Search results for: clinical quality and safety

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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Authors: Shalini Tripathi, Pardeep Kumar

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The method of translating observed symptoms into disease names is known as disease diagnosis. The ability to solve clinical problems in a complex manner is critical to a doctor's effectiveness in providing health care. The accuracy of his or her expertise is crucial to the survival and well-being of his or her patients. Artificial Intelligence (AI) has a huge economic influence depending on how well it is applied. In the medical sector, human brain-simulated intellect can help not only with classification accuracy, but also with reducing diagnostic time, cost and pain associated with pathologies tests. In light of AI's present and prospective applications in the biomedical, we will identify them in the paper based on potential benefits and risks, social and ethical consequences and issues that might be contentious but have not been thoroughly discussed in publications and literature. Current apps, personal tracking tools, genetic tests and editing programmes, customizable models, web environments, virtual reality (VR) technologies and surgical robotics will all be investigated in this study. While AI holds a lot of potential in medical diagnostics, it is still a very new method, and many clinicians are uncertain about its reliability, specificity and how it can be integrated into clinical practice without jeopardising clinical expertise. To validate their effectiveness, more systemic refinement of these implementations, as well as training of physicians and healthcare facilities on how to effectively incorporate these strategies into clinical practice, will be needed.

Keywords: Artificial Intelligence, medical diagnosis, virtual reality, healthcare ethical implications 

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Authors: Evagelos Korobilis-Magas, Adekunle Oke

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The constantly increasing tendency towards a global economy and the subsequent increase in exporting, as a result, has inevitably led to a growing interest in the topic of export success as well. Numerous studies, particularly in the past three decades, have examined a plethora of determinants to export performance. However, to the authors' best knowledge, no study up to date has ever considered decision quality as a potential antecedent to export success by attempting to test the relationship between decision quality and export performance. This is a surprising deficiency given that the export marketing literature has long ago suggested that quality decisions are regarded as the crucial intervening variable between sound decision–making and export performance. This study integrates the different definitions of decision quality proposed in the literature and the key themes incorporated therein and adapts it to an export context. Apart from laying the conceptual foundations for the delineation of this elusive but very important construct, this study is the first ever to test the relationship between decision quality and export performance. Based on survey data from a sample of 189 British export decision-makers and within a contingency theory framework, the results reveal that there is a direct, positive link between decision quality and export performance. This finding opens significant future research avenues and has very important implications for both theory and practice.

Keywords: export performance, decision quality, mixed methods, contingency theory

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Authors: Mohan Kotamrazu

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Tall buildings block and divert strong upper level winds to the ground. These high velocity winds many a time create adverse wind effects at ground level which can be uncomfortable and even compromise the safety of pedestrians and people who frequent the spaces in the vicinity of tall buildings. Discomfort can be experienced around the entrances and corners of tall buildings. Activities such as strolling or sitting in a park, waiting for a bus near a tall building can become highly unpleasant. For the elderly unpleasant conditions can also become dangerous leading to accidents and injuries. Today there is a growing concern among architects, planners and urban designers about the wind environment in the vicinity of tall building. Regulating authorities insist on wind tunnel testing of tall buildings in cities such as Wellington, Auckland, Boston, San Francisco, etc. prior to granting permission for their construction The present paper examines the different ways that tall buildings can induce strong winds at pedestrian level and their impact on people who frequent the spaces around tall buildings.

Keywords: tall buildings, wind effects, wind comfort, wind safety

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Authors: Suchana Marahatta, Sabina Bhattarai, Bishnu Hari Paudel, Dilip Thakur

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Background: Every year thousands of patients develop nerve damage and disabilities as a result of leprosy which can be prevented by early detection and treatment. So, early detection and treatment of nerve function impairment is of paramount importance in leprosy. Objectives: To assess the electrophysiological pattern of the peripheral nerves in leprosy patients and to compare it with clinical assessment tools. Materials and Methods: In this comparative cross-sectional study, 74 newly diagnosed leprosy patients without reaction were enrolled. They underwent thorough evaluation for peripheral nerve function impairment using clinical tests [i.e. nerve palpation (NP), monofilament (MF) testing, voluntary muscle testing (VMT)] and nerve conduction study (NCS). Clinical findings were compared with that of NCS using SPSS version 11.5. Results: NCS was impaired in 43.24% of leprosy patient at the baseline. Among them, sensory NCS was impaired in more patients (32.4%) in comparison to motor NCS (20.3%). NP, MF, and VMT were impaired in 58.1%, 25.7%, and 9.4% of the patients, respectively. Maximum concordance of monofilament testing and sensory NCS was found for sural nerve (14.7%). Likewise, the concordance of motor NP and motor NCS was the maximum for ulnar nerve (14.9%). When individual parameters of the NCS were considered, amplitude was found to be the most frequently affected parameter for both sensory and motor NCS. It was impaired in 100% of cases with abnormal NCS findings. Conclusion: Since there was no acceptable concordance between NCS findings and clinical findings, we should consider NCS whenever feasible for early detection of neuropathy in leprosy. The amplitude of both sensory nerve action potential (SNAP) and compound nerve action potential (CAMP) could be important determinants of the abnormal NCS if supported by further studies.

Keywords: leprosy, nerve function impairment, neuropathy, nerve conduction study

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Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes

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Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.

Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart

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Authors: Tanja Salary

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This paper discusses a study conducted in a juvenile justice facility regarding medication errors. It includes an introduction to data collected about medication errors in a juvenile justice facility from 2011 - 2019 and explores contributing factors that relate to those errors. The data was obtained from electronic incident records of medication errors that were documented from the years 2011 through 2019. In addition, the presentation reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional health care facilities to juvenile justice residential facilities and acknowledges a gap in research. The theoretical/conceptual framework for the research study was Bandura and Adams’s self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory. Despite the lack of evidence in previous studies addressing medication errors in juvenile justice facilities, this presenter will share information that adds to the body of knowledge, including the potential relationship of medication errors and contributing factors of race and age. Implications for future research include the effect that education and training will have on the communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: Juvenile justice, medication errors, juveniles, error reduction strategies

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Authors: Gulcan Sahal, Nermin Hande Avcioglu, Isil Seyis Bilkay

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Klebsiella species which are natural colonizers of human upper respiratory and human gastrointestinal tracts are also responsible for every reoccurring nosocomial infections by means of having ability to form slimy layers known as biofilm on many surfaces. Therefore, in this study, investigation of biofilm formation in K. pneumoniae and K. rhinoscleromatis and examination of each Klebsiella strains’ clinical information in the light of their biofilm formation results were aimed. In this respect, biofilm formation of Klebsiella strains was analyzed via crystal violet binding assay. According to our results, biofilm formation levels of K. pneumoniae and K. rhinoscleromatis strains were different from each other. Additionally, in comparison to K. rhinoscleromatis strains, K. pneumoniae was observed to include higher amounts of strong biofilm forming strains. Besides, it was also seen that clinical information of patients from which strong biofilm forming Klebsiella strains were isolated were similar to each other. Our results indicate that there should be more precautions against K. pneumoniae which includes higher amount of strong biofilm forming strains.

Keywords: biofilm formation, Klebsiella pneumoniae, Klebsiella rhinoscleromatis, biosystems engineering

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Authors: Hamdy Khamis Korayem, Manal Yehia Tayel, Abeer Shawky El Hadedy, Emmanuel Kamal Aziz Saba, Shimaa Badr Abdelnaby Badr

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The aim of the current study was to demonstrate whether serum Interleukin-18 (IL-18) is increased in rheumatoid arthritis (RA) and its correlation with disease activity, functional disability and quality of life in RA patients. The study included 30 RA patients and 20 healthy normal control subjects. The RA patients were diagnosed according to the 2010 ACR/EULAR classification criteria for RA with the exclusion of those who had diabetes mellitus, endocrine disorders, associated rheumatologic diseases, viral hepatitis B or C and other diseases with increased serum IL-18 level. All patients were subjected to clinical evaluation of the musculoskeletal system. Disease activity was assessed by disease activity score 28 with 4 variables (DAS 28). Functional disability was assessed by health assessment questionnaire disability index (HAQ-DI). The quality of life was assessed by Short form-36 (SF-36) questionnaire. Radiological assessment of both hands and feet by Sharp/van der Heijde (SvH) scoring method. Laboratory parameters including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) were assessed in patients and serum level of IL-18 in both patients and control subjects. There was no statistically significant difference between patient and control group as regards age and sex. Among patients, 29 % were females and the age range was between 25 to 55 years. Extra-articular manifestations were presented in 56.7% of the patients. The mean of DAS 28 score was 5.73±1.46 and that of HAQ-DI was 1.22±0.72 while that of SF-36 was 40.03±13.96. The level of serum IL-18 was significantly higher in patients than in the control subjects (P= 0.030). Serum IL-18 was correlated with ACPA among the patient group. There were no statistically significant correlations between serum IL-18 and DAS28, HAQ-DI, SF-36, total SvH score and the other laboratory results. In conclusion, IL-18 is significantly higher in RA patient than in healthy control subjects and positively correlated with ACPA level. IL-18 is associated with extra-articular manifestations. However, it is not correlated with other laboratory parameters, disease activity, functional disability, quality of life nor radiological severity.

Keywords: disease activity score, Interleukin-18, quality of life assessment, rheumatoid arthritis

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Authors: Ayubova Nargiza Mirzabixulaevna, Kiryakov Dmitriy Andreyevich

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Relevance: According to experts from the World Health Organization, in 80% of cases, the causes of skin cancer are external factors: polluted air, radioactive substances, solar flares, and free radicals. In dermatology, one of the most common related to obligate diseases is actinic keratosis. Actinic keratosis (AC) is an area of abnormal proliferation and differentiation of keratinocytes, which carry the risk of progression into invasive squamous cell carcinoma of the skin. The purpose of the study is to study the prevalence of various forms of actinic keratosis among the population of Uzbekistan. Materials and methods of research: The study is based on the observation and clinical laboratory examination of 96 patients who were divided by gender and age. Women made up 45% and men made up 55%. The youngest patient was 43 years old, and the oldest was 92 years old. The control group consisted of 40 patients. The following clinical signs were evaluated: peeling, hyperkeratosis, erythema, pigmentation, atrophy. Results: Studies have shown that of all forms of actinic keratosis, erythematous (36%), hyperkeratotic (27%), pigmented (12%), cutaneous horn (7.0%), atrophic (7.0%), Actinic cheilitis (6%), lichenoid (5%) are common. Conclusion: Thus, the data we have obtained indicate that the main and pronounced clinical sign in the erythematous form is erythema and the hyperkeratic form is often found. With cutaneous horn, there is a sharp hyperkeratosis of the epidermis.

Keywords: actinic keratosis, patient, skin cancer, obligate diseases

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Authors: Bernat-Carles Serdà Ferrer, Arantza Del Valle Gómez

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The Quality of Life (QoL) paradigm is multidimensional, dynamic and modular and its definition differs across the cancer continuum. The challenge in the interpretation of QoL data in clinical research is that QoL is influenced by psychological phenomena such as adaptation to illness. This research aims to obtain a valid and sensitive assessment of QoL change over the continuum disease, and to evaluate a rehabilitation programme aimed at inverting the observed decrease in QoL when patients return to daily living activities. The sample comprised 66 men. Patients were first assessed to establish a baseline (P1-diagnosis). This was followed by a post-test (P2-discharge) and a then-test measurement (P3-retrospective evaluation) and after returning home patients were randomized in experimental and control groups. The experimental group attended a rehabilitation programme over 24 weeks (P4). Results show that from baseline to post-test, QoL decreased significantly. The recalibration then-test confirmed a low QoL in all periods evaluated. Significant differences between the experimental and control groups prove the positive effect of the Exercise Rehabilitation Programme (ERP) on QoL. Understanding the real dynamic of QoL over time would help to adapt rehabilitation programmes by improving sensitivity and efficacy and provide professionals with a more accurate perception of the impact of treatment and side effects on patients’ QoL. Our results underline the importance of changing the approach adopted by health professionals towards one of watchful waiting on patients’ QoL until their complete recovery in daily life.

Keywords: exercise, prostate cancer, quality of life, rehabilitation programme, response shift

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Authors: Maryam Azimi, Amin Banitalebi-Dehkordi, Yuanyuan Dong, Mahsa T. Pourazad, Panos Nasiopoulos

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While there exists a wide variety of Low Dynamic Range (LDR) quality metrics, only a limited number of metrics are designed specifically for the High Dynamic Range (HDR) content. With the introduction of HDR video compression standardization effort by international standardization bodies, the need for an efficient video quality metric for HDR applications has become more pronounced. The objective of this study is to compare the performance of the existing full-reference LDR and HDR video quality metrics on HDR content and identify the most effective one for HDR applications. To this end, a new HDR video data set is created, which consists of representative indoor and outdoor video sequences with different brightness, motion levels and different representing types of distortions. The quality of each distorted video in this data set is evaluated both subjectively and objectively. The correlation between the subjective and objective results confirm that VIF quality metric outperforms all to their tested metrics in the presence of the tested types of distortions.

Keywords: HDR, dynamic range, LDR, subjective evaluation, video compression, HEVC, video quality metrics

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Authors: Rafael Zhindon Almeida

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Surface water quality is an important concern for the evaluation and prediction of water quality conditions. The objective of this study is to develop a statistical model that can accurately predict the water quality of the El Macho estuary in the city of Machala, El Oro province. The methodology employed in this study is of a basic type that involves a thorough search for theoretical foundations to improve the understanding of statistical modeling for water quality analysis. The research design is correlational, using a multivariate statistical model involving multiple linear regression and principal component analysis. The results indicate that water quality parameters such as fecal coliforms, biochemical oxygen demand, chemical oxygen demand, iron and dissolved oxygen exceed the allowable limits. The water of the El Macho estuary is determined to be below the required water quality criteria. The multiple linear regression model, based on chemical oxygen demand and total dissolved solids, explains 99.9% of the variance of the dependent variable. In addition, principal component analysis shows that the model has an explanatory power of 86.242%. The study successfully developed a statistical model to evaluate the water quality of the El Macho estuary. The estuary did not meet the water quality criteria, with several parameters exceeding the allowable limits. The multiple linear regression model and principal component analysis provide valuable information on the relationship between the various water quality parameters. The findings of the study emphasize the need for immediate action to improve the water quality of the El Macho estuary to ensure the preservation and protection of this valuable natural resource.

Keywords: statistical modeling, water quality, multiple linear regression, principal components, statistical models

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Authors: Nipawan Tharasak, Sajeewan Darbavasu

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This research aims 1) to study the opinion, problems and obstacles to internal educational quality assurance system for individual and the university levels, 2) to propose an approach to the development of quality assurance system of Suan Sunandha Rajabhat University. A study of problems and obstacles to internal educational quality assurance system of the university conducted with sample group consisting of staff and quality assurance committee members of the year 2010. There were 152 respondents. 5 executives were interviewed. Tool used in the research was document analysis. The structure of the interview questions and questionnaires with 5-rate scale. Reliability was 0.981. Data analysis were percentage, mean and standard deviation with content analysis. Results can be divided into 3 main points: (1) The implementation of the internal quality assurance system of the university. It was found that in overall, input, process and output factors received high scores. Each item is considered, the preparation, planning, monitoring and evaluation. The results of evaluation to improve the reporting and improvement according to an evaluation received high scores. However, the process received an average score. (2) Problems and obstacles. It was found that the personnel responsible for the duty still lack understanding of indicators and criteria of the quality assurance. (3) Development approach: -Staff should be encouraged to develop a better understanding of the quality assurance system. -Database system for quality assurance should be developed. -The results and suggestions should be applied in the next year development planning.

Keywords: development system, internal quality assurance, education, educational quality assurance

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Authors: Saad M. Darwish

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Recently, software quality issues have come to be seen as important subject as we see an enormous growth of agencies involved in software industries. However,these agencies cannot guarantee the quality of their products, thus leaving users in uncertainties. Software certification is the extension of quality by means that quality needs to be measured prior to certification granting process. This research participates in solving the problem of software assessment by proposing a model for assessment and certification of software product that uses a fuzzy inference engine to integrate both of process–driven and application-driven quality assurance strategies. The key idea of the on hand model is to improve the compactness and the interpretability of the model’s fuzzy rules via employing an ant colony optimization algorithm (ACO), which tries to find good rules description by dint of compound rules initially expressed with traditional single rules. The model has been tested by case study and the results have demonstrated feasibility and practicability of the model in a real environment.

Keywords: optimization technique, quality assurance, software certification model, software assessment

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Authors: Jean Pierre Hagenimana, Paulin Ruhato Banguti, Rebecca Lynn Churchill Anderson, Jean de Dieu Tuyishime, Gaston Nyirigira, Eugene Tuyishime

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Background: Little is known regarding the effectiveness of pain protocols and guidelines used in Emergency Departments (ED) in Sub-Saharan Africa (SSA). Therefore, to shed light on this research gap, this study aimed to evaluate the quality of pain management following the implementation of both the WHO pain ladder-based trauma pain management protocol in two Rwandan teaching hospitals. Methods: This was a pre-and post-intervention study. The intervention was a 1-day acute pain course training for ED clinical staff followed by 1 week of mentorship on the use of the WHO pain ladder-based trauma pain management. Results: 261 participants were enrolled in the study (124 before the intervention and 137 after the intervention). The number of patients with undocumented pain scores decreased from 58% to 24% after the intervention (p-value > 0.001), and most patients (62%) had mild pain. In addition, patients who were satisfied with the quality of pain management increased significantly from 42% before the intervention to 80% (p-value > 0.001). Barriers were identified, however, including inadequate training and experience, shortage of staff, and patient’s reluctance to report pain. Conclusion: The implementation of the WHO pain ladder-based trauma pain management protocol significantly improved the quality of pain management in both CHUK and CHUB referral Hospital emergency departments. Despite this, some barriers remain, such as inadequate training and experience, shortage of staff, and patient’s reluctance to report pain. Appropriate interventions should be implemented to address the identified barriers and ensure adequate pain management for patients admitted at the emergency departments in referral hospitals in Rwanda.

Keywords: pain management, trauma, emergency departments, Rwanda

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Authors: Sujan Mahamud

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Purpose: A major challenge in radiotherapy treatment is to deliver precise dose of radiation to the tumor with minimum dose to the healthy normal tissues. Recently, gel dosimetry has emerged as a powerful tool to measure three-dimensional (3D) dose distribution for complex delivery verification and quality assurance. These dosimeters act both as a phantom and detector, thus confirming the versatility of dosimetry technique. The aim of the study is to know the application of Gel Dosimeters in Radiotherapy and find out the comparison with 1D and 2D dimensional dosimeters. Methods and Materials: The study is carried out from Gel Dosimeter literatures. Secondary data and images have been collected from different sources such as different guidelines, books, and internet, etc. Result: Analyzing, verifying, and comparing data from treatment planning system (TPS) is determined that gel dosimeter is a very excellent powerful tool to measure three-dimensional (3D) dose distribution. The TPS calculated data were in very good agreement with the dose distribution measured by the ferrous gel. The overall uncertainty in the ferrous-gel dose determination was considerably reduced using an optimized MRI acquisition protocol and a new MRI scanner. The method developed for comparing measuring gel data with calculated treatment plans, the gel dosimetry method, was proven to be a useful for radiation treatment planning verification. In 1D and 2D Film, the depth dose and lateral for RMSD are 1.8% and 2%, and max (Di-Dj) are 2.5% and 8%. Other side 2D+ ( 3D) Film Gel and Plan Gel for RMSDstruct and RMSDstoch are 2.3% & 3.6% and 1% & 1% and system deviation are -0.6% and 2.5%. The study is investigated that the result fined 2D+ (3D) Film Dosimeter is better than the 1D and 2D Dosimeter. Discussion: Gel Dosimeters is quality control and quality assurance tool which will used the future clinical application.

Keywords: gel dosimeters, phantom, rmsd, QC, detector

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Authors: A. Shashank Tiwari, S. P. Mahapatra

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Scale-up is defined as the process of increasing batch size. Scale-up of a process viewed as a procedure for applying the same process to different output volumes. There is a subtle difference between these two definitions: batch size enlargement does not always translate into a size increase of the processing volume. In mixing applications, scale-up is indeed concerned with increasing the linear dimensions from the laboratory to the plant size. On the other hand, processes exist (e.g., tableting) where the term ‘scale-up’ simply means enlarging the output by increasing the speed. To complete the picture, one should point out special procedures where an increase of the scale is counterproductive and ‘scale-down’ is required to improve the quality of the product. In moving from Research and Development (R&D) to production scale, it is sometimes essential to have an intermediate batch scale. This is achieved at the so-called pilot scale, which is defined as the manufacturing of drug product by a procedure fully representative of and simulating that used for full manufacturing scale. This scale also makes it possible to produce enough products for clinical testing and to manufacture samples for marketing. However, inserting an intermediate step between R&D and production scales does not, in itself, guarantee a smooth transition. A well-defined process may generate a perfect product both in the laboratory and the pilot plant and then fail quality assurance tests in production.

Keywords: scale up, research, size, batch

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Authors: Keh-Wen Carin Chuang, Kuan-Chou Chen

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Our society is in a constant state of change. Technology advancements continue to affect our daily lives. How we work, communicate and entertain ourselves has changed dramatically in the past decades. As our society learns to accept and adapt to the many different technological advances that seem to inundate every part of our lives, the education institutions must migrate from traditional methods of instruction to online education in order to take full advantage of the opportunities provided by these technology advancements. There are many benefits that can be gained for university and society from offering online programs by utilizing advanced technologies. But the programs must not be implemented carelessly. The key to providing a quality online program is the issue of perceived quality, which takes into account the viewpoint of all stakeholders involved. To truly ensure the institutional quality, however, a systemic view of all factors contributing to the quality must be analyzed and linked to one another — allowing education administrators to understand how each factor contributes to the perceived quality of online education. The perceived quality of an online program will be positively reinforced only through an organizational-wide effort that focuses on managed administration, augmenting online program branding, skilled faculty, supportive alumni, student satisfaction, and effective delivery systems — each of which is vital to a quality online program. This study focuses on the concept of quality assurance in the start-up, implementation, and sustainability of online education. A case of online MBA program will be analyzed to explore the quality assurance. The difficulties in promoting online education quality is the fact that universities are complex networks of disciplinary, social, economic, and political fiefdoms, both internal and external factors to the institutions. As such, the system analysis, a systems-thinking approach, on the issue of perceived quality is ideal to investigate the factors and how each factor contributes to the perceived quality in the online education domain.

Keywords: systems thinking, quality assurance, online education, MBA program

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Authors: Rayanne Branco Dos Santos Lima, Lorena Pinheiro Barbosa, Kamila Ferreira Lima, Victor Manuel Tegoma Ruiz, Monyka Brito Lima Dos Santos, Maria Wendiane Gueiros Gaspar, Luzia Camila Coelho Ferreira, Leandro Cardozo Dos Santos Brito, Deyse Maria Alves Rocha

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Introduction: The lack of regulation of the baby's sleep-wake pattern in the first years of life affects the health of thousands of women. Maternal sleep deprivation can trigger or aggravate psychosomatic problems such as depression, anxiety and stress that can directly influence maternal safety, with consequences for the baby's and mother's sleep. Such conditions can affect the family's quality of life and child development. Objective: To correlate maternal security with maternal state anxiety scores and the mother's and baby's total sleep time. Method: Cross-sectional study carried out with 96 mothers of babies aged 10 to 24 months, accompanied by nursing professionals linked to a Federal University in Northeast Brazil. Study variables were maternal security, maternal state anxiety scores, infant latency and sleep time, and total nocturnal sleep time of mother and infant. Maternal safety was calculated using a four-point Likert scale (1=not at all safe, 2=somewhat safe, 3=very safe, 4=completely safe). Maternal anxiety was measured by State-Trait Anxiety Inventory, state-anxiety subscale whose scores vary from 20 to 80 points, and the higher the score, the higher the anxiety levels. Scores below 33 are considered mild; from 33 to 49, moderate and above 49, high. As for the total nocturnal sleep time, values between 7-9 hours of sleep were considered adequate for mothers, and values between 9-12 hours for the baby, according to the guidelines of the National Sleep Foundation. For the sleep latency time, a time equal to or less than 20 min was considered adequate. It is noteworthy that the latency time and the time of night sleep of the mother and the baby were obtained by the mother's subjective report. To correlate the data, Spearman's correlation was used in the statistical package R version 3.6.3. Results: 96 women and babies participated, aged 22 to 38 years (mean 30.8) and 10 to 24 months (mean 14.7), respectively. The average of maternal security was 2.89 (unsafe); Mean maternal state anxiety scores were 43.75 (moderate anxiety). The babies' average sleep latency time was 39.6 min (>20 min). The mean sleep times of the mother and baby were, respectively, 6h and 42min and 8h and 19min, both less than the recommended nocturnal sleep time. Maternal security was positively correlated with maternal state anxiety scores (rh=266, p=0.009) and negatively correlated with infant sleep latency (rh= -0.30. P=0.003). Baby sleep time was positively correlated with maternal sleep time. (rh 0.46, p<0.001). Conclusion: The more secure the mothers considered themselves, the higher the anxiety scores and the shorter the baby's sleep latency. Also, the longer the baby sleeps, the longer the mother sleeps. Thus, interventions are needed to promote the quality and efficiency of sleep for both mother and baby.

Keywords: sleep, anxiety, infant, mother-child relations

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Authors: Tara Gurung, Suprina Prajapati

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Health and well being of people is a crucial for accomplishing sustainable development goals of any country. The present study focuses on quality of life of patients undergoing hemodialysis. Hemodialysis is a life sustaining treatment for patients with end stage renal disease (ESRD). Hemodialysis can bring about significant impairment in health related quality of life (HRQOL). The purpose of this study was to assess the quality of life of hemodialysis patients undergoing hemodialysis. A descriptive cross-sectional research design was utilized in total 100 samples using random sampling technique. The findings revealed that the total quality of life of the patients was 30.41±3.99 out of 100. The total physical component score was statistically significant with education status of the patients where p value for t test was 0.03 (p=0.03) and occupation of the patients where p value for the ANOVA test was 0.007 (p=0.007). The study recommended that it would be better if awareness programs regarding chronic kidney disease and life style modification in hemodialysis patients is given to the patients so that it would help patients to maintain the HRQOL.

Keywords: health and well bing, hemodialysis, patients quality of life

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Authors: Ogunlana Olarewaju Fatai, Kelani Fatai Adeshina

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The interplay of corruption and institutional quality determines how effective and efficient an economy progresses. An efficient institutional quality is a key requirement for economic stability. Institutional quality in most cases has been used interchangeably with Governance and these have given room for proxies that legitimized Governance as measures for institutional quality. A poorly-tailored institutional quality has a penalizing effect on corruption and economic growth, while defective institutional quality breeds corruption. Corruption is a hydra-headed phenomenon as it manifests in different forms. The most celebrated definition of corruption is given as “the use or abuse of public office for private benefits or gains”. It also denotes an arrangement between two mutual parties in the determination and allocation of state resources for pecuniary benefits to circumvent state efficiency. This study employed Barro (1990) type augmented model to analyze the nexus among corruption, institutional quality and economic growth in Nigeria using annual time series data, which spanned the period 1996-2019. Within the analytical framework of Johansen Cointegration technique, Error Correction Mechanism (ECM) and Granger Causality tests, findings revealed a long-run relationship between economic growth, corruption and selected measures of institutional quality. The long run results suggested that all the measures of institutional quality except voice & accountability and regulatory quality are positively disposed to economic growth. Moreover, the short-run estimation indicated a reconciliation of the divergent views on corruption which pointed at “sand the wheel” and “grease the wheel” of growth. In addition, regulatory quality and the rule of law indicated a negative influence on economic growth in Nigeria. Government effectiveness and voice & accountability, however, indicated a positive influence on economic growth. The Granger causality test results suggested a one-way causality between GDP and Corruption and also between corruption and institutional quality. Policy implications from this study pointed at checking corruption and streamlining institutional quality framework for better and sustained economic development.

Keywords: institutional quality, corruption, economic growth, public policy

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Authors: V. Ayishwarya Bharathi, S. M. Hasker, J. Indhu, M. Mohamed Azarudeen, G. Gowthami, R. Vinoth Rajan, N. Vijayarangan

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Identification of water quality conditions in a river system based on limited observations is an essential task for meeting the goals of environmental management. The traditional method of water quality testing is to collect samples manually and then send to laboratory for analysis. However, it has been unable to meet the demands of water quality monitoring today. So a set of automatic measurement and reporting system of water quality has been developed. In this project specifies Water quality parameters collected by multi-parameter water quality probe are transmitted to data processing and monitoring center through GPRS wireless communication network of mobile. The multi parameter sensor is directly placed above the water level. The monitoring center consists of GPRS and micro-controller which monitor the data. The collected data can be monitor at any instant of time. In the pollution control board they will monitor the water quality sensor data in computer using Visual Basic Software. The system collects, transmits and processes water quality parameters automatically, so production efficiency and economy benefit are improved greatly. GPRS technology can achieve well within the complex environment of poor water quality non-monitored, and more specifically applicable to the collection point, data transmission automatically generate the field of water analysis equipment data transmission and monitoring.

Keywords: multiparameter sensor, GPRS, visual basic software, RS232

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Authors: Sadaf Sahar, Usman Qamar, Sadaf Ayaz

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In the software development lifecycle, the quality prediction techniques hold a prime importance in order to minimize future design errors and expensive maintenance. There are many techniques proposed by various researchers, but with the increasing complexity of the software lifecycle model, it is crucial to develop a flexible system which can cater for the factors which in result have an impact on the quality of the end product. These factors include properties of the software development process and the product along with its operation conditions. In this paper, a neural network (perceptron) based software quality prediction technique is proposed. Using this technique, the stakeholders can predict the quality of the resulting software during the early phases of the lifecycle saving time and resources on future elimination of design errors and costly maintenance. This technique can be brought into practical use using successful training.

Keywords: software quality, fuzzy logic, perception, prediction

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Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

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In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

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Authors: Seon-Young Lee, Harkiran Sagoo, Katherine Whitehurst, Georgina Wellstead, Alexander Fowler, Riaz Agha, Dennis Orgill

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Introduction: Systematic reviews attempt to answer research questions by synthesising the data within primary papers. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research and healthcare policy. We sought to determine the reporting quality of recent systematic reviews in plastic surgery. Methods: This systematic review was conducted in line with the Cochrane handbook, reported in line with the PRISMA statement and registered at the ResearchRegistry (UIN: reviewregistry18). MEDLINE and EMBASE databases were searched in 2013 and 2014 for systematic reviews by five major plastic surgery journals. Screening, identification and data extraction was performed independently by two teams. Results: From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 out of 27 items (59.3%; range 6-26, 95% CI 14-17). Compliance between individual PRISMA items showed high variability. It was poorest for items related to the use of review protocol (item 5; 5%) and presentation of data on risk of bias of each study (item 19; 18%), while being the highest for description of rationale (item 3; 99%) and sources of funding and other support (item 27; 95%), and for structured summary in the abstract (item 2; 95%). Conclusion: The reporting quality of systematic reviews in plastic surgery requires improvement. ‘Hard-wiring’ of compliance through journal submission systems, as well as improved education, awareness and a cohesive strategy among all stakeholders is called for.

Keywords: PRISMA, reporting quality, plastic surgery, systematic review, meta-analysis

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Authors: Oktay Nusratov, Ramin Rzaev, Aydin Goyushov

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Fuzzy inference method based approach to the forming of modular intellectual system of assessment the quality of communication services is proposed. Developed under this approach the basic fuzzy estimation model takes into account the recommendations of the International Telecommunication Union in respect of the operation of packet switching networks based on IP-protocol. To implement the main features and functions of the fuzzy control system of quality telecommunication services it is used multilayer feedforward neural network.

Keywords: quality of communication, IP-telephony, fuzzy set, fuzzy implication, neural network

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Authors: Philemon Rakoto

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This paper tests the improvement of financial reporting quality when firms award stock options to their executives. The originality of this study is that we introduce the moderating effect of business ethics in the model. The sample is made up of 116 Canadian high-technology firms with available data for the fiscal year ending in 2012. We define the quality of financial reporting as the value relevance of accounting information as developed by Ohlson. Our results show that executive stock option award alone does not improve the quality of financial reporting. Rather, the quality improves when a firm awards stock options to its executives and investors perceive that the level of business ethics in that firm is high.

Keywords: business ethics, Canada, high-tech firms, stock options, value relevance

Procedia PDF Downloads 487

Authors: Sayantika Biswas, Dipanshu Sur, Amitoj Athwal, Ratnabali Chakravorty

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Title: Impact of serum estrogen and progesterone levels in the outcome pregnancy rate in frozen embryo transfer cycles. A prospective cohort study Objective: The aim of the current study was to evaluate the effect of serum estradiol (E2) and progesterone (P4) levels at different time points on pregnancy outcomes in frozen embryo transfer (FET) cycles. Materials & Method: A prospective cohort study was performed in patients undergoing frozen embryo transfer. Patients under age 37 years of age with at least one good blastocyst or three good day 3 embryos were included in the study. For endometrial preparation, 14 days of oral estradiol use (2X2 mg for 5 days. 3X2 mg for 4 days, and 4X2 mg for 5 days) was followed by vaginal progesterone twice a day and 50 mg intramuscular progesterone twice a day. Embryo transfer was scheduled 72-76 hrs or 116-120hrs after the initiation of progesterone. Serum E2 and P4 levels were examined at 4 times a) at the start of the menstrual cycle prior to the hormone supplementation. b) on the day of P4 start. c) on the day of ET. d) on the third day after ET. Result: A total 41 women were included in this study (mean age 31.8; SD 2.8). Clinical pregnancy rate was 65.55%. Serum E2 levels on at the start of the menstrual cycle prior to the hormone supplementation and on the day of P4 start were high in patients who achieved pregnancy compared to who did not (P=0.005 and P=0.019 respectively). P4 levels on on the day of ET were also high in patients with clinical pregnancy. On the day of P4 start, a serum E2 threshold of 186.4 pg/ml had a sensitivity of 82%, and P4 had a sensitivity of 71% for the prediction of clinical pregnancy at the threshold value 16.00 ng/ml. Conclusion: In women undergoing FET with hormone replacement, serum E2 level >186.4 pg/ml on the day of the start of progesterone and serum P4 levels >16.00 ng/ml on embryo transfer day are associated with clinical pregnancy.

Keywords: serum estradiol, serum progesterone, clinical pregnancy, frozen embryo transfer

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Authors: Supannee Chaiumporn

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This article is to introduce the meaning and form of social quality moving process as indicated by members of two suburb communities with different social and cultural contexts. The form of social quality moving process is very significant for the community and social development, because it will make the people living together with sustainable happiness. This is a qualitative study involving 30 key-informants from two suburb communities. Data were collected though key-informant interviews, and analyzed using logical content description and descriptive statistics. This research found that on the social quality component, the people in both communities stressed the procedure for social quality-making. This includes the generousness, sharing and assisting among people in the communities. These practices helped making people to live together with sustainable happiness. Living as a family or appear to be a family is the major social characteristic of these two communities. This research also found that form of social quality’s moving process of both communities stress relation of human and nature; “nature overpower humans” paradigm and influence of religious doctrine that emphasizes relations among humans. Both criteria make the form of social’s moving process simple, adaptive to nature and caring for opinion sharing and understanding among each other before action. This form of social quality’s moving process is composed of 4 steps; (1) awareness building, (2) motivation to change, (3) participation from every party concerned (4) self-reliance.

Keywords: social quality, form of social quality moving process, happiness, different social and cultural context

Procedia PDF Downloads 385