Search results for: quality care

Authors: Tareq Al Muhareb, Jasper Graham-Jones

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The service quality is a significant element in aviation industry especially in the international airports. Through this paper, the researchers built a model based on Lean six sigma methodologies and applied it in the departure area at KKIA (King Khalid International Airport) in order to assess it. This model characterized with many special features that can become over the cultural differences in aviation industry since it is considered the most critical circumstance in this field. Applying the model of this study is depending on following the DMAIC procedure systemized in lean thinking aspects. This model of Lean-six-sigma as a managerial procedure is mostly focused on the change management culture that requires high level of planning, organizing, modifying, and controlling in order to benefit from strengths as well as revoke weaknesses.

Keywords: lean-six-sigma, service quality, aviation industry, KKIA (King Khalid International Airport), SERVQUAL

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Authors: Desiree Vandenberghe, Johan Albrecht

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Non-communicable diseases (NCDs) are responsible for the vast majority of deaths in the European Union (EU) and represent a large share of total health care spending. A future increase in this health and financial burden is likely to be driven by population ageing, lifestyle changes and technological advances in medicine. Without adequate prevention measures, this burden can severely threaten population health and economic development. To tackle this challenge, a correct assessment of the current burden of NCDs is required, as well as a projection of potential increases of this burden. The contribution of this paper is to offer perspective on the evolution of the NCD burden towards the future and to give an indication of the potential of prevention policy. A Non-Homogenous, Semi-Markov model for the EU was constructed, which allowed for a projection of the cost burden for the four main NCDs (cancer, cardiovascular disease, chronic respiratory disease and diabetes mellitus) towards 2030 and 2050. This simulation is done based on multiple baseline scenarios that vary in demand and supply factors such as health status, population structure, and technological advances. Finally, in order to assess the potential of preventive measures to curb the cost explosion of NCDs, a simulation is executed which includes increased efforts for preventive health care measures. According to the Markov model, by 2030 and 2050, total costs (direct and indirect costs) in the EU could increase by 30.1% and 44.1% respectively, compared to 2015 levels. An ambitious prevention policy framework for NCDs will be required if the EU wants to meet this challenge of rising costs. To conclude, significant cost increases due to Non-Communicable Diseases are likely to occur due to demographic and lifestyle changes. Nevertheless, an ambitious prevention program throughout the EU can aid in making this cost burden manageable for future generations.

Keywords: non-communicable diseases, preventive health care, health policy, Markov model, scenario analysis

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Authors: Marie Bieber, Fabrice Cosson, Olivier Schmitt

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Europe's Global Navigation Satellite System, Galileo, provides worldwide positioning and navigation services. The satellites in space are only one part of the Galileo system. An extensive ground infrastructure is essential to oversee the satellites and ensure accurate navigation signals. High reliability and availability of the entire Galileo system are crucial to continuously provide positioning information of high quality to users. Outages are tracked, and operational availability is regularly assessed. A highly flexible and adaptive tool has been developed to automate the Galileo system availability analysis. Not only does it enable a quick availability consolidation, but it also provides first steps towards improving the data quality of maintenance tickets used for the analysis. This includes data import and data preparation, with a focus on processing strings used for classification and identifying faulty data. Furthermore, the tool allows to handle a low amount of data, which is a major constraint when the aim is to provide accurate statistics.

Keywords: availability, data quality, system performance, Galileo, aerospace

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Authors: N. C. Ghosh, Niladri Das, Prolay Mondal, Ranajit Ghosh

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Groundwater quality deterioration due to human activities has become a prime factor of modern life. The major concern of the study is to access spatial variation of groundwater quality and to identify the sources of groundwater chemicals and its impact on human health of the concerned area. Multivariate statistical techniques, cluster, principal component analysis, and hydrochemical fancies are been applied to measure groundwater quality data on 14 parameters from 107 sites distributed randomly throughout the Birbhum district. Five factors have been extracted using Varimax rotation with Kaiser Normalization. The first factor explains 27.61% of the total variance where high positive loading have been concentrated in TH, Ca, Mg, Cl and F (Fluoride). In the studied region, due to the presence of basaltic Rajmahal trap fluoride contamination is highly concentrated and that has an adverse impact on human health such as fluorosis. The second factor explains 24.41% of the total variance which includes Na, HCO₃, EC, and SO₄. The last factor or the fifth factor explains 8.85% of the total variance, and it includes pH which maintains the acidic and alkaline character of the groundwater. Hierarchical cluster analysis (HCA) grouped the 107 sampling station into two clusters. One cluster having high pollution and another cluster having less pollution. Moreover hydromorphological facies viz. Wilcox diagram, Doneen’s chart, and USSL diagram reveal the quality of the groundwater like the suitability of the groundwater for irrigation or water used for drinking purpose like permeability index of the groundwater, quality assessment of groundwater for irrigation. Gibb’s diagram depicts that the major portion of the groundwater of this region is rock dominated origin, as the western part of the region characterized by the Jharkhand plateau fringe comprises basalt, gneiss, granite rocks.

Keywords: correlation, factor analysis, hydrological facies, hydrochemistry

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Authors: Galih Imaduddin

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Knowledge has been viewed as one of the most important resources in organizations, including those that operate in the healthcare sector. On that basis, Knowledge Management (KM) is crucial for healthcare organizations to improve their productivity and ensure effective utilization of their resources. Despite the growing interests to understand how KM might work for healthcare organizations, there is only a modest amount of empirical inquiries which have specifically focused on the tools and initiatives to share knowledge. Hence, the main purpose of this paper is to investigate the way healthcare organizations, particularly public sector ones, utilize knowledge sharing tools and initiatives for the benefit of patient-care. Employing a qualitative method, 13 (thirteen) Community Health Centers (CHCs) from a high-performing district health setting in Indonesia were observed. Data collection and analysis involved a repetition of document retrievals and interviews (n=41) with multidisciplinary health professionals who work in these CHCs. A single case study was cultivated reflecting on the means that were used to share knowledge, along with the factors that inhibited the exchange of knowledge among those health professionals. The study discovers that all of the thirteen CHCs exhibited and applied knowledge sharing means which included knowledge documents, virtual communication channels (i.e. emails and chatting applications), and social learning forums such as staff meetings, morning briefings, and communities of practices. However, the intensity of utilization was different among these CHCs, in which organizational culture, leadership, professional boundaries, and employees’ technological aptitude were presumed to be the factors that inhibit knowledge sharing processes. Making a distance with the KM literature of other sectors, this study denounces the primacy of technology-based tools, suggesting that socially-based initiatives could be more reliable for sharing knowledge. This suggestion is largely due to the nature of healthcare work which is still predominantly based on the tacit form of knowledge.

Keywords: knowledge management, knowledge sharing, knowledge sharing tools and initiatives, knowledge sharing inhibitors, primary health care organizations

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Authors: Men An Pan, Hong Ren Chen, Chih Heng Shih, Hsing Yuan Yen

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Pingtung County is located in the southernmost region of Taiwan. During the winter season, pollutants due to insufficient dispersion caused by the downwash of the northeast monsoon lead to the poor air quality of the County. Through the implementation of various control methods, including the application of permits of air pollution, fee collection of air pollution, control oil fume of catering sectors, smoke detection of diesel vehicles, regular inspection of locomotives, and subsidies for low-polluting vehicles. Moreover, to further mitigate the air pollution, additional alternative controlling strategies are also carried out, such as construction site control, prohibition of open-air agricultural waste burning, improvement of river dust, and strengthening of road cleaning operations. The combined efforts have significantly reduced air pollutants in the County. However, in order to effectively and promptly monitor the ambient air quality, the County has subsequently deployed micro-sensors, with a total of 400 IoTs (Internet of Things) micro-sensors for PM2.5 and VOC detection and 3 air quality monitoring stations of the Environmental Protection Agency (EPA), covering 33 townships of the County. The covered area has more than 1,300 listed factories and 5 major industrial parks; thus forming an Internet of Things (IoTs) based multi-level air quality monitoring system. The results demonstrate that the IoTs multi-level air quality sensors combined with other strategies such as “sand and gravel dredging area technology monitoring”, “banning open burning”, “intelligent management of construction sites”, “real-time notification of activation response”, “nighthawk early bird plan with micro-sensors”, “unmanned aircraft (UAV) combined with land and air to monitor abnormal emissions”, and “animal husbandry odour detection service” etc. The satisfaction improvement rate of air control, through a 2021 public survey, reached a high percentage of 81%, an increase of 46% as compared to 2018. For the air pollution complaints for the whole year of 2021, the total number was 4213 in contrast to 7088 in 2020, a reduction rate reached almost 41%. Because of the spatial-temporal features of the air quality monitoring IoTs system by the application of microsensors, the system does assist and strengthen the effectiveness of the existing air quality monitoring network of the EPA and can provide real-time control of the air quality. Therefore, the hot spots and potential pollution locations can be timely determined for law enforcement. Hence, remarkable results were obtained for the two years. That is, both reduction of public complaints and better air quality are successfully achieved through the implementation of the present IoTs system for real-time air quality monitoring throughout Pingtung County.

Keywords: IoT, PM, air quality sensor, air pollution, environmental monitoring

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Authors: Shahna K. C., Belay Menon, Taniya Joshua

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As globalization in the era progresses, spatial inequality is turned to be one of the major concerns; the main intent of the Study is to focus on if there is any interdependencies of culture economy and resource availability on creating spatial inequality in cities. The paper tries to establish the relationship between spatial inequality – the quality of life – the DETERMINANT TRIAD (culture, economy, resource availability). Slum area of Dharavi is taken to evaluate the influence of these determinants on the quality of life as spatial inequality is evident there. Interdependencies of the determinants on creating spatial inequality is evaluated. For this, It is understood that these three parameters, i.e., culture, economy, resource availability, are determinants of urban design, each from the social, economic, environmental domains of sustainability, respectively. And there are studies individually on each of these aspects, how they determine the urban spaces, and how influential on the whole process of urbanization. Now extending the study towards the interdependencies of these three so as to find out how these trilogy shapes the urban form and space.

Keywords: spatial inequality, culture, economy, resource availability, quality of life

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Authors: Ainura Tursunalieva, Irene Hudson

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Continuous improvement of both the quality and safety of health care is an important goal in Australia and internationally. The intensive care unit (ICU) receives patients with a wide variety of and severity of illnesses. Accurately identifying patients at risk of developing complications or dying is crucial to increasing healthcare efficiency. Thus, it is essential for clinicians and researchers to have a robust framework capable of evaluating the risk profile of a patient. ICU scoring systems provide such a framework. The Acute Physiology and Chronic Health Evaluation III and the Simplified Acute Physiology Score II are ICU scoring systems frequently used for assessing the severity of acute illness. These scoring systems collect multiple risk factors for each patient including physiological measurements then render the assessment outcomes of individual risk factors into a single numerical value. A higher score is related to a more severe patient condition. Furthermore, the Mortality Probability Model II uses logistic regression based on independent risk factors to predict a patient’s probability of mortality. An important overlooked limitation of SAPS II and MPM II is that they do not, to date, include interaction terms between a patient’s vital signs. This is a prominent oversight as it is likely there is an interplay among vital signs. The co-existence of certain conditions may pose a greater health risk than when these conditions exist independently. One barrier to including such interaction terms in predictive models is the dimensionality issue as it becomes difficult to use variable selection. We propose an innovative scoring system which takes into account a dependence structure among patient’s vital signs, such as systolic and diastolic blood pressures, heart rate, pulse interval, and peripheral oxygen saturation. Copulas will capture the dependence among normally distributed and skewed variables as some of the vital sign distributions are skewed. The estimated dependence parameter will then be incorporated into the traditional scoring systems to adjust the points allocated for the individual vital sign measurements. The same dependence parameter will also be used to create an alternative copula-based model for predicting a patient’s probability of mortality. The new copula-based approach will accommodate not only a patient’s trajectories of vital signs but also the joint dependence probabilities among the vital signs. We hypothesise that this approach will produce more stable assessments and lead to more time efficient and accurate predictions. We will use two data sets: (1) 250 ICU patients admitted once to the Chui Regional Hospital (Kyrgyzstan) and (2) 37 ICU patients’ agitation-sedation profiles collected by the Hunter Medical Research Institute (Australia). Both the traditional scoring approach and our copula-based approach will be evaluated using the Brier score to indicate overall model performance, the concordance (or c) statistic to indicate the discriminative ability (or area under the receiver operating characteristic (ROC) curve), and goodness-of-fit statistics for calibration. We will also report discrimination and calibration values and establish visualization of the copulas and high dimensional regions of risk interrelating two or three vital signs in so-called higher dimensional ROCs.

Keywords: copula, intensive unit scoring system, ROC curves, vital sign dependence

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Authors: Ajay Kumar Sarathe, Abhinay Kumar

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Production of quality products required for specific engineering applications is an important issue. The roughness of the surface plays an important role in the quality of the product by using appropriate machining parameters to eliminate wastage due to over machining. To increase the quality of the surface, the optimum machining parameter setting is crucial during the machining operation. The effect of key machining parameters- spindle speed, feed rate, and depth of cut on surface roughness has been evaluated. Experimental work was carried out using High Speed Steel tool and AlSI 1018 as workpiece material. In this study, the predictive model has been developed using Box-Behnken Design. An experimental investigation has been carried out for this work using BBD for three factors and observed that the predictive model of Ra value is closed to predictive value with a marginal error of 2.8648 %. Developed model establishes a correlation between selected key machining parameters that influence the surface roughness in a AISI 1018. F

Keywords: ANOVA, BBD, optimisation, response surface methodology

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Authors: Luisa Unda, Kamran Ahmed, Paul Mather

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We examine the effect of board characteristics on the performance and asset quality of credit unions in Australia, using a large sample covering the period 2004-2012. Credit unions are unique in that they are customer-owned financial institutions and directors are democratically elected by members, which is distinctly different from other financial institutions, such as commercial banks. We find that board remuneration, board expertise, and attendance at board meetings have significantly positive impacts on credit union performance and asset quality, while board members who hold multiple directorships (busy directors), have a significant negative impact on credit union performance. Financial performance also improves with larger boards and long-tenured directors in credit unions. All of these relations hold after we control for alternative measures of performance, credit union characteristics and endogeneity problem.

Keywords: credit unions, corporate governance, board of directors, financial performance, Australia, asset quality

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Authors: Lei Liu

Abstract:

Since the famous opening up and reform strategy of China, lots of migrants have flowed from rural areas to urban areas. In this paper, the author investigates the rural elderly left behind, which are defined aged people left alone at home while their adult children have to migrant outside. This phenomenon is a quite general and serious social problem that cannot be ignored, accompanied by the process of urbanization and regional transferring of rural labor. The Chinese internal migration not only exerts great influence to China’s economy and urbanization but also obviously reduces the labor and care to rural aged people. Contrary to assumptions in some migration and aging studies, which show the inevitable negative effects of migration upon the old age care, the author highlights unique features in their daily strategies of house holding to integrate into society with the analysis of the conception of social inclusion. Through life history interviews with elderly left behind in one rural village, this article sheds light on three different factors of social inclusion, namely, economic inclusion, social identity and political inclusion and shows its necessaries to fully understand the status of the social wellbeing of rural elderly left behind.

Keywords: labor migration, elderly left behind, social inclusion, rural China

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Authors: P. Venu, Joeju M. Issac

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Quality Function Deployment (QFD) is a systematic technique that creates a platform where the customer responses can be positively converted to design attributes. The accuracy of a QFD process heavily depends on the data that it is handling which is captured from customers or QFD team members. Customized computer programs that perform Quality Function Deployment within a stipulated time have been used by various companies across the globe. These programs heavily rely on storage and retrieval of the data on a common database. This database must act as a perfect source with minimum missing values or error values in order perform actual prioritization. This paper introduces a missing/error data handler module which uses Genetic Algorithm and Fuzzy numbers. The prioritization of customer requirements of sesame oil is illustrated and a comparison is made between proposed data handler module-based deployment and manual deployment.

Keywords: hybrid data handler, QFD, prioritization, module-based deployment

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Authors: Tahereh Talebi, Reza Ghomashchi, Pejman Talemi, Sima Aminorroaya

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A high quality crack-free film of Bi₂Te₃ material has been deposited for the first time using electrophoretic deposition (EPD) and microstructures of various films have been investigated. One of the most important thermoelectric (TE) applications is Bi₂Te₃ to manufacture TE generators (TEG) which can convert waste heat into electricity targeting the global warming issue. However, the high cost of the manufacturing process of TEGs keeps them expensive and out of reach for commercialization. Therefore, utilizing EPD as a simple and cost-effective method will open new opportunities for TEG’s commercialization. This method has been recently used for advanced materials such as microelectronics and has attracted a lot of attention from both scientists and industry. In this study, the effect of media of suspensions has been investigated on the quality of the deposited films as well as their microstructure. In summary, finding an appropriate suspension is a critical step for a successful EPD process and has an important effect on both the film’s quality and its future properties.

Keywords: Bi2Te3, electrical conductivity, electrophoretic deposition, thermoelectric materials, thick films

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Authors: Thuy T. T. Tran, Hamish Coates, Sophie Arkoudis

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Evaluation instruments of teaching are abundant; however, these do not prompt any enhancement in the quality of teaching, not least because these instruments are framed only by teacher-centered conceptions of teaching. There is a need for more sophisticated teaching evaluation measures that focus on student learning and multi-stakeholder involvement. This study aims to develop such an evaluation instrument for Vietnamese higher education. The study uses several kinds of methods. The instrument was initially drafted through in-depth review of research, paying close attention to Vietnamese higher education. Draft evaluation instruments were produced and reviewed by 34 experts. The outcomes of this qualitative and quantitative data reveal an instrument that highlights the value of a multisource student-centered approach, and the rich integration of contextual and cultural traits where Confucian values are emphasized. The validation affirms that evaluating teaching in such way will facilitate the continuous learning growth of all stakeholders involved.

Keywords: multi stakeholders, quality teaching, student learning, teaching evaluation

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Authors: Agustin Baidez, Yolanda Ramirez

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There is currently a growing interest in the improvement of university governance and the disclosure of information on governance processes as an essential part of the transparency and accountability of universities. This paper aims to examine the extent and quality of voluntary corporate governance disclosure by public Spanish universities on their websites in relation to information need of stakeholders. The results of this study show that Spanish university stakeholders attach great importance to the disclosure of specific information on aspects of corporate governance. However, the quality of disclosed information on university governance in public Spanish universities websites is in the middle level. In order to satisfy the information needs of university stakeholders, Spanish universities can be recommended to focus on reporting higher quality information on university autonomy in financing, autonomy in management, autonomy regarding student selection and assessment, degree of consanguinity of executive directors, report on assigned public funding based on results, and management reports.

Keywords: university, governance, transparency, stakeholders

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Authors: SunWoo Lee, TaeBum Lee, YoonHwa Park, YooJeong Kim

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Solar lentigines appear predominantly on chronically sun-exposed areas of skin, such as the face and the back of the hands. Among the several ways to lentigines treatment, quality-switched lasers are well-known effective treatment for removing solar lentigines. The present pilot study was therefore designed to assess the efficacy of quality-switched ruby laser treatment of such lentigines compare between pretreatment and posttreatment of skin brightness. Twenty-two adults with chronic sun-damaged skin (mean age 52.8 years, range 37–74 years) were treated at the Korean site. A 694 nm Q-switched ruby laser was used, with the energy density set from 1.4 to 12.5 J/cm2, to treat solar lentigines. Average brightness of skin color before ruby laser treatment was 137.3 and its skin color was brightened after ruby laser treatment by 150.5. Also, standard deviation of skin color was decreased from 17.8 to 16.4. Regarding the multivariate model, age and energy were identified as significant factors for skin color brightness change in lentigo depigmentation by ruby laser treatment. Their respective odds ratios were 1.082 (95% CI, 1.007–1.163), and 1.431 (95% CI, 1.051–1.946). Lentigo depigmentation treatment using ruby lasers resulted in a high performance in skin color brightness. Among the relative factors involve with ruby laser treatment, age and energy were the most effective factors which skin color change to brighter than pretreatment.

Keywords: depigmentation, lentigine, quality switched ruby laser, skin color

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Authors: Raymond Chi Fai Si Tou, Jacey Ja Young Choe, Amy Siu Ian So

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Smart hotels can be defined as the hotel which has an intelligent system, through digitalization and networking which achieve hotel management and service information. In addition, smart hotels include high-end designs that integrate information and communication technology with hotel management fulfilling the guests’ needs and improving the quality, efficiency and satisfaction of hotel management. The purpose of this study is to identify appropriate factors that may influence guests’ satisfaction and intention to revisit Smart Hotels based on service quality measurement of lodging quality index and extended UTAUT theory. Unified Theory of Acceptance and Use of Technology (UTAUT) is adopted as a framework to explain technology acceptance and use. Since smart hotels are technology-based infrastructure hotels, UTATU theory could be as the theoretical background to examine the guests’ acceptance and use after staying in smart hotels. The UTAUT identifies four key drivers of the adoption of information systems: performance expectancy, effort expectancy, social influence, and facilitating conditions. The extended UTAUT modifies the definitions of the seven constructs for consideration; the four previously cited constructs of the UTAUT model together with three new additional constructs, which including hedonic motivation, price value and habit. Thus, the seven constructs from the extended UTAUT theory could be adopted to understand their intention to revisit smart hotels. The service quality model will also be adopted and integrated into the framework to understand the guests’ intention of smart hotels. There are rare studies to examine the service quality on guests’ satisfaction and intention to revisit in smart hotels. In this study, Lodging Quality Index (LQI) will be adopted to measure the service quality in smart hotels. Using integrated UTAUT theory and service quality model because technological applications and services require using more than one model to understand the complicated situation for customers’ acceptance of new technology. Moreover, an integrated model could provide more perspective insights to explain the relationships of the constructs that could not be obtained from only one model. For this research, ten in-depth interviews are planned to recruit this study. In order to confirm the applicability of the proposed framework and gain an overview of the guest experience of smart hotels from the hospitality industry, in-depth interviews with the hotel guests and industry practitioners will be accomplished. In terms of the theoretical contribution, it predicts that the integrated models from the UTAUT theory and the service quality will provide new insights to understand factors that influence the guests’ satisfaction and intention to revisit smart hotels. After this study identifies influential factors, smart hotel practitioners could understand which factors may significantly influence smart hotel guests’ satisfaction and intention to revisit. In addition, smart hotel practitioners could also provide outstanding guests experience by improving their service quality based on the identified dimensions from the service quality measurement. Thus, it will be beneficial to the sustainability of the smart hotels business.

Keywords: intention to revisit, guest satisfaction, qualitative interviews, smart hotels

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Authors: Daniel D'Souza, Ping Zou

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The period before, during, and after menopause is a sensitive time for women as they experience intense physical and psychological health changes and symptoms. These changes accompany the hormonal changes that mark the end of a woman’s reproductive age. To help mitigate and cope with these changes, prompt and correct treatment is needed. eHealth has emerged as a branch of telemedicine in the past few decades as an alternate avenue for patients to receive care quickly and conveniently, as it relies on the Internet and computers. Within the past few years, eHealth has also given rise to mHealth, which is the use of personal mobile devices to receive treatment and care. However, there is a lack of study on their use for menopause. This review aimed to review and summarize the literature for eHealth or mHealth and menopause. Several databases related to women’s health and digital health were searched for original studies about eHealth or mHealth and menopause. The search yielded 25 results. The results were generally positive, with these interventions being feasible and having positive effects on physical and psychosocial outcomes. However, several issues were raised regarding their design process that may inadvertently prevent these interventions from addressing the needs of all potential users. Therefore, while eHealth and mHealth certainly represent a future model of healthcare delivery for menopausal women, further research and design modifications are needed before this can happen.

Keywords: eHealth, menopause, mHealth, midlife women

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Authors: Armando Luis Vieira, Carlos Costa, Arthur Araújo

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The tourism system is viewable as a network of relationships amongst business partners where the success of each actor will ultimately be determined by the success of the whole network. Especially since the publication of Gümmesson’s (1996) ‘theory of imaginary organisations’, which suggests that organisational effectiveness largely depends on managing relationships and sharing resources and activities, relationship quality (RQ) has been increasingly recognised as a main source of value creation and competitive advantage. However, there is still ambiguity around this topic, and managers and researchers have been recurrently reporting the need to better understand and capitalise on the quality of interactions with business partners. This research aims at testing an RQ model from a relational, imaginary organisation’s approach. Two mail surveys provide the perceptions of 725 hotel representatives about their business relationships with tour operators, and 1,224 corporate client representatives about their business relationships with hotels (21.9 % and 38.8 % response rate, respectively). The analysis contributes to enhance our understanding on the linkages between RQ and its determinants, and identifies the role of their dimensions. Structural equation modelling results highlight trust as the dominant dimension, the crucial role of commitment and satisfaction, and suggest customer orientation as complementary building block. Findings also emphasise problem solving behaviour and selling orientation as the most relevant dimensions of customer orientation. The comparison of the two ‘dyads’ deepens the discussion and enriches the suggested theoretical and managerial guidelines concerning the contribution of quality relationships to business performance.

Keywords: corporate clients, destination competitiveness, hotels, relationship quality, structural equations modelling, tour operators

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Authors: Ihn Sook Jeong, Eun Joo Lee, Jae Hyung Kim, Gun Ho Kim, Young Jun Hwang

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This study investigated intravenous (IV) infiltration using bioelectrical impedance for 27 hospitalized patients in a long-term care hospital. Impedance parameters showed significant differences before and after infiltration as follows. First, the resistance (R) after infiltration significantly decreased compared to the initial resistance. This indicates that the IV solution flowing from the vein due to infiltration accumulates in the extracellular fluid (ECF). Second, the relative resistance at 50 kHz was 0.94 ± 0.07 in 9 subjects without infiltration and was 0.75 ± 0.12 in 18 subjects with infiltration. Third, the magnitude of the reactance (Xc) decreased after infiltration. This is because IV solution and blood components released from the vein tend to aggregate in the cell membrane (and acts analogously to the linear/parallel circuit), thereby increasing the capacitance (Cm) of the cell membrane and reducing the magnitude of reactance. Finally, the data points plotted in the R-Xc graph were distributed on the upper right before infiltration but on the lower left after infiltration. This indicates that the infiltration caused accumulation of fluid or blood components in the epidermal and subcutaneous tissues, resulting in reduced resistance and reactance, thereby lowering integrity of the cell membrane. Our findings suggest that bioelectrical impedance is an effective method for detection of infiltration in a noninvasive and quantitative manner.

Keywords: intravenous infiltration, impedance, parameters, resistance, reactance

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Authors: Catherine Constantinidis (Nee Tsacalos)

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This paper presents one aspect of the larger Masters qualitative study exploring the roles of married Greek Orthodox clergy, the Priest and Presbytera, under the wing of the Greek Orthodox Archdiocese of Australia. This ground breaking research necessitated the creation of primary data within a phenomenological paradigm drawing from lived experiences of the Priests and Presbyteres in contemporary society. As a Social Worker, a bilingual (Greek/English) Mental Health practitioner and a Presbytera, the questions constantly raised and pondered are: Who do the Priest and Presbytera turn to when they experience difficulties or problems? Where do they go for support? What is in place for their emotional and psychological health and well-being? Who cares for the spiritual carer? Who is there to catch our falling clergy and their wives? What is their 'safety net'? Identified phenomena of angst, stress, frustration and confusion experienced by the Priest and (by extension) the Presbytera, within their position, coupled with basic assumptions, perceptions and expectations about their roles, the role of the organisation (the Church), and their role as spouse often caused confusion and in some cases conflict. Unpacking this complex and multi-dimensional relationship highlighted not only the roller coaster of emotions, potentially affecting their physical and mental health, but also the impact on the interwoven relationships of marriage and ministry. The author considers these phenomena in the light of bilingual cultural and religious organisational practice frameworks, specifically the Greek Orthodox Church, whilst filtering these findings through a mental health lens. One could argue that it is an expectation that clergy (and by default their wives) take on the responsibility to be kind, nurturing and supportive to others. However, when it comes to taking care of self, they are not nearly as kind. This research looks at a recurrent theme throughout the interviews where all participants talked about limited support systems and poor self care strategies and the impact this has on their ministry, mental, emotional, and physical health and ultimately on their relationships with self and others. The struggle all participants encountered at some point in their ministry was physical, spiritual and psychological burn out. The overall aim of the researcher is to provide a voice for the Priest and the Presbytera painting a clearer picture of these roles and facilitating an awareness of struggles and dilemmas faced in their ministry. It is hoped these identified gaps in self care strategies and support systems will provide solid foundations for building a culturally sensitive, empathetic and effective support system framework, incorporating the spiritual and psychological well-being of the Priest and Presbytera, a ‘safety net’. A supplementary aim is to inform and guide ministry practice frameworks for clergy, spouses, the church hierarchy and religious organisations on a local and global platform incorporating some sort of self-care system.

Keywords: care for the carer, mental health, Priest, Presbytera, religion, support system

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Authors: Senthilkumar S, Vijayakumar R M , Soorianathasundaram K, Durga Devi D

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A study was conducted to assess the influence of brassinosteroid and other bioregulators as pre-harvest sprays on yield and quality of newly introduced Californian grape cv. Italia. The vines were exposed to standardized pruning level of pruning 50% of the canes to 5-6 bud level for fruiting and 50% of the canes to two bud level for vegetative growth. The influence of brassinosteroid was assessed using BR (1 ppm) alone and in combination with GA3 and CPPU, sprayed at three different stages over the control (water spray) were given as treatments. The results revealed that the bunches treated with Brassinosteroid (1 ppm) + GA3 (10 ppm) at pea stage i.e., 7-8 mm berry size, recorded the maximum values on yield characters like bunch weight (719.94 g), yield per vine (12.70 kg/vine) and yield per hectare (15.88 t). The berry characters and quality traits were also significantly influenced by the application of bioregulators. The maximum value for all those characters was registered under bunch sprays of Brassinosteroid (1 ppm) + GA3 (10 ppm) at pea stage. The economic feasibility indicated that the treatment combination Brassinosteroid (1 ppm) + GA3 (10 ppm) at pea stage (7-8 mm berry size) had registered the maximum benefit cost ratio of 3.13, as compared to 1.89 in control (water spray). Overall, it was observed that a combined bunch spray of Brassinosteroid (1 ppm) + GA3 (10 ppm) at pea stage (7-8 mm berry size) was adjudged as the best treatment for promoting the crop for better the bunch quality and yield.

Keywords: bioregulators, brassinosteroid, CPPU, GA3, Italia grape cultivar

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Authors: Jamel Boukhatem, Semia Rachid, Marmar Nasr

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Considering the differences between oil- and non-oil-producing countries, this paper aims to evaluate the impact of financial development (FD) and institutional quality (IQ) on CO2 emissions in 15 MENA (Middle East and North Africa) countries over the period 1996-2018 using the Panel ARDL approach. We found evidence to support an unconditional long run effect of FD on environmental conditions (EC), with quite significant differences between the two groups of countries. While FD leads to environmental degradation (ED) in non-oil-producing countries, it helps protect the environment in oil-producing ones. Regarding the effects of IQ on EC, they are not significant in both short- and long run for non-oil-producing countries, but they are significant for oil-producing ones only in the long run. In the short run, IQ indicators haven’t significant effects on EC for the two groups of countries.

Keywords: financial development, institutional quality, environmental conditions, Panel ARDL

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Authors: Tatjana Rakcejeva, Jelena Zagorska, Elina Zvezdina

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The aim of the current research was to investigate the gassy ozone effect on quality parameters of flaxes made form whole biologically activated wheat grains. The research was accomplished on in year 2012 harvested wheat grains variety ′Zentos′. Grains were washed, wetted; grain biological activation was performed in the climatic chamber up to 24 hours. After biological activation grains was compressed; than flaxes was dried in convective drier till constant moisture content 9±1%. For grain treatment gassy ozone concentration as 0.0002% and treatment time – 6 min was used. In the processed flaxes the content of A and G tocopherol decrease by 23% and by 9%; content of B2 and B6 vitamins – by 11% and by 10%; elaidic acid – by 46%, oleic acid – by 29%; arginine (by 80%), glutamine (by 74%), asparagine and serine (by 68%), valine (by 62%), cysteine (by 54%) and tyrosine (by 47%).

Keywords: gassy ozone, flaxes, biologically activated grains, quality parameters, treatment

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Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

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Authors: Jenee Gooden, Kevin Vasquez-monterroso, Lady Paula Dejesus, Sandra Wainwright, Daniel Kim, Mackenzie Walker

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Introduction: Pyoderma gangrenosum (PG) is a rare, rapidly progressive, neutrophilic ulcerative colitis condition with an incidence of 3 to 10 cases per year ¹ ². Due to the similar appearance, PG is often misdiagnosed as a diabetic ulcer in diabetic patients. Though they may clinically appear similar in appearance, the treatment protocol and diagnostic criteria differ. Also, end-stage renal disease (ESRD) is often a condition seen in diabetic patients, which can have a significant impact on wound healing due to the wide range of uremic toxins³. This case study demonstrates a multidisciplinary team and multimodal treatment approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine for an uncontrolled diabetic with pyoderma gangrenosum of a significant circumferential wound, covering almost the entire right lower extremity. Methods:56 y.o male presents with multiple PG ulcerations, including the chest, right posterior lower extremity and sacrum. All ulcerations were previously managed by the same wound care specialist. His chief complaint was worsening PG ulcerations accompanied by a fever of 103 °F . This case study focuses on the wound to his RLE. Past medical history significant for diabetes mellitus type 2 with hemoglobin A1c of 10% and end stage renal disease (ESRD) on hemodialysis. A multidisciplinary team approach by podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine was successfully used to perform right lower extremity limb salvage. The patient was managed by rheumatology for the continuation of prior medication, as well as the mutual agreement with wound care for the addition of dapsone. A coronary CT angiogram was performed by interventional cardiology, but no significant disease was noted, and no further vascular workup was necessary. Multiple surgical sharp wide excisional debridements with application of allografts and split thickness skin grafts for the circumferential ulceration that encompassed almost the entire right lower extremity were performed by both podiatric surgery and general surgery. Wound cultures and soft tissue biopsies were performed, and infectious disease managed antibiotic therapy. Hyperbaric oxygen therapy and wound vac therapy by wound care were also completed as adjunct management. Results: Prevention of leg amputation by limb salvage of the RLE was accomplished by a multidisciplinary team approach, with the wound size decreasing over a total of 29 weeks from 600 cm² to 12.0 x 3.5 x 0.2 cm. Our multidisciplinary team included podiatric surgery, general surgery, rheumatology, infectious disease, interventional cardiology, wound care and hyperbaric medicine. Discussion: Wound healing, in general, can have its challenges, and those challenges are only magnified when accompanied by multiple systemic illnesses. Though the negative impact of diabetes on wound healing is well known, the compound impact of being a diabetic with ESRD and having pyoderma gangrenosum is not. This case demonstrates the necessity for a multidisciplinary team approach with a wide array of treatment modalities to optimize wound healing and perform limb salvage with prevention of lower extremity amputation.

Keywords: diabetes, podiatry, pyoderma gangrenosum, end stage renal disease

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Authors: Ana Paula Cavalcanti Furtado, Silvio Meira

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Context: The quality of a software product can be directly influenced by the quality of its development process. Therefore, immature or ad-hoc test processes are means that are unsuited for introducing systematic test automation, and should not be used to support improving the quality of software. Objective: In order to conduct this research, the benefits and limitations of and gaps in automating software testing had to be assessed in order to identify the best practices and to propose a strategy for systematically introducing test automation into software development processes. Method: To conduct this research, an exploratory bibliographical survey was undertaken so as to underpin the search by theory and the recent literature. After defining the proposal, two case studies were conducted so as to analyze the proposal in a real-world environment. In addition, the proposal was also assessed through a focus group with specialists in the field. Results: The proposal of a Framework for Automating Software Testing (FAST), which is a theoretical framework consisting of a hierarchical structure to introduce test automation. Conclusion: The findings of this research showed that the absence of systematic processes is one of the factors that hinder the introduction of test automation. Based on the results of the case studies, FAST can be considered as a satisfactory alternative that lies within the scope of introducing and maintaining test automation in software development.

Keywords: software process improvement, software quality, software testing, test automation

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Authors: Tak Mau Simon Chan

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While there is growing reflection of the adverse impacts instigated by the flourishing gaming industry on the physical health and job satisfaction of those who work in Macau casinos, there is also a critical void in our understanding of the mental health of croupiers and how casino employment interacts with the family system. From a systemic approach, it would be most effective to examine the ‘dealer issues’ collectively and offer assistance to both the individual dealer and the family system of dealers. Therefore, with the use of a mixed method study design, the levels of anxiety, depression and sleeping quality of a sample of 1124 dealers who are working in Macau casinos have been measured in the present study, and 113 dealers have been interviewed about the impacts of casino employment on their family life. This study presents some very important findings. First, the quantitative study indicates that gender is a significant predictor of depression and anxiety levels, whilst lower income means less quality sleep. The Pearson’s correlation coefficients show that as the Zung Self-rating Anxiety Scale (ZSAS) scores increase, the Zung Self-rating Depression Scale (ZSDS) and Pittsburgh Sleep Quality Index (PSQI) scores will also simultaneously increase. Higher income, therefore, might partly explain for the reason why mothers choose to work in the gaming industry even with shift work involved and a stressful work environment. Second, the findings from the qualitative study show that aside from the positive impacts on family finances, the shift work and job stress to some degree negatively affect family responsibilities and relationships. There are resultant family issues, including missed family activities, and reduced parental care and guidance, marital intimacy, and communication with family members. Despite the mixed views on the gender role differences, the respondents generally agree that female dealers have more family and child-minding responsibilities at home, and thus it is more difficult for them to balance work and family. Consequently, they may be more vulnerable to stress at work. Thirdly, there are interrelationships between work and family, which are based on a systemic inquiry that incorporates work- individual- family. Poor physical and psychological health due to shift work or a harmful work environment could affect not just work performance, but also life at home. Therefore, a few practice points about 1) work-family conflicts in Macau; 2) families-in- transition in Macau; and 3) gender and class sensitivity in Macau; are provided for social workers and family practitioners who will greatly benefit these families, especially whose family members are working in the gaming industry in Macau. It is concluded that in addressing the cultural phenomenon of “dealer’s complex” in Macau, a systemic approach is recommended that addresses both personal psychological needs and family issue of dealers.

Keywords: family, work stress, mental health, Macau, dealers, gaming industry

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Authors: Anushka Saxena, Rakhi Wahee Pratap

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Skincare textiles, an emerging field at the crossroads of textile technology and wellness, offer groundbreaking innovations that aim to enhance health and well-being through everyday wear. This research paper explores the diverse spectrum of skin-friendly textiles, with a focus on key categories such as cosmetotextiles, skincare finishes, marine collagen fabrics, and nanotextiles. These developments reflect a shift towards a more holistic approach to clothing, where garments not only serve as fashion or protection but also contribute actively to personal care and wellness. Cosmetotextiles represent a transformative fusion of beauty and textile industries, where fabrics are impregnated with active cosmetic ingredients that provide skincare benefits as they are worn. By incorporating substances such as vitamins, moisturizers, essential oils, and antioxidants, these textiles continuously release beneficial ingredients to the skin throughout the day. The result is improved skin hydration, enhanced smoothness, and targeted therapeutic effects that redefine how clothing can interact with the body. Marine collagen fabrics introduce a novel approach to skincare, harnessing collagen derived from marine life to improve skin elasticity, hydration, and overall texture. With their natural bioactive compounds, these textiles can help stimulate skin repair and rejuvenation, positioning them as a promising tool in both beauty and medical applications. Marine collagen offers the dual benefit of contributing to sustainable textiles while delivering scientifically-backed skincare benefits. Nanotextiles, on the other hand, leverage the advancements in nanotechnology by integrating nanoparticles into fabric structures. These textiles exhibit multifunctional properties, such as antimicrobial action, UV protection, and wound-healing capabilities, making them highly suitable for medical textiles. Nanotextiles provide an avenue for creating clothing that not only protects the skin from environmental aggressors but also aids in recovery, regeneration, and long-term health maintenance. This paper provides an in-depth overview of healing textiles, examining their current advancements, practical applications, and the challenges faced in their development. Furthermore, it explores the future prospects of this innovative field, particularly its potential in bridging the gap between cutting-edge technology and traditional textile practices. As consumer demand for multifunctional and health-promoting textiles grows, healing textiles present a promising solution for improving quality of life through fabric innovation.

Keywords: skincare textiles, nanotechnology, cosmetotextiles, nanotextiles, marine collagen textiles and health

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Authors: Silvija Šiljeg, Ante Šiljeg, Branko Cavrić

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Housing is considered as a basic human need and important component of the quality of life (QoL) in urban areas worldwide. In contemporary housing studies, the concept of the quality of housing (QoH) is considered as a multi-dimensional and multi-disciplinary field. It emphasizes connection between various aspects of the QoL which could be measured by quantitative and qualitative indicators at different spatial levels (e.g. local, city, metropolitan, regional). The main goal of this paper is to examine the QoH and compare results of quantitative analysis with the clutter land use categories derived for selected local communities in Croatian Coastal City of Zadar. The qualitative housing analysis based on the four housing indicators (out of total 24 QoL indicators) has provided identification of the three Zadar’s local communities with the highest estimated QoH ranking. Furthermore, by using GIS overlay techniques, the QoH was merged with the urban environment analysis and introduction of spatial metrics based on the three categories: the element, class and environment as a whole. In terms of semantic-content analysis, the research has also generated a set of indexes suitable for evaluation of “housing state of affairs” and future decision making aiming at improvement of the QoH in selected local communities.

Keywords: housing, quality, indicators, indexes, urban environment, GIS, element, class

Procedia PDF Downloads 412