimental group and two months at home, once per day, respectively and the control group received no special action. Immediately after the end of the period with was used for evaluating the quality of life in both the experimental and control groups were survey and data using independent t-test were used for statistical analysis. Results: The general dimensions of quality of life scores before and after intervention, there was significant difference (P=0/001). But this difference was not significant after QOL (P=0/2). Between QOL scores before and after treatment between the two groups was statistically significant (P=0/02). Conclusion: Benson relaxation has the desired effect on quality of life in hemodialysis patients and can be used as a useful method to enhance the quality of life in hemodialysis patients, implementation and training will be given.

Keywords: hemodialysis, quality of life, Benson muscle relaxation, biomedicine

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Authors: Fakhruddin Esa, Yusri Yusof

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The confirmatory of Total Quality Management (TQM) implementation is most vital in quality management. This paper focuses on employees' perceptions towards TQM implementation in a local automotive company supplier. The objectives of this study are first and foremost to determine the perception of TQM implementation among the staff, and secondly to ascertain the correlation between the variables, and lastly to identify the relative influence of the 10 TQM variables on the cost of poor quality (COPQ). The TQM implementation is perceived to be moderate. All correlation is found to be significant and five variables having positively moderate to high correlation. Out of 10 variables, quality system improvement, reward and recognition and customer focus influence the perceived COPQ. This study extended a discussion on these three variables contribution to TQM in general and the human resource development in the organization. A significant recommendation to lowering costs of internal error, such as trouble shooting and scraps are also discussed. Certain components of further research that would add value to this study have also been suggested and perhaps could be implemented at policy-level initiatives.

Keywords: cost of poor quality (COPQ), correlation, total quality management (TQM), variables

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Authors: Komal Fizza

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All around the world in every field professionals are taking great support from their computers. Computer assisted strategies not only increase the efficiency of the professionals but also in case of healthcare they help in life-saving interventions. The background of this current research is aimed towards two things; first to find out if computer assisted strategies are useful for Pharmacist for not and secondly how much these assist a Pharmacist to do quality interventions. Shifa International Hospital is a 500 bedded hospital, and it is running Antimicrobial Stewardship, during their stewardship rounds pharmacists observed that a lot of wrong doses of antibiotics were coming at times those were being overlooked by the other pharmacist even. So, with the help of MIS team the patients were categorized into adult and peads depending upon their age. Minimum and maximum dose of every single antibiotic present in the pharmacy that could be dispensed to the patient was developed. These were linked to the order entry window. So whenever pharmacist would type any order and the dose would be below or above the therapeutic limit this would give an alert to the pharmacist. Whenever this message pop-up this was recorded at the back end along with the antibiotic name, pharmacist ID, date, and time. From 14th of January 2015 and till 14th of March 2015 the software stopped different users 350 times. Out of this 300 were found to be major errors which if reached to the patient could have harmed them to the greater extent. While 50 were due to typing errors and minor deviations. The pilot study showed that computer assisted strategies can be of great help to the pharmacist. They can improve the efficacy and quality of interventions.

Keywords: antibiotics, computer assisted strategies, pharmacist, stewardship

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Authors: Eyob Seife, Tesfalem Teshome, Bereket Seyoum, Behailu Getachew, Yohans Demis

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Developing countries continue to face preventable communicable diseases, such as vaccine-preventable diseases. The Expanded Programme on Immunization (EPI) was established by the World Health Organization in 1974 to control these diseases. Health data use is crucial in decision-making, but ensuring data quality remains challenging. The study aimed to assess the accuracy ratio, timeliness, and quality index of regular immunization programme data in the Birkod district of the Somali Region, Ethiopia. For poor data quality, technical, contextual, behavioral, and organizational factors are among contributors. The study used a quantitative cross-sectional design conducted in September 2022GC using WHO-recommended data quality self-assessment tools. The accuracy ratio and timeliness of reports on regular immunization programmes were assessed for two health centers and three health posts in the district for one fiscal year. Moreover, the quality index assessment was conducted at the district level and health facilities by trained assessors. The study found poor data quality in the accuracy ratio and timeliness of reports at all health units, which includes zeros. Overreporting was observed for most facilities, particularly at the health post level. Health centers showed a relatively better accuracy ratio than health posts. The quality index assessment revealed poor quality at all levels. The study recommends that responsible bodies at different levels improve data quality using various approaches, such as the capacitation of health professionals and strengthening the quality index components. The study highlighted the need for attention to data quality in general, specifically at the health post level, and improving the quality index at all levels, which is essential.

Keywords: Birkod District, data quality, quality index, regular immunization programme, Somali Region-Ethiopia

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Authors: Tawfig Falani, Abdulalaziz Saleh

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Air pollution has become a major environmental issue with definitive repercussions on human health. Global concerns have been raised about the health effects of deteriorating air quality due mainly to widespread industrialization and urbanization. To assess the quality of air in Brega, air quality indicators were calculated using the U.S. Environmental Protection Agency procedure. Air quality was monitored from 01/10/2019 to 28/02/2021 with a daily average measuring six pollutants of particulate matter <2.5µm (PM2.5), and <10µm (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), and carbon monoxide (CO). The result indicated that air pollution at general air quality monitoring sites for sulphur dioxide, carbon monoxide, PM₁₀ and PM2.5 and nitrogen dioxide are always within the permissible limit. Referring to a monthly average of Pollutants in the Brega Industrial area, all months were out of AQG limit for NO₂, and the same with O₃ except for two months. For PM2.5 and PM₁₀ 7, 5 out of 17 months were out of limits, respectively. Relative AQI for ozone is found in the range of moderate category of general air pollution, and the worst month was Nov. 2020, which was marked as Very Unhealthy category, then the next two months (Dec. 2020 and Jan. 2021 ) were Unhealthy categories. It's the first time that we have used the AQI in SOC, and not usually used in Libya to identify the quality of air pollution. So, I think it will be useful if AQI is used as guidance for specified air pollution. That dictate putting monitoring stations beside any industrial activity that has emissions of the six major air pollutants.

Keywords: air quality, air pollutants, air quality index (AQI), particulate matter

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Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

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Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: catchment area of healthcare, chronic disease management, Geographic information system, quality of diabetes care

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Authors: Nor Asrina Binti Ramlee

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Voltage sag, voltage swell, high-frequency noise and voltage transients are kinds of disturbances in power quality. They are also known as power quality events. Equipment used in the industry nowadays has become more sensitive to these events with the increasing complexity of equipment. This leads to the importance of distributing clean power quality to the consumer. To provide better service, the best analysis on power quality is very vital. Thus, this paper presents the events detection focusing on voltage sag and swell. The method is developed by applying time domain signal analysis using wavelet transform approach in MATLAB. Four types of mother wavelet namely Haar, Dmey, Daubechies, and Symlet are used to detect the events. This project analyzed real interrupted signal obtained from 22 kV transmission line in Skudai, Johor Bahru, Malaysia. The signals will be decomposed through the wavelet mothers. The best mother is the one that is capable to detect the time location of the event accurately.

Keywords: power quality, voltage sag, voltage swell, wavelet transform

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Authors: Khadidja Mebarki, Naceur Boussouar, Nabila Ihaddadene, M. Akermi

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Food products are particularly sensitive, since they concern the health of the consumer, whether it’s be from the health point of view or commercial, this kind of product must be subjected to rigorous controls, in order to prevent any fraud. Quality and safety are essential for food security, public health and economic development. The strengthening of food security is essential to increase food security which is considered reached when all individuals can at any time access safe and nutritious food they need to lead healthy and active lives. The objective of this project is to initiate a quality approach in the laboratories of the quality control and the repression of fraud. It will be directed towards the application of good laboratory practices, traceability, management of quality documents (quality, procedures and specification manual) and quality audits. And to prepare the ground for a possible accreditation by ISO 17025 standard of BECHAR laboratory’s. The project will take place in four main stages: 1- Preparation of an audit grid; 2- Realization of a quality audit according to the method of 5 M completed by a section on quality documentation; 3- Drafting of an audit report and proposal for recommendations; 4- Implementation of corrective actions on the ground. This last step consisted in the formalization of the cleaning disinfection plan; work on good hygiene practices, establishment of a mapping of processes and flow charts of the different processes of the laboratory, classifying quality documents and formalizing the process of document management. During the period of the study within the laboratory, all facets of the work were almost appreciated, as we participated in the expertise performed in within it.

Keywords: quality, management, ISO 17025 accreditation, GLP

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Authors: Nadia Fatima Zahra Malki

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The aim of the study is to show the role of total Quality Management on firm performance, research relied on the views of a sample managers working in the Marinel pharmaceutical company. The research aims to achieve many objectives, including increasing awareness of the concepts of Total Quality Management on Firm Performance, especially in the manufacturing firm, providing a future vision of the possibility of success, and the actual application of the Principles of Total Quality Management in the manufacturing company. The research adopted a default model was built after a review and analysis of the literature review in the context of one hypothesis's main points at the origin of a group of sub-hypotheses. The research presented a set of conclusions, and the most important of these conclusions was that there is a relationship between the Principles of TQM and Firm Performance.

Keywords: total quality management, competitive advantage, companies, objectives

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Authors: Sibusiso Buthelezi, Rugira Regis Marie-Modeste, Deliwe Rene Phetlhu

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Introduction: Mother-to-child transmission persists owing to inadequate implementation of prevention of mother-to-child transmission programmes, particularly in rural areas. To achieve a target of zero new HIV infection in children born from women living with HIV, the involvement of mothers and caregivers is undeniable. Therefore, there is a need to explore the views of the mothers because of the role they play in their own right when it comes to preventing their children from contracting HIV by consistently adhering to the guidelines of the prevention of mother-to-child transmission programme. Thus, this study sought to explore and describe the perceptions of mothers on their role in the prevention of HIV to their children exposed to HIV and further explore their perceptions of the childcare received in the healthcare facility. Methods: The study was conducted in November-December 2019 in Ngaka Modiri Molema in North West Province in South Africa. A qualitative exploratory, descriptive research design was used. Purposive sampling was used to select the mothers of children exposed to HIV during the mother`s clinic attendance. Data collection was done through semi-structured individual interviews with mothers of children exposed to HIV. Colaizzi`s method of data analysis was used to analyse data in this study. Results: Seven themes emerged from data analysis, namely: health benefits from coming to the healthcare facility, communication, information needs, attitude of healthcare workers, healthcare administration system, the role of a mother, and disclosure of HIV status. Conclusion: This study revealed systematic gaps that exist in the programme, which hinder the childcare services of children exposed to HIV and socio-economically related hindrances. Mothers’ roles, such as exclusive breastfeeding, taking their own medication, and child follow-up visits, remain inadequate. The study findings show that there is a need to develop a contextual-tailored intervention strategy that would improve the implementation of prevention of mother-to-child transmission in rural areas.

Keywords: children exposed to HIV, mothers’ role to prevent MTCT, mothers’ perceptions on childcare, PMTCT in rural areas

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Authors: Harvey Hyman, Thomas Hull

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As one of the largest cancer treatment centers in the United States, we continuously confront the challenge of how to leverage the best possible technological solutions, in order to provide the highest quality of service to our customers – the doctors, nurses and patients at Moffitt who are fighting every day for the prevention and cure of cancer. This paper reports on the transition from a vertical to a horizontal IT infrastructure. We discuss how the new frameworks and methods such as public, private and hybrid cloud, brokering cloud services are replacing the traditional vertical paradigm for computing. We also report on the impact of containers, micro services, and the shift to continuous integration/continuous delivery. These impacts and changes in delivery methodology for computing are driving how we accomplish our strategic IT goals across the enterprise.

Keywords: cloud computing, IT infrastructure, IT architecture, healthcare

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Authors: Abdullah Alsarrani, Leandro Garcia, Ruth Hunter, Laura Dunne

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Social integration with friends has an important role in shaping adolescents’ behavior and determining their well-being. Friendship features such as companionship, trust, closeness, intimacy, and conflicts all form the concept of friendship quality. The quality of friendship relationships can either enhance or impede mental development during adolescence. Therefore, this systematic review was conducted to understand the association between friendship quality and adolescents’ mental wellbeing. The evidence was synthesized from a search of five databases (Medline, Embase, ProQuest, Scopus, and PsycINFO). Thirty-two articles out of 18801 records were included in the review. The relationship between friendship quality and depression has been investigated extensively in the literature and negative (beneficial) associations were found in twelve studies out of sixteen. Poor peer relationship was linked to loneliness in eight studies out of nine. All five studies on life satisfaction and quality of peer connection found a positive association. In five studies, optimal peer relationship was found to be associated with happiness. A positive association between friendship quality and self-esteem in four out of five applicable studies. Friendship quality was found to be correlated with subjective well-being in all of three included studies focused on this area. The review demonstrates the paramount value of promoting healthy friendship to adolescents’ subjective well-being constructs. Interventions that aim to promote subjective wellbeing among adolescents should consider the development and maintenance of healthy friendships.

Keywords: adolescents, friendship quality, peer, wellbeing

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Authors: Sarah K. Amer, Nagwa Badr, Osman Ibrahim, Ahmed Hamad

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This paper surveys the effectiveness of software process quality assurance frameworks, with some focus on Capability Maturity Model Integration (CMMI) - a framework that has become widely adopted in software organizations. The importance of quality improvement in software development, and the differences in the outcomes of quality framework implementation between Middle Eastern and North African (MENA-region) countries and non-MENA-region countries are discussed. The greatest challenges met in the MENA region are identified, with particular focus on Egypt and its rising software development industry.

Keywords: software quality, software process improvement, software development methodologies, capability maturity model integration

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Authors: Arun Kumar, Neelesh Haulder

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This paper identifies and resolves some key issues relating to a specific aspect within the supply chain logistics of the public health care industry in the Republic of Mauritius. The analysis and the proposed solution are performed using soft systems methodology (SSM). Through the application of this relevant systematic approach at problem solving, the aim is to obtain an in-depth analysis of the problem, incorporating every possible world view of the problem and consequently to obtain a well explored solution aimed at implementing relevant changes within the current supply chain logistics of the health care industry, with the purpose of tackling the key identified issues.

Keywords: soft systems methodology, CATWOE, healthcare, logistics

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Authors: Mehrnoosh Pirhayati

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In this study, the researcher tried to propose a model of Translation Criticism (TC) regarding the phenomenon of Translation Quality Assessment (TQA). With changing the general view on re/writing as an illegal act, the researcher defined a scale for the act of translation and determined the redline of translation with other products. This research attempts to show TC as a related phenomenon to TQA. This study shows that TQA with using the rules and factors of TC as depicted in both product-oriented analysis and process-oriented analysis, determines the orientation or the level of the quality of translation. This study also depicts that TC, regarding TQA’s perspective, reveals the aim of the translation of original text and the root of ideological manipulation and re/writing. On the other hand, this study stresses the existence of a direct relationship between the linguistic materials and semiotic codes of a text or book. This study can be fruitful for translators, scholars, translation criticizers, and translation quality assessors, and also it is applicable in the area of pedagogy.

Keywords: a model of translation criticism, a model of translation quality assessment, critical discourse analysis (CDA), re/writing, translation criticism (TC), translation quality assessment (TQA)

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Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

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Obesity is associated with significant personal impacts on health and has a substantial economic burden on payers due to increased healthcare use. A contemporary estimate of the healthcare costs associated with obesity at the population level are lacking. This evidence may provide further rationale for weight management strategies. Methods: Adults who underwent a medical procedure between 2012 and 2019 in Alberta, Canada were categorized into the investigational cohort (had body mass index [BMI]-defined class 2 or 3 obesity based on a procedure-associated code) and the control cohort (did not have the BMI procedure-associated code); those who had bariatric surgery were excluded. Characteristics were presented and healthcare costs ($CDN) determined over a 1-year observation period (2019/2020). Logistic regression and a generalized linear model with log link and gamma distribution were used to assess total healthcare costs (comprised of hospitalizations, emergency department visits, ambulatory care visits, physician visits, and outpatient prescription drugs); potential confounders included age, sex, region of residence, and whether the medical procedure was performed within 6-months before the observation period in the partial adjustment, and also the type of procedure performed, socioeconomic status, Charlson Comorbidity Index (CCI), and seven obesity-related health conditions in the full adjustment. Cost ratios and estimated cost differences with 95% confidence intervals (CI) were reported; incremental cost differences within the adjusted models represent referent cases. Results: The investigational cohort (n=220,190) was older (mean age: 53 standard deviation [SD]±17 vs 50 SD±17 years), had more females (71% vs 57%), lived in rural areas to a greater extent (20% vs 14%), experienced a higher overall burden of disease (CCI: 0.6 SD±1.3 vs 0.3 SD±0.9), and were less socioeconomically well-off (material/social deprivation was lower [14%/14%] in the most well-off quintile vs 20%/19%) compared with controls (n=1,955,548). Unadjusted total healthcare costs were estimated to be 1.77-times (95% CI: 1.76, 1.78) higher in the investigational versus control cohort; each healthcare resource contributed to the higher cost ratio. After adjusting for potential confounders, the total healthcare cost ratio decreased, but remained higher in the investigational versus control cohort (partial adjustment: 1.57 [95% CI: 1.57, 1.58]; full adjustment: 1.21 [95% CI: 1.20, 1.21]); each healthcare resource contributed to the higher cost ratio. Among urban-dwelling 50-year old females who previously had non-operative procedures, no procedures performed within 6-months before the observation period, a social deprivation index score of 3, a CCI score of 0.32, and no history of select obesity-related health conditions, the predicted cost difference between those living with and without obesity was $386 (95% CI: $376, $397). Conclusions: If these findings hold for the Canadian population, one would expect an estimated additional $3.0 billion per year in healthcare costs nationally related to BMI-defined obesity (based on an adult obesity rate of 26% and an estimated annual incremental cost of $386 [21%]); incremental costs are higher when obesity-related health conditions are not adjusted for. Results of this study provide additional rationale for investment in interventions that are effective in preventing and treating obesity and its complications.

Keywords: administrative data, body mass index-defined obesity, healthcare cost, real world evidence

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Authors: Edu Marcelina, Sule Sheidu A., Nsor Eunice

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As open and distance education is gradually becoming an acceptable means of solving the problem of access in higher education, quality has now become one of the main concerns among institutions and stakeholders of open and distance learning (ODL) and the education sector in general. This study assessed the challenges of academic quality in the open and distance learning (ODL) education in Nigeria using Distance Learning Institute (DLI), University of Lagos and National Open University of Nigeria as a case. In carrying out the study, a descriptive survey research design was employed. A researcher-designed and validated questionnaire was used to elicit responses that translated to the quantitative data for this study. The sample comprised 665 students of the Distance Learning Institute (DLI), and National Open University of Nigeria (NOUN), carefully selected through the method of simple random sampling. Data collected from the study were analyzed using Chi-Square (X2) at 0.05 Level of significance. The results of the analysis revealed that; the use of ICT tools is a factor in ensuring quality in the Open and Distance Learning (ODL) operations; the quality of the materials made available to ODL students will determine the quality of education that will be received by the students; and the time scheduled for students for self-study, online lecturing/interaction and face to face study and the quality of education in Open and Distance Learning Institutions has a lot of impact on the quality of education the students receive. Based on the findings, a number of recommendations were made.

Keywords: open and distance learning, quality, ICT, face-to-face interaction

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