Search results for: quality improvement

Authors: V. I. Kozyavkin, L. F. Shestopalova, T. B. Voloshyn

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Introduction: Rehabilitation of children with Autism is the issue of the day in psychiatry and neurology. It is attributed to constantly increasing quantity of autistic children - Autistic Spectrum Disorders (ASD) Existing rehabilitation approaches in treatment of children with Autism improve their medico- social and social- psychological adjustment. Experience of treatment for different kinds of Autistic disorders in International Clinic of Rehabilitation (ICR) reveals the necessity of complex intensive approach for healing this malady and wider implementation of a Kozyavkin method for treatment of children with ASD. Methods: 19 children aged from 3 to 14 years were examined. They were diagnosed ‘Autism’ (F84.0) with comorbid neurological pathology (from pyramidal insufficiency to para- and tetraplegia). All patients underwent rehabilitation in ICR during two weeks, where INRS approach was used. INRS included methods like biomechanical correction of the spine, massage, physical therapy, joint mobilization, wax-paraffin applications. They were supplemented by art- therapy, ergotherapy, rhythmical group exercises, computer game therapy, team Olympic games and other methods for improvement of motivation and social integration of the child. Estimation of efficacy was conducted using parent’s questioning and done twice- on the onset of INRS rehabilitation course and two weeks afterward. For efficacy assessment of rehabilitation of autistic children in ICR standardized tool was used, namely Autism Treatment Evaluation Checklist (ATEC). This scale was selected because any rehabilitation approaches for the child with Autism can be assessed using it. Results: Before the onset of INRS treatment mean score according to ATEC scale was 64,75±9,23, it reveals occurrence in examined children severe communication, speech, socialization and behavioral impairments. After the end of the rehabilitation course, the mean score was 56,5±6,7, what indicates positive dynamics in comparison to the onset of rehabilitation. Generally, improvement of psychoemotional state occurred in 90% of cases. Most significant changes occurred in the scope of speech (16,5 before and 14,5 after the treatment), socialization (15.1 before and 12,5 after) and behavior (20,1 before and 17.4 after). Conclusion: As a result of INRS rehabilitation course reduction of autistic symptoms was noted. Particularly improvements in speech were observed (children began to spell out new syllables, words), there was some decrease in signs of destructiveness, quality of contact with the surrounding people improved, new skills of self-service appeared. The prospect of the study is further, according to evidence- based medicine standards, deeper examination of INRS and assessment of its usefulness in treatment for Autism and ASD.

Keywords: intensive neurophysiological rehabilitation system (INRS), international clinic od rehabilitation, ASD, rehabilitation

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Authors: Hayfa Almutary, Noof Eid Al Shammari

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Aim: The management of depression in patients undergoing hemodialysis remains challenging. The aim of this study was to evaluate the effectiveness of a breathing training program on quality of life and depression among patients on hemodialysis. Design: A one-group pretest-posttest quasi-experimental design was used. Methods: Data were collected from hemodialysis units at three dialysis centers. Initial baseline data were collected, and a breathing training program was implemented. The breathing training program included three types of breathing exercises. The impact of the intervention on outcomes was measured using both the Kidney Disease Quality of Life Short Version and the Beck Depression Inventory-Second Edition from the same participants. The participants were asked to perform the breathing training program three times a day for 30 days. Results: The mean age of the patients was 52.1 (SD:15.0), with nearly two-thirds of them being male (63.4%). Participants who were undergoing hemodialysis for 1–4 years constituted the largest number of the sample (46.3%), and 17.1% of participants had visited a psychiatric clinic 1-3 times. The results show that the breathing training program improved overall quality of life and reduced symptoms and problems. In addition, a significant decrease in the overall depression score was observed after implementing the intervention. Conclusions: The breathing training program is a non-pharmacological intervention that has proven visible effectiveness in hemodialysis. This study demonstrated that using breathing exercises reduced depression levels and improved quality of life. The integration of this intervention in dialysis units to manage psychological issues will offer a simple, safe, easy, and inexpensive intervention. Future research should compare the effectiveness of various breathing exercises in hemodialysis patients using longitudinal studies. Impact: As a safety precaution, nurses should initially use non-pharmacological interventions, such as a breathing training program, to treat depression in those undergoing hemodialysis.

Keywords: breathing training program, depression, exercise, quality of life, hemodialysis

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Authors: Umamaheswari Shanmugam, Silvia Ronchi

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that can use the large amount and variety of data generated during healthcare services every day; one of the significant advantages of these new technologies is the ability to get experience and knowledge from real-world use and to improve their performance continuously. Healthcare systems and institutions can significantly benefit because the use of advanced technologies improves the efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and protect patients' safety. The evolution and the continuous improvement of software used in healthcare must consider the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device's approval. Still, they are necessary to ensure performance, quality, and safety. At the same time, they can be a business opportunity if the manufacturer can define the appropriate regulatory strategy in advance. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems

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Authors: Abeer Amayri, Akif A. Bulgak

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Due to today’s globalization as well as outsourcing practices of the companies, the Supply Chain (SC) performances have become more dependent on the efficient movement of material among places that are geographically dispersed, where there is more chance for disruptions. One such disruption is the quality and delivery uncertainties of outsourcing. These uncertainties could lead the products to be unsafe and, as is the case in a number of recent examples, companies may have to end up in recalling their products. As a result of these problems, there is a need to develop a methodology for selecting suppliers globally in view of risks associated with low quality and late delivery. Accordingly, we developed a two-stage stochastic model that captures the risks associated with uncertainty in quality and delivery as well as a solution procedure for the model. The stochastic model developed simultaneously optimizes supplier selection and purchase quantities under price discounts over a time horizon. In particular, our target is the study of global organizations with multiple sites and multiple overseas suppliers, where the pricing is offered in suppliers’ local currencies. Our proposed methodology is applied to a case study for a US automotive company having two assembly plants and four potential global suppliers to illustrate how the proposed model works in practice.

Keywords: global supply chains, quality, stochastic programming, supplier selection

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Authors: Robert Ab Butarbutar, Sutan Musa Buyana

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Purpose: The purpose of this study is to empirically test the correlation between several variables: perceived quality, overall customer satisfaction and brand attitude to brand loyalty on Maxim magazine in Indonesia. Since the room of adult magazine in Indonesia is restricted, the study of this category has became so interesting to reveal how those variables occur. Design/ methodology/ approach: The combination of exploratory, descriptive and causal research design used in this study. Non-probability sampling, specifically purposive sampling used to determine 160 respondents. Path analysis used to examine the contribution of antecedents variables, perceived quality, overall satisfaction and brand attitude in contribution to brand loyalty. Additional respondents serve for in-depth interview to enrich findings from questionnaire that directly distributed. Findings: The research shows that perceived quality positively contribute to overall satisfaction and brand attitude. Overall satisfaction also positively influence brand attitude and brand loyalty. Finally, brand attitude directly impact to brand loyalty. Despite the hypothesis testing, qualitative research also shows specific behavior of Indonesian customer in consuming adult magazine. Research limitation/implication: This research limited to adult male (18 years at minimum) and who live in big city as Jakarta. Broader geographical coverage is advisable for further research. This study also serves a call for additional empirical research into different product category that targeted to adult male, Since the research of this segment is quite scarce. Managerial Implications: Since findings show perceived quality positively impact and strong contribute to overall satisfaction and brand attitude, it implies for adult magazine to be driven by quality of content. The selection of model, information of current lifestyle of urban male became prioritizes in developing perceived quality. Differentiation also emerges as critical issues since consumer difficult to differentiate significantly one magazine to another. The way magazine deliver its content toward distinctive communication is highly recommended. Furthermore, brand loyalty faces big challenge. Interactivity toward events and social media become critically important. Originality/ value: perceived quality plays as prerequisite to develop overall satisfaction and brand attitude. Finding shows customer difficult to differentiate among adult magazines. Therefore, brand loyalty become a big challenge for company.

Keywords: perceived quality, overall satisfaction, brand attitude, adult magazine

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Authors: Mahdi Ghasemi-Varnamkhasti, Ayat Mohammad-Razdari, Seyedeh-Hoda Yoosefian

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Taste is an important sensory property governing acceptance of products for administration through mouth. The advent of artificial sensorial systems as non-destructive tools able to mimic chemical senses such as those known as electronic tongue (ET) has open a variety of practical applications and new possibilities in many fields where the presence of taste is the phenomenon under control. In recent years, electronic tongue technology opened the possibility to exploit information on taste attributes of fruits providing real time information about quality and ripeness. Electronic tongue systems have received considerable attention in the field of sensor technology during the last two decade because of numerous applications in diverse fields of applied sciences. This paper deals with some facets of this technology in the quality monitoring of fruits along with more recent its applications.

Keywords: fruit, electronic tongue, non-destructive, taste machine, horticultural

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Authors: R. M. Kilonzo, S. Bedingfield, K. Smith, K. Hudgins Smith, K. Couper, R. Ratley, Z. Taylor, A. Engelman, M. Renne

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Introduction: The mental health needs of university students continue to evolve, necessitating a strategic approach to service delivery. The East Tennessee State University (ETSU) Counseling Center developed its inaugural Strategic Plan (2024-2028) to enhance student mental health services. The plan focuses on improving access, quality of care, and service visibility, aligning with the university’s mission to support academic success and student well-being. Aim: This strategic plan aims to establish a comprehensive framework for delivering high-quality, evidence-based mental health services to ETSU students, addressing current challenges, and anticipating future needs. Methods: The development of the strategic plan was a collaborative effort involving the Counseling Center’s leadership, staff, with technical support from Doctor of Public Health-community and behavioral health intern. Multiple workshops, online/offline reviews, and stakeholder consultations were held to ensure a robust and inclusive process. A SWOT analysis and stakeholder mapping were conducted to identify strengths, weaknesses, opportunities, and challenges. Key performance indicators (KPIs) were set to measure service utilization, satisfaction, and outcomes. Results: The plan resulted in four strategic priorities: service application, visibility/accessibility, safety and satisfaction, and training programs. Key objectives include expanding counseling services, improving service access through outreach, reducing stigma, and increasing peer support programs. The plan also focuses on continuous quality improvement through data-driven assessments and research initiatives. Immediate outcomes include expanded group therapy, enhanced staff training, and increased mental health literacy across campus. Conclusion and Recommendation: The strategic plan provides a roadmap for addressing the mental health needs of ETSU students, with a clear focus on accessibility, inclusivity, and evidence-based practices. Implementing the plan will strengthen the Counseling Center’s capacity to meet the diverse needs of the student population. To ensure sustainability, it is recommended that the center continuously assess student needs, foster partnerships with university and external stakeholders, and advocate for increased funding to expand services and staff capacity.

Keywords: strategic plan, university counseling center, mental health, students

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Authors: A. A. Hassani, M. Nasri Nasrabadi

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According to population growth and increasing water needs of industrial and agricultural sections and lack of existing water sources, also increases of wastewater and new wastewater treatment plant construction’s high costs, it is inevitable to reuse wastewater with the approach of increasing wastewater treatment capacity and output sewage quality. In this regard, the first sewage reuse plan in industrial uses was designed with the approach of qualitative and quantitative improvement due to the increased organic load of the output sewage of Qom Shokohieh city’s’ in wastewater treatment plant. This research investigated qualitative factors COD, BOD, TSS, TDS, and input and output heavy metal of MBR-RO system and ability of increase wastewater acceptance capacity by existing in wastewater treatment plant. For this purpose, experimental results of seven-month navigation system have been used from 07/01/2013 to 02/01/2014. Existing data analysis showed that MBR system is able to remove 93.2% COD, 94.4% BOD, 13.8% TDS, 98% heavy metals and RO system is able to remove 98.9% TDS. This study showed that MBR-RO integration system is able to increase the capacity of refinery by 30%.

Keywords: industrial wastewater, wastewater reuse, MBR, RO

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Authors: Romella C. Lina, Matthew Daniel V. Leysa, Zarah D. F. Libozada, Maria Francesca I. Lirio, Angelo A. Liwag, Gabriel D. Ramos, Margaret M. Natividad

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This study aimed to determine the effectiveness of Buteyko Method in asthma control and quality of life of school-age children wherein a pretest-posttest design was utilized to measure the changes after the administration of Buteyko Method. Fourteen (14) subjects with bronchial asthma, aged 7-11 participated in the study. They were equally divided into two groups: the control group received no intervention while the experimental group was asked to attend sessions of Buteyko Method lecture and demonstration. The experimental group was visited for three (3) consecutive weeks to monitor their progress and compliance. Both groups were asked to answer ACQ pre- and post-intervention and PAQLQ before the start of the intervention phase and every week during the follow-up visits. In comparing the asthma control pre-test and post-test mean scores of the control group, no significant difference was noted (p=0.177) while the experimental group showed a significant difference after the administration of Buteyko Method (p=0.002). Moreover, the quality of life pre-test and post-test mean scores of the control group showed no significant difference in any week within one month of follow-up (p=0.736, 0.604, 0.689) while the experimental group showed a significant difference on the third week (p = 0.035) and fourth week (p=0.002) but no significant difference on the second week (p=0.111). Therefore, the use of Buteyko Method within 3-4 weeks as an adjunct to conventional management of asthma helps in improving asthma control and quality of life of school-age children.

Keywords: Buteyko Method, asthma, school-age children, asthma control, quality of life

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Authors: Bartosz Osiecki, Jane Liu

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Pollutants emitted from forest fires such as PM₂.₅ and carbon monoxide (CO) have been found to impact the air quality of distant regions through long-range transport. PM₂.₅ is of particular concern due to its transport capacity and implications for human respiratory and cardiovascular health. As such, significant increases in PM₂.₅ concentrations have been exhibited in urban areas downwind of fire sources. This study seeks to expand on this literature by evaluating the impacts of long-range forest fire emission transport on air quality in Toronto, Ontario, as a means of evaluating the vulnerability of this major urban center to distant fire events. In order to draw correlations between the fire event and air pollution episode in Toronto, MODIS fire count data and HYPLSIT trajectories are used to assess the date, location, and severity of the fire and track the trajectory of emissions (respectively). Forward and back-trajectories are run, terminating at the West Toronto air monitoring station. PM₂.₅ and CO concentrations in Toronto during September 2017 are found to be significantly elevated, which is likely attributable to the fire activity. Other sites in Ontario including Toronto (East, North, Downtown), Mississauga, Brampton, and Hamilton (Downtown) exhibit similar peaks in PM₂.₅ concentrations. This work sheds light on the non-local, natural factors influencing air quality in urban areas. This is especially important in the context of climate change which is expected to exacerbate intense forest fire events in the future.

Keywords: air quality, forest fires, PM₂.₅, Toronto

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Authors: Adriana Avila Zuniga Nordfjeld

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This paper provides a literature review to document the state of the art with respect to handling 'human bias' in decision making within the established quality management systems (QMS) and LEAN theory, in the context of shipbuilding. Previous research shows that in shipbuilding there is a huge deviation from the planned man-hours under the project management to the actual man-hours used because of errors in planning and reworks caused by human bias in the information flows among others. This reduces the efficiency and increases operational costs. Thus, the research question is how QMS and LEAN handle biases. The findings show the gap in studying the integration of methods to handle human bias in decision making into QMS and lean, not only within shipbuilding but also in general. Theoretical and practical implications are discussed for researchers and practitioners in the areas of decision making QMS, LEAN, and future research is suggested.

Keywords: human bias, decision making, LEAN shipbuilding, quality management systems

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Authors: Seher Arslankaya, Bahar Uludağ

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Meeting the needs and demands of customers and pleasing the customers are important requirements for companies in food sectors where the growth of competition is significantly unpredictable. Customer satisfaction is also one of the key concepts which is mainly driven by wide range of customer preference and expectation upon products and services introduced and delivered to them. In order to meet the customer demands, the companies that engage in food sectors are expected to have a well-managed set of Total Quality Management (TQM), which sets out to improve quality of products and services; to reduce costs and to increase customer satisfaction by restructuring traditional management practices. It aims to increase customer satisfaction by meeting (their) customer expectations and requirements. The achievement would be determined with the help of customer satisfaction surveys, which is done to obtain immediate feedback and to provide quick responses. In addition, the surveys would also assist the making of strategic planning which helps to anticipate customer future needs and expectations. Meanwhile, periodic measurement of customer satisfaction would be a must because with the better understanding of customers perceptions from the surveys (done by questioners), the companies would have a clear idea to identify their own strengths and weaknesses that help the companies keep their loyal customers; to stand in comparison toward their competitors and map out their future progress and improvement. In this study, we propose a survey based on customer satisfaction measurement method and its statistical analysis for sales and logistic activities of food firms. Customer satisfaction would be discussed in details. Furthermore, after analysing the data derived from the questionnaire that applied to customers by using the SPSS software, various results obtained from the application would be presented. By also applying ANOVA test, the study would analysis the existence of meaningful differences between customer demographic proportion and their perceptions. The purpose of this study is also to find out requirements which help to remove the effects that decrease customer satisfaction and produce loyal customers in food industry. For this purpose, the customer complaints are collected. Additionally, comments and suggestions are done according to the obtained results of surveys, which would be useful for the making-process of strategic planning in food industry.

Keywords: customer satisfaction measurement and analysis, food industry, SPSS, TQM

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Authors: Eyob Seife, Molla Alemayaehu, Tesfalem Teshome, Bereket Seyoum, Behailu Getachew

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Globally, immunization averts between 2 and 3 million deaths yearly, but Vaccine-Preventable Diseases still account for more in Sub-Saharan African countries and takes the majority of under-five deaths yearly, which indicates the need for consistent and on-time information to have evidence-based decision so as to save lives of these vulnerable groups. However, ensuring data of sufficient quality and promoting an information-use culture at the point of collection remains critical and challenging, especially in remote areas where the Ararso district is selected based on a hypothesis of there is a difference in reported and recounted immunization data consistency. Data quality is dependent on different factors where organizational, behavioral, technical and contextual factors are the mentioned ones. A cross-sectional quantitative study was conducted on September 2022 in the Ararso district. The study used the world health organization (WHO) recommended data quality self-assessment (DQS) tools. Immunization tally sheets, registers and reporting documents were reviewed at 4 health facilities (1 health center and 3 health posts) of primary health care units for one fiscal year (12 months) to determine the accuracy ratio, availability and timeliness of reports. The data was collected by trained DQS assessors to explore the quality of monitoring systems at health posts, health centers, and at the district health office. A quality index (QI), availability and timeliness of reports were assessed. Accuracy ratios formulated were: the first and third doses of pentavalent vaccines, fully immunized (FI), TT2+ and the first dose of measles-containing vaccines (MCV). In this study, facility-level results showed poor timeliness at all levels and both over-reporting and under-reporting were observed at all levels when computing the accuracy ratio of registration to health post reports found at health centers for almost all antigens verified. A quality index (QI) of all facilities also showed poor results. Most of the verified immunization data accuracy ratios were found to be relatively better than that of quality index and timeliness of reports. So attention should be given to improving the capacity of staff, timeliness of reports and quality of monitoring system components, namely recording, reporting, archiving, data analysis and using information for decisions at all levels, especially in remote and areas.

Keywords: accuracy ratio, ararso district, quality of monitoring system, regular immunization program, timeliness of reports, Somali region-Ethiopia

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Authors: Lourenço José, Elsa Melo, Sandra Viera, Ana Pinheiro

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Introduction: People with stroke in Angola face challenges in accessing appropriate healthcare and rehabilitation services. There is a lack of information on the quality of care provided and the development of early intervention plans Methods: Two different methods will be chosen. The exploratory, descriptive, and longitudinal study (E1) to characterize health care for people with stroke, housed in 2 hospitals in Luanda; the quality and transverse study (E2) concerning the development and evaluation of a strategic early intervention plan for a stroke patient. Ethical and deontological principles for an investigation will be proposed. Results: Contributor to the knowledge of the reality of providing care to the person after a stroke, in Angola; Propose and develop an early action plan. Contribute to integration to influence policy makers on the need for assistance with stroke, aiming at their functional, family and social rehabilitation, particularly in the labor market.

Keywords: stroke, functional recovery, quality of life, health

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Authors: María de los Ángeles Zárate López, Juan Antonio Pitones Rubio

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Quality of life and sustainability in cities are among the most important challenges faced by designers, city planners and urban managers. The Mexican city of Tijuana has a particular dynamic in its demographics which has been accelerated by its border city condition, putting to the test the ability from authorities to provide the population with the necessary services to aspire for a deserving quality of life. In the recent story of Tijuana, we found that the housing policy and the solutions presented by private housing developers have not met the best living conditions for end users by far, thereby adding issues to current social problems which impact the whole metropolitan area, including damage to the natural environment. Therefore this research presents the case study about the situation of a suburban housing development near Tijuana named “Villa del Campo” and exposes the problems of this specific project (originally labelled as a “sustainable” proposal) demonstrating that, once built, the place does not reflect the quality of life that it promised as a project. Currently, this housing development has a number of problematic issues such as the faulty operating conditions of public utilities and serious cases of crime inside the neighborhood. There is no intention to only expose the negative side of this case study, but to explore some alternatives which could help solving the most serious problems at the place, considering possible architectural and landscape interventions within the housing complex to help achieve the optimal conditions of livability and sustainability required by their inhabitants.

Keywords: suburban, housing, quality of life, sustainability, Tijuana, demographics

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Authors: Yousif Mohamed Y. Abdallah, Eltayeb Wagallah

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Image enhancement allows the observer to see details in images that may not be immediately observable in the original image. Image enhancement is the transformation or mapping of one image to another. The enhancement of certain features in images is accompanied by undesirable effects. To achieve maximum image quality after denoising, a new, low order, local adaptive Gaussian scale mixture model and median filter were presented, which accomplishes nonlinearities from scattering a new nonlinear approach for contrast enhancement of bones in bone scan images using both gamma correction and negative transform methods. The usual assumption of a distribution of gamma and Poisson statistics only lead to overestimation of the noise variance in regions of low intensity but to underestimation in regions of high intensity and therefore to non-optional results. The contrast enhancement results were obtained and evaluated using MatLab program in nuclear medicine images of the bones. The optimal number of bins, in particular the number of gray-levels, is chosen automatically using entropy and average distance between the histogram of the original gray-level distribution and the contrast enhancement function’s curve.

Keywords: bone scan, nuclear medicine, Matlab, image processing technique

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Authors: Napasri Suwanajote

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The purposes of this research were to analyse and evaluate successful factors in OTOP production process for the developing of learning centre on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The research has been designed as a qualitative study to gather information from 30 OTOP producers in Bangkontee District, Samudsongkram Province. They were all interviewed on 3 main parts. Part 1 was about the production process including 1) production 2) product development 3) the community strength 4) marketing possibility and 5) product quality. Part 2 evaluated appropriate successful factors including 1) the analysis of the successful factors 2) evaluate the strategy based on Sufficiency Economic Philosophy and 3) the model of learning centre on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality. The results showed that the production did not affect the environment with potential in continuing standard quality production. They used the raw materials in the country. On the aspect of product and community strength in the past 1 year, it was found that there was no appropriate packaging showing product identity according to global market standard. They needed the training on packaging especially for food and drink products. On the aspect of product quality and product specification, it was found that the products were certified by the local OTOP standard. There should be a responsible organization to help the uncertified producers pass the standard. However, there was a problem on food contamination which was hazardous to the consumers. The producers should cooperate with the government sector or educational institutes involving with food processing to reach FDA standard. The results from small group discussion showed that the community expected high education and better standard living. Some problems reported by the community included informal debt and drugs in the community. There were 8 steps in developing the model of learning centre on OTOP production process based on Sufficiency Economic Philosophy for sustainable life quality.

Keywords: production process, OTOP, sufficiency economic philosophy, marketing management

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Authors: Preecha Phongpeng

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The objectives of this research are to assess the prevalence of travel businesses websites in Thailand, investigate and evaluate the quality of travel business websites in Thailand. The sample size includes 323 websites from the population of 1,458 websites. The study covers 4 types of travel business websites including: 78 general travel agents, 30 online reservation travel agents, 205 hotels, 7 airlines, and 3 car-rental companies with nation-wide operation. The findings indicated that e-tourism in Thailand is at its growth stage, with only 13% of travel businesses having websites, 28% of them providing e-mail and the quality of travel business websites in Thailand was at the average level. Seven common problems were found in websites: lack of travel essential information, insufficient transportation information, lack of navigation tools, lack of link pages to other organizations, lack of safety features, unclear online booking functions, and lack of special features also as well.

Keywords: traveling business, website evaluation, e-commerce, e-tourism

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Authors: Kristine Kalnica-Dorosenko, Aiga Svede

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Amblyopia or 'lazy eye' is impaired or dim vision without obvious defect or change in the eye. It is often associated with abnormal visual experience, most commonly strabismus, anisometropia or both, and form deprivation. The main task of amblyopia treatment is to ameliorate etiological factors to create a clear retinal image and, to ensure the participation of the amblyopic eye in the visual process. The treatment of amblyopia and eccentric fixation is usually associated with problems in the therapy. Eccentric fixation is present in around 44% of all patients with amblyopia and in 30% of patients with strabismic amblyopia. In Latvia, amblyopia is carefully treated in various clinics, but eccentricity diagnosis is relatively rare. Conflict which has developed relating to the relationship between the visual disorder and the degree of eccentric fixation in amblyopia should to be rethoughted, because it has an important bearing on the cause and treatment of amblyopia, and the role of the eccentric fixation in this case. Visuoscopy is the most frequently used method for determination of eccentric fixation. With traditional visuoscopy, a fixation target is projected onto the patient retina, and the examiner asks to look straight directly at the center of the target. An optometrist then observes the point on the macula used for fixation. This objective test provides clinicians with direct observation of the fixation point of the eye. It requires patients to voluntarily fixate the target and assumes the foveal reflex accurately demarcates the center of the foveal pit. In the end, by having a very simple method to evaluate fixation, it is possible to indirectly evaluate treatment improvement, as eccentric fixation is always associated with reduced visual acuity. So, one may expect that if eccentric fixation in amlyopic eye is found with visuoscopy, then visual acuity should be less than 1.0 (in decimal units). With occlusion or another amblyopia therapy, one would expect both visual acuity and fixation to improve simultaneously, that is fixation would become more central. Consequently, improvement in fixation pattern by treatment is an indirect measurement of improvement of visual acuity. Evaluation of eccentric fixation in the child may be helpful in identifying amblyopia in children prior to measurement of visual acuity. This is very important because the earlier amblyopia is diagnosed – the better the chance of improving visual acuity.

Keywords: amblyopia, eccentric fixation, visual acuity, visuoscopy

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Authors: Megan Weisbart

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Background/Significance: The Intensive Care Unit (ICU) environment contributes to nurse burnout. Burnout costs include decreased employee compassion, missed workdays, worse patient outcomes, diminished job performance, high turnover, and higher organizational cost. Meaningful recognition, nurturing of interpersonal connections, and mindfulness-based interventions are associated with decreased burnout. The purpose of this quality improvement project was to decrease Neonatal ICU (NICU) nurse burnout using a Wellness Bundle that fosters meaningful recognition, interpersonal connections and includes mindfulness-based interventions. Methods: The Professional Quality of Life Scale Version 5 (ProQOL5) was used to measure burnout before Wellness Bundle implementation, after six months, and will be given yearly for three years. Meaningful recognition bundle items include Online submission and posting of staff shoutouts, recognition events, Nurses Week and Unit Practice Council member gifts, and an employee recognition program. Fostering of interpersonal connections bundle items include: Monthly staff games with prizes, social events, raffle fundraisers, unit blog, unit wellness basket, and a wellness resource sheet. Quick coherence techniques were implemented at staff meetings and huddles as a mindfulness-based intervention. Findings: The mean baseline burnout score of 14 NICU nurses was 20.71 (low burnout). The baseline range was 13-28, with 11 nurses experiencing low burnout, three nurses experiencing moderate burnout, and zero nurses experiencing high burnout. After six months of the Wellness Bundle Implementation, the mean burnout score of 39 NICU nurses was 22.28 (low burnout). The range was 14-31, with 22 nurses experiencing low burnout, 17 nurses experiencing moderate burnout, and zero nurses experiencing high burnout. Conclusion: A NICU Wellness Bundle that incorporated meaningful recognition, fostering of interpersonal connections, and mindfulness-based activities was implemented to improve work environments and decrease nurse burnout. Participation bias and low baseline response rate may have affected the reliability of the data and necessitate another comparative measure of burnout in one year.

Keywords: burnout, NICU, nurse, wellness

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Authors: Harshkumar K. Desai, Anuj K. Desai, Jay P. Patel, Snehal V. Trivedi, Yogendrasinh Parmar

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The need of continuous improvement in a product or process in this era of global competition leads to apply value engineering for functional and aesthetic improvement in consideration with economic aspect too. Solar industries located at G.I.D.C., Makarpura, Vadodara, Gujarat, India; a manufacturer of variety of CNC Machines had a challenge to analyze the structural design of column, base, carriage and table of CNC Milling Machine in the account of reduction of overall weight of a machine without affecting the rigidity and accuracy at the time of operation. The identified task is the first attempt to validate and optimize the proposed design of ribbed structure statically using advanced modeling and analysis tools in a systematic way. Results of stress and deformation obtained using analysis software are validated with theoretical analysis and found quite satisfactory. Such optimized results offer a weight reduction of the final assembly which is desired by manufacturers in favor of reduction of material cost, processing cost and handling cost finally.

Keywords: CNC milling machine, optimization, finite element analysis (FEA), weight reduction

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Authors: Hugo d’Albert, Udo Lindemann

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The number of automotive electronic systems that allow realizing new functions, like driver assistance systems, has been increasing extremely in the last decade. Although they bring several benefits, their malfunctions can lead to severe consequences, such as personal injury of road users. Functional safety is an approach to identify these critical malfunctions and arrange technical systems that include only tolerable risk. This approach is– in comparison with other technical areas– relatively new in the automotive sector. For a long time, the automotive systems have based on mechanical components and approved principles, like robust design. With a growing number of electric and electronic components in the modern cars and realizing by software of the system functions, the need for new standards and methods to assure the functional safety has arisen. This paper described the current state of engineering for safety in automotive sector and discusses new directions to meet the challenges of the future.

Keywords: automotive systems, functional safety, quality engineering, quality management

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Authors: Umang H. Gajjar, K. M. Khambholja, R. K. Patel

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Semecarpus anacardium shows the presence of bioflavonoids, phenolic compounds, bhilawanols, minerals, vitamins and amino acids. Detoxified S. anacardium and its oils are considered to have anti-inflammatory properties and used in nervous debility, neuritis, rheumatism and leprous modules. S. anacardium if used without purification causes toxic skin inflammation problem because it contains toxic phenolic oil. During this Shodhana Process - An ayurvedic purification method, toxic phenolic oil was removed, have marked effect on the concentration of the phytoconstituent & antioxidant activity of S. anacardium. Total phenolic content decreased up to 70 % (from 28.9 %w/w to 8.94 %w/w), while there is a negligible effect on the concentration of total flavonoid (7.51 %w/w to 7.43 %w/w) and total carbohydrate (0.907 %w/w to 0.853 % w/w) content. IC50& EC50 value of extract of S. anacardium before and after purification are 171.7 & 314.3 while EC50values are 280.μg/ml & 304. μg/ml, shows that antioxidant activity of S. anacardium is decreased but the safety profile of the drug is increased as the toxic phenolic oil was removed during Shodhana - An ayurvedic purification method.

Keywords: Semecarpus anacardium, Shodhana process, safety profile, improvement

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Authors: Vita Lele, Vadims Bartkevics, Iveta Pugajeva, Paulina Zavistanaviciute, Daiva Zadeike, Grazina Juodeikiene, Elena Bartkiene

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Different combinations of appropriate technological properties showing lactic acid bacteria (Pediococcus pentosaceus VLGL183 and Enterococcus pseudoavium VLGL 234, Lactobacillus plantarum VLGL135 and Pediococcus pentosaceus VLGL183, Pediococcus pentosaceus VLGL183 and Lactobacillus brevis VLGL173, Pediococcus pentosaceus VLGL183 and Leuconostoc mesenteroides VLGL242, Pediococcus pentosaceus VLGL183 and Lactobacillus curvatus VLGL51, Lactobacillus plantarum VLGL135 and Lactobacillus curvatus VLGL51) for wheat sourdough production were used, and the influence of different sourdoughs on wheat bread quality parameters was evaluated. The highest overall acceptability (135.8 mm in 140 mm hedonic scale) of the bread produced with L. plantarum VLGL135 and P. pentosaceus VLGL183 sourdough was established. Also, bread produced with above mention sourdough, has the highest specific volume, shape coefficient, moisture content, and porosity, 3.40 ml /g; 2.59, 33.7 %, and 76.6 %, respectively. It was found, that the used sourdoughs reduce acrylamide content in bread (from 29.5 to 67.2%), just, the isolated lactic acid bacteria strains could be recommended for higher quality and safer bread production.

Keywords: acrylamide, lactic acid bacteria, quality, sourdough, wheat bread

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Authors: Lutaf Ali, Haris Ahmed, Hina Najmi

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Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.

Keywords: access, family planning, underserved population, socio-demographic facts

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Authors: Uwalomwa Uwuigbe, Olubukola Ranti Uwuigbe, Jinadu Olugbenga, Otekunrin Adegbola

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Corporate reporting has evolved over the years resulting from criticisms of the precedent by shareholders, stakeholders and other relevant financial institutions. Integrated reporting has become a globalized corporate reporting style, with its adoption around the world occurring rapidly to bring about an improvement in the quality of corporate reporting. While some countries have swiftly clinched into reporting in an integrated manner, others have not. In addition, there are ample research that has been conducted on the benefits of adopting integrated reporting, however, the same is not true in developing economies like Nigeria. Hence, this study basically examined the factors determining the adoption of integrated reporting in Nigeria. One hundred (100) copies of questionnaire was administered to financial managers of 20 selected listed companies in the Nigeria stock exchange market. The data obtained was analysed using the Spearman Rank Order Correlation via the Statistical Package for Social Science. This study observed that there is a significant relationship between the social pressures of isomorphic changes and integrated reporting adoption in Nigeria. The study recommends the need for an enforcement mechanism to be put in place while considering the adoption of integrated reporting in Nigeria, enforcement mechanisms should put into consideration the investors demand, the level of economic development, and the degree of corporate social responsibility.

Keywords: corporate social responsibility, isomorphic, integrated reporting, Nigeria, sustainability

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Authors: M. O. Eyankware, D. O. Ufomata

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Groundwater samples were collected from Otovwodo-Ughelli and Environ with the aim of assessing groundwater quality of the area. Twenty (20) water samples from Boreholes (BH) (six) and Hand Dug Wells (HDW) (fourteen) were randomly sampled and were analysed for different physiochemical and bacteriological parameters. The following 16 parameters have been considered viz: pH, electrical conductivity, temperature, total hardness, total dissolved solids, dissolved oxygen, biological oxygen demand, phosphate, sulphate, chloride, nitrate, calcium, sodium, chloride, magnesium, and total suspended solids. On comparing the results against drinking quality standards laid by World Health Organization and Nigeria industrial standard, it was found that the water quality parameters were not above the (WHO, 2011 and NIS, 2007) permissible limit. Microbial analysis reveals the presence of coliform and E.coli in two hand-dug well (HDW7 and 13) and one borehole well (BH20). These contaminations are perhaps traceable to have originated from human activities (septic tanks, latrines, dumpsites) and have affected the quality of groundwater in Otovwodo-Ughelli. From the piper trilinear diagram, the dominant ionic species is alkali bicarbonate water type, with bicarbonate as the predominant ion (Na+ + K+)-HCO3.

Keywords: groundwater, surface water, Ughelli, Nigeria industrial standard, who standard

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Authors: Jim Shih-Chiao Chin , Tsai Lin Hsu, Shui Lien Chen

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This article extends the relation between company’s employee and customers in market. According to the previous researches, most researchers analyzed and focused on customers’ brand perception. In the recently, some scholars star to explore the brand management from company viewpoint. The aim of this study is to explore whether consumers perception would be affected by the firm brand. This research would like to examine the relationship between individual consumers and corporate brands in the business-to-consumers sector. First, the study develops a framework that the connection with consumer and company. Second, this article uses three dimensions, brand knowledge, brand commitment, and brand equity to measure employees’ loyalty of brand and applies brand relationship quality to gauge the level of brand’s importance in consumer’s mind. This paper uses SPSS 20.0 and AMOS 20.0 to test consumers’ minds toward the brand equity which the company provides. There are totally 862 valid questionnaires returned, and 431 participants are consumers; the other 431 participants are employees. Those questionnaires are one-by-one to consumer and employee so those are 431 pairs questionnaires. Based on 431 pairs of consumers and company’s employees, analyzed results show that brand knowledge and brand commitment play important roles influencing brand equity. The results also demonstrate the extra-role brand equity positively impact on the brand relationship quality of consumers. In addition, the findings reveal that the company can improve brand relationship quality of consumers by enhancing extra-role brand equity. There is a sufficient evidence denote that brand relationship quality not only shows about the brand of customers’ thought but also implies company how to build the brand to impress on consumers. These findings provide the degree of the brand in consumers’ cognition. The brand-owner employee can reference the conclusion to creative new strategic to the next time or can be one of the company’s competitive advantages. Those results and conclusions are contributed to management practice and future.

Keywords: brand knowledge, brand commitment, brand equity, brand relationship quality

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Authors: Harith Mohammed Benbouali

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The concept of sustainable development is becoming increasingly important in our society. The efforts of specialized agencies, cleverly portrayed in the media, allow a widespread environmental awareness. Far from the old environmental movement in the backward-looking nostalgia, the environment is combined with today's progress. Many areas now include these concerns in their efforts, this in order to try to reduce the negative impact of human activities on the environment. The quantitative dimension of development has given way to the quality aspect. However, this feature is not common, and the initial target was abandoned in favor of economic considerations. Specialists in the field of building and construction have constantly sought to further integrate the environmental dimension, creating a seal of high environmental quality buildings. The pursuit of well-being of neighborhood residents and the quality of buildings are also a hot topic in planning. Quality of life is considered so on, since financial concerns dominate to the detriment of the environment and the welfare of the occupants. This work concerns the development of an analytical method based on multiple indicators of objectives across the district. The quantification of indicators related to objectives allows the construction professional, the developer or the community, to quantify and compare different alternatives for development of a neighborhood. This quantification is based on the use of simulation tools and a multi-criteria aggregation.

Keywords: sustainable development, environment, district, indicators, multi-criteria analysis, evaluation

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Authors: Erin C. Rodenburg, Jennifer McWhirter, Andrew Papadopoulos

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Support workers for adults with developmental disabilities promote the care and wellbeing of a historically underserved population. Poor employment training and low work satisfaction for these disability support workers are linked to low productivity, poor quality of care, turnover, and intention to leave employment. Therefore, to improve the lives of those within disability support homes, both client and caregiver, it is vital to determine where improvements to training and support for those providing direct care can be made. The current study aims to explore disability support worker’s perceptions of the training received in their employment at the residential homes, how it prepared them for their role, and where there is room for improvement with the aim of developing recommendations for an improved training experience. Responses were collected from 85 disability support workers across 40 Ontario group homes. Findings suggest most disability support workers within the 40 support homes feel adequately trained in their responsibilities of employment. For those who did not feel adequately trained, the main issues expressed were a lack of standardization in training, a need for more continuous training, and a move away from trial and error in performing tasks to support clients with developmental disabilities.

Keywords: developmental disabilities, disability workers, support homes, training

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