Search results for: clinical quality

Authors: Albena Ivanova, Jill Kurp, Austin Hampe

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Cereal products in the US contain rich information on the front of the package (FOP) as well as point-of-purchase (POP) summaries provided by the store. These summaries frequently are confusing and misleading to the consumer. This study explores the relationship between perceived quality, objective quality, price, and value in the cold cereal industry. A total of 270 cold cereal products were analyzed and the price, quality and value for different summaries were compared using ANOVA tests. The results provide evidence that the United States Department of Agriculture Organic FOP/POP are related to higher objective quality, higher price, but not to a higher value. Whole grain FOP/POP related to a higher objective quality, lower or similar price, and higher value. Heart-healthy POP related to higher objective quality, similar price, and higher value. Gluten-free FOP/POP related to lower objective quality, higher price, and lower value. Kid's cereals were of lower objective quality, same price, and lower value compared to family and adult markets. The findings point to a disturbing tendency of companies to continue to produce lower quality products for the kids’ market, pricing them the same as high-quality products. The paper outlines strategies that marketers and policymakers can utilize to contribute to the increased objective quality and value of breakfast cereal products in the United States.

Keywords: cereals, certifications, front-of-package claims, consumer health.

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Authors: A. Satty, H. Mwambi

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Much clinical trials data-based research are characterized by the unavoidable problem of dropout as a result of missing or erroneous values. This paper aims to review some of the various techniques to address the dropout problems in longitudinal clinical trials. The fundamental concepts of the patterns and mechanisms of dropout are discussed. This study presents five general techniques for handling dropout: (1) Deletion methods; (2) Imputation-based methods; (3) Data augmentation methods; (4) Likelihood-based methods; and (5) MNAR-based methods. Under each technique, several methods that are commonly used to deal with dropout are presented, including a review of the existing literature in which we examine the effectiveness of these methods in the analysis of incomplete data. Two application examples are presented to study the potential strengths or weaknesses of some of the methods under certain dropout mechanisms as well as to assess the sensitivity of the modelling assumptions.

Keywords: incomplete longitudinal clinical trials, missing at random (MAR), imputation, weighting methods, sensitivity analysis

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Authors: Leesa Mohanty, Ashok Banerjee

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Better audit quality signifies the financial statements of the auditee firm reflect true and fair view of their actual state of affairs, which reduces information asymmetry between management and shareholders, as a result, helps protect interests of shareholders. This study examines the impact of joint audit on audit quality. It is motivated by the ongoing debate where The Institute of Chartered Accountants of India (ICAI), the regulatory body governing auditors, has advocated the finance ministry and the Reserve Bank of India (RBI) for the mandatory use of joint audit in private banks to enhance the quality of audit. Earlier, the Government of India had rejected the plea by ICAI for mandatory joint audits in large companies stating it is not a viable option for promoting domestic firms. We introduce a new measure of audit quality. Drawing from the domain of text analytics, we use relevant phrases in audit reports to gauge audit quality and demonstrate that joint audit improves audit quality. We also, for robustness, use prevalent proxy for audit quality (Big N Auditor, ratio of audit fees to total fees) and find negative effect of joint audit on audit quality. We, therefore highlight that different proxy for audit quality show opposite effect of joint audit.

Keywords: audit fees, audit quality, Big N. Auditor, joint audit

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Authors: Marc Dorval, Marie-Hélène Jobin

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This work presents the various perspectives, dimensions, components and definitions given to quality in the operations management (OM) and healthcare services (HCS) literature in time, highlighting gaps and learning opportunities between the two disciplines through a thorough search into their rich and distinct body of knowledge. Greater and new insights about the general nature of quality are obtained with findings such as in OM, quality has been approached in six fairly distinct paradigms (excellence, value, conformity to specifications, attributes, satisfaction and meeting or exceeding customer expectations), whereas in HCS, two approaches are prominent (Donabedian’s structure, process and outcomes model and Lohr and Schroeder’s circumscribed definition). The two disciplines views on quality seem to have progressed much in parallel with little cross-learning from each other. This work then proposes an encompassing definition of quality as a lever and suggests further research and development avenues for a better use of the concept of quality by academics and practitioners alike toward the goals of greater organizational performance and improved management in healthcare and possibly other service domains.

Keywords: healthcare, management, operations, quality, services

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Authors: Khadije Khazaeli, Farzane Saberi

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Spinal cord injury is one of the traumatic events which has a great impact on the quality of life. spirituality has been used to improve many disorders and abnormalities in recent years and positive results have been seen; accordingly, the present study investigated the relationship between spirituality and quality of life in these patients. This study is a cross-sectional study of the correlation type was conducted on 100 people with spinal cord injury in Isfahan province in 2016 by the available sample method. Spirituality was assessed through the Spiritual Attitude Questionnaire and quality of life through the World Health Organization Quality of Life Questionnaire. Pearson correlation and regression tests were used to analyze the data. The results of this study showed that spirituality has a significant relationship with the quality of life of patients with spinal cord injury. It was also proved that all sub-units of spirituality, including attitude and spiritual ability, can affect all components of quality of life. The findings suggest that spirituality, along with other factors, can lead to a significant improvement in quality of life and, ultimately, general health of patients with SCI.

Keywords: spinal cord injury, quality of life, spirituality, patients

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Authors: Chengxuan Geng, Yizhou E

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This paper mainly examines the changes in the relationship between earnings management and audit quality before and after financial crisis in the context of American firms from 2005 to 2010. Based on a sample of 3584 firm year observations, we find that there are changes concerning the relation between accrual-based earnings management and audit quality during the pre-crisis and post-crisis periods. However, the results do not provide enough evidence with regard to the variances in the association between real activities earnings management and audit quality during these two periods.

Keywords: audit quality, earnings management, financial crisis, relationship

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Authors: Bruno Pinto Vieira, Marco Antonio Calijorne Soares, Armando Sérgio de Aguiar Filho

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Nowadays, a massive amount of information has been produced by different data sources, including mobile devices and transactional systems. In this scenario, concerns arise on how to maintain or establish data quality, which is now treated as a product to be defined, measured, analyzed, and improved to meet consumers' needs, which is the one who uses these data in decision making and companies strategies. Information that reaches low levels of quality can lead to issues that can consume time and money, such as missed business opportunities, inadequate decisions, and bad risk management actions. The step of selecting, identifying, evaluating, and selecting data sources with significant quality according to the need has become a costly task for users since the sources do not provide information about their quality. Traditional data quality control methods are based on user experience or business rules limiting performance and slowing down the process with less than desirable accuracy. Using advanced machine learning algorithms, it is possible to take advantage of computational resources to overcome challenges and add value to companies and users. In this study, machine learning is applied to data quality analysis on different datasets, seeking to compare the performance of the techniques according to the dimensions of quality assessment. As a result, we could create a ranking of approaches used, besides a system that is able to carry out automatically, data quality assessment.

Keywords: machine learning, data quality, quality dimension, quality assessment

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Authors: Sujata Chaturvedi, Ishita Pant, Deepak Kumar Jha, Vinod Kumar Singh Gautam, Chandra Bhushan Tripathi

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Objective: To describe clinical, histopathological and immunohistochemical profile of glioblastoma in patients and to correlate these findings with patient survival. Material and methods: 30 cases of histopathologically diagnosed glioblastomas were included in this study. These cases were analysed in detail for certain clinical and histopathological parameters. Immunohistochemical staining for p53, epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), mouse double minute 2 homolog (MDM2) and Ki67 was done and scores were calculated. Results of these findings were correlated with patient survival. Results: A retrospective analysis of the histopathology records and clinical case files was done in 30 cases of glioblastoma (WHO grade IV). The mean age of presentation was 50.6 years with a male predilection. The most common involved site was the frontal lobe. Amongst the clinical parameters, age of the patient and extent of surgical resection showed a significant correlation with the patient survival. Histopathological parameters showed no significant correlation with the patient survival, while amongst the immunohistochemical parameters expression of MDM2 showed a significant correlation with the patient survival. Conclusion: In this study incorporating clinical, histopathological and basic panel of immunohistochemistry, age of the patient, extent of the surgical resection and expression of MDM2 showed significant correlation with the patient survival.

Keywords: glioblastoma, p53, EGFR, VEGF, MDM2, Ki67

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Authors: Daniel Walker, Adam Qureshi, David Marchant, Alex Bahrami Balani

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The present study aimed to assess the impact of concussion and physical pain on depression and health-related quality of life. Depressive symptoms were assessed using the Center for Epidemiological Studies' Depression Scale, and scores of health-related quality of life were measured by health-related quality of life short form-12. Data analysis of 67 participants (concussed 32 vs. 35 non-concussed) revealed that (i) 52% were displaying depressive symptoms (concussed 30% vs. non-concussed 22%) (ii) concussion had a significant effect on depressive symptoms when controlling for pain but no effect on the quality of life scores when controlling the same variable (iii) pain had a significant effect on depressive symptoms and quality of life. With this, both concussion and physical pain seem to have a negative impact on mental health; however, individuals may only recognise a reduction in quality of life with increased physical pain, hence a deterioration in mental well-being could be disregarded as a factor of health-related quality of life.

Keywords: depression, quality of life, concussion, physical pain

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Authors: Ilir Rexhepi, Naim Ismajli

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Quality and quality management are key factors of success nowadays. Public sector and quality management in this sector contains many challenges and difficulties, most notably in a new country like Kosovo. This study analyses the process of implementation of quality management system in public administration institutions in this country. The main objective is to show how to set up a quality management system and how does the quality management system setup affect the overall public administration services in Kosovo. This study shows how the efficiency and effectiveness of public institution services/performance is rapidly improving through the establishment and functionalization of Quality Management System. The specific impact of established QMC within the organization has resulted with the identification of mission related processes within the entire system including input identification, the person in charge and the way of conversion to the output of each activity though the interference with other service processes within the system. By giving detailed analyses of all steps of implementation of the Quality Management System, its effect and consequences towards the overall public institution service performance, we try to go one step further, by showing it as a very good example or tool of other public institutions for improving their service performance. Interviews with employees, middle and high level managers including the quality manager and general secretaries are also part of analyses in this paper.

Keywords: quality, quality management system, efficiency, public administration institutions

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Authors: Suppara Charoenpoom

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The objectives of this research was to design and develop a quality management of the school buildings and environment. A quantitative and qualitative mixed research methodology was used. The population sample included 14 directors of primary schools. Two research tools were used. The first research tool included an in-depth interview and questionnaire. The second research tool included the Quality Business Process and Quality Work Procedure, and a Key Performance Indicator of each activity. The statistics included mean and standard deviation. The findings for the development of a quality management process of buildings and environment administration of the basic schools consisted of one quality business process (QBP) and seven quality work processes (QWP). The result from the experts’ evaluation revealed that the process and implementation of quality management of the school buildings and environment has passed the inspection process with consensus. This implies that the process of quality management of the school buildings and environment is suitable for implementation. Moreover, the level of agreement in the feasibility of the implementation of this plan had the mean in the range of 0.64-1.00 which suggests the design of the new plan is acceptable.

Keywords: process, building, environment, management

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Authors: Maria Ahmad, Alexandra Valetopoulou, Michael D. Christian

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Background: London’s Air Ambulance (LAA) provides advanced pre-hospital trauma care across London, bringing specialist resources and expert trauma teams to patients. Since its inception 32 years ago, LAA has treated over 40,000 pre-hospital patients and significantly contributed to pre-hospital patient care in London. To the authors’ best knowledge, this is the first analysis to quantify the magnitude of the publication impact of LAA on the international field of pre-hospital medicine. Method: We searched the Scopus, Web of Science, Google Scholar and PubMed databases to identify LAA focused articles. These were defined as articles on the topic of pre-hospital medicine which either utilised data from LAA, or focused on LAA patients, or were authored by LAA clinicians. A bibliometric analysis was conducted and the impact of each eligible article was classified as either: high (article directly influenced the change or creation of clinical guidelines); medium (the article was referenced in clinical guidelines or had >20 Google Scholar citations or >10 PubMed citations); or low impact (article had <20 Google Scholar citations or <10 PubMed citations). Results: The literature search yielded 1,120 articles in total. 198 articles met our inclusion criteria, and their full text was analysed to determine the level of impact. 19 articles were classified as high-impact, 76 as medium-impact, and 103 as low-impact. 20 of the 76 medium-impact articles were referenced in clinical guidelines but had not prompted changes to the guidelines. Conclusion: To our knowledge, this review is the first to quantify the significant publication impact of LAA within the field of pre-hospital medicine over the last 32 years. LAA publications have focused on and driven clinical innovations in trauma care, particularly in pre-hospital anaesthesia, haemorrhage control, and major incidents, with many impacting national and international guidelines. We recommend a greater emphasis on multidisciplinary pre-hospital collaboration in publications in future research and quality improvement projects across all pre-hospital services.

Keywords: air ambulance, pre-hospital medicine, London’s Air Ambulance, London HEMS

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Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff

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Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.

Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement

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Authors: Mohsen Varzande

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Translators’ professional and academic characteristics may directly influence their translation quality. The present study aimed at investigating whether translators’ degree in translation and years of professional experience predict their translation quality. Following a causal-comparative study, a sample of one hundred professional translators was selected using purposive sampling method. The participants were divided into two groups each containing individuals with and without a degree in translation, respectively. The participants were asked to translate a paragraph to assess their translation quality. For data analysis, appropriate statistical procedures including correlation and regression were used. Results showed that both degree in translation and years of professional experience significantly predict translation quality. Also, the interaction of translators’ years of professional experience and degree in translation significantly affect their translation quality. An implication could be that besides providing translators with academic knowledge and theories, practical training in translation is necessary as a prerequisite for a competent translator.

Keywords: translation, degree in translation, translation quality, professional experience

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Authors: Alexandra McKinzie, Lucy Brown, Sarah Komanapalli, Sarah Swiezy, Caitlin Bernard

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Background: While 25% of US women will seek an abortion before age 45, targeted laws have led to a decline in abortion clinics, subsequently leaving 96% of Indiana counties and the 70% of Hoosier women residing in these counties without access to services they desperately need.1,2 Despite the need for a physician workforce that is educated and able to provide full-spectrum reproductive health care, few medical institutions have a standardized family planning and abortion pre-clinical curriculum. Methods: A Qualtrics survey was disseminated to students from Indiana University School of Medicine (IUSM) to evaluate (1) student interest in curriculum reform, (2) self-assessed preparedness to counsel on contraceptive and pregnancy options, and (3) preferred modality of instruction for family planning and abortion topics. Based on the pre-panel survey feedback, a case-based pregnancy options counseling panel will be implemented in the students’ pre-clinical, didactic course Endocrine, Reproductive, Musculoskeletal, Dermatologic Systems (ERMD) in February 2022. A Qualtrics post-panel survey will be disseminated to evaluate students’ perceived efficacy and quality of the panel, as well as their self-assessed preparedness to counsel on pregnancy options. Results: Participants in the pre-panel survey (n=303) were primarily female (61.72%) and White (74.43%). Across all class levels, many (60.80%) students expected to learn about family planning and abortion in their pre-clinical education. While most (84-88%) participants felt prepared to counsel about common, non-controversial pharmacotherapies (e.g. beta-blockers and diuretics), only 20% of students felt prepared to counsel on abortion options. Overall, 85.67% of students believed that IUSM should enhance its reproductive health coverage in pre-clinical, didactic courses. Traditional lectures, panels, and direct clinical exposure were the most popular instructional modalities. Expected Results: The authors predict that following the panel, students will indicate improved confidence in providing pregnancy options counseling. Additionally, students will provide constructive feedback on the structure and content of the panel for incorporation into future years’ curriculum. Conclusions: IUSM students overwhelmingly expressed interest in expanding their pre-clinical curriculum’s coverage of family planning and abortion topics. To specifically improve students’ self-assessed preparedness to provide pregnancy options counseling and address students’ self-cited learning gaps, a case-based provider panel session will be implemented in response to students’ preferred modality feedback.

Keywords: options counseling, family planning, abortion, curriculum reform, case-based panel

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Authors: Sheikh Omar Sillah

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Introduction: Monitoring is an important means of ensuring the smooth implementation and quality of clinical trials. For many years, traditional site monitoring approaches have been critical in detecting data errors but not optimal in identifying fabricated and implanted data as well as non-random data distributions that may significantly invalidate study results. The objective of this paper was to provide recommendations based on best statistical monitoring practices for detecting data-integrity issues suggestive of fabrication and implantation early in the study conduct to allow implementation of meaningful corrective and preventive actions. Methodology: Electronic bibliographic databases (Medline, Embase, PubMed, Scopus, and Web of Science) were used for the literature search, and both qualitative and quantitative studies were sought. Search results were uploaded into Eppi-Reviewer Software, and only publications written in the English language from 2012 were included in the review. Gray literature not considered to present reproducible methods was excluded. Results: A total of 18 peer-reviewed publications were included in the review. The publications demonstrated that traditional site monitoring techniques are not efficient in detecting data anomalies. By specifying project-specific parameters such as laboratory reference range values, visit schedules, etc., with appropriate interactive data monitoring, statistical monitoring can offer early signals of data anomalies to study teams. The review further revealed that statistical monitoring is useful to identify unusual data patterns that might be revealing issues that could impact data integrity or may potentially impact study participants' safety. However, subjective measures may not be good candidates for statistical monitoring. Conclusion: The statistical monitoring approach requires a combination of education, training, and experience sufficient to implement its principles in detecting data anomalies for the statistical aspects of a clinical trial.

Keywords: statistical monitoring, data anomalies, clinical trials, traditional monitoring

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Authors: Wafaa M. El- Kotb, Soheir Mohamed Weheida, Manal E. Fareed

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The aim of this study was to determine the effect of implementing a teaching module about diet and exercises on clinical outcomes of patients with gout. Subjects: A purposive sample of 60 adult gouty patients was selected and randomly and alternatively divided into two equal groups 30 patients in each. Setting: The study was conducted in orthopedic out patient's clinic of Menoufia University. Tools of the study: Three tools were utilized for data collection: Knowledge assessment structured interview questionnaire, Clinical manifestation assessment tools and Nutritional assessment sheet. Results: All patients of both groups (100 %) had poor total knowledge score pre teaching, while 90 % of the study group had good total knowledge score post teaching by three months compared to 3.3 % of the control group. Moreover the recovery outcomes were significantly improved among study group compared to control group post teaching. Conclusion: Teaching study group about diet and exercises significantly improved their clinical outcomes. Recommendation: Patient's education about diet and exercises should be ongoing process for patients with gout.

Keywords: clinical outcomes, diet, exercises, teaching module

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Authors: Sarina Sahmeddini, Fahimeh Safarpour, Forough Pazhuheian

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With the concepts of minimally invasive treatment and preventive dentistry gaining more and more recognition by dentists, there are many published clinical trials comparing the use of the erbium laser with traditional drilling for caries removal. However, the efficacy of the erbium laser is still controversial. The aim of this review study is to compare the effects of tooth preparation by laser irradiation and conventional preparation by bur to identify the best means for cavity preparation and reduction of recurrent caries. Randomized controlled trials, controlled clinical trials, and prospective, and retrospective cohort studies were included in this review. The eligibility criteria included studies in humans’ permanent teeth in which cavities were conducted in their cervical third and proximal surfaces. PubMed, Google scholar, and Scopus about Er:YAG laser and bur prepared cavities were carried out. The studies’ details were organized in four tables according to the groups: (1) Microleakage; (2) Morphological changes; (3) Microhardness; and (4) Bond strength. The initial search resulted in 134 articles, 12 studies published from 2012 up to March 2020 were included in this review. According to the risk of bias evaluation, all studies were classified as high quality. Clinical implications: Er:YAG lasers with the energy levels between 250 to 300 mJ can be proper alternatives to conventional burs, as minimal invasive instruments with no significant differences or better results in microleakage, microhardness, and bond strength compared with conventional burs. In conclusion, Er:YAG laser irradiations accompanied by phosphoric acid etching can reduce the chance of recurrent carries.

Keywords: lasers, drilling, caries, micro leakage

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Authors: Jafar Kazemzadeh, Soheila Rabiepoor, Saeedeh Alizadeh

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Introduction: Burn, especially in women, can affect the quality of life and their quality of life due to a change in appearance. This study was designed to investigate the relationship between quality of life and sexual satisfaction in women with burn. Methods: This was a descriptive-analytical cross-sectional study conducted on 101 women with severe burns referring to Imam Khomeini Hospital in Urmia in 2016. The data gathering scales were demographic questionnaire, burn specific health scale-brief (BSHS-B) and index of sexual satisfaction (ISS). The data were analyzed using SPSS software version 16. Results: Mean score of quality of life was 102.94 ± 20.88 and sexual satisfaction was 57.03 ± 25.91. Also, there was a significant relationship between quality of life and its subscales with sexual satisfaction and some demographic variables (p < 0.05). Conclusion: According to the results of this study, it should be noted that interventional efforts for improving sexual satisfaction and thus improving the quality of life in these patients are important. The findings of this study appear to be effective in planning for women with a history of burns.

Keywords: burn, quality of life, sexual satisfaction, women

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Authors: Mahera Abdulrahman, Satish Chandrasekhar Nair

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Growing demand for human health research in the United Arab Emirates (UAE) has prompted the need to develop a robust research ethics oversight, particularly given the large unskilled-worker immigrant population and the elderly citizens utilizing health services. Examination of the structure, function, practices and outcomes of the human research ethics committees (HREC) was conducted using two survey instruments, reliable and validated. Results indicate that in the absence of a national ethics regulatory body, the individual emirate’s governed 21 HRECs covering health facilities and academic institutions in the UAE. Among the HRECs, 86% followed International Council for Harmonization-Good Clinical Practice guidelines, 57% have been in operation for more than five years, 81% reviewed proposals within eight weeks, 48% reviewed for clinical and scientific merit apart from ethics, and 43% handled more than 50 research proposals per year. However, researcher recognition, funding transparency, adverse event reporting systems were widespread in less than one-third of all HRECs. Surprisingly, intellectual property right was not included as a research output. Research was incorporated into the vision and mission statements of many (62%) organizations and, mechanisms such as research publications, collaborations, and recognitions were employed as key performance indicators to measure research output. In spite, resources to generate research output such as dedicated budget (19%), support staff (19%) and continuous training and mentoring program for medical residents and HREC members were somehow lacking. HREC structure and operations in the UAE are similar to other regions of the world, resources allocation for efficient, quality monitoring, continuous training, and the creation of a clinical research network are needed to strengthen the clinical research enterprise to scale up for the future. It is anticipated that the results of this study will benefit investigators, regulators, pharmaceutical sponsors and the policy makers in the region.

Keywords: institutional review board, ethics committee, human research ethics, United Arab Emirates (UAE)

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Authors: Ghoul Rachid Brahim

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Introduction: Back pain is a real public health problem with a significant socio-economic impact. It is the consequence of a degeneration of the lumbar intervertebral disc (IVD). This often asymptomatic pathology is compatible with an active life. As soon as it becomes symptomatic, conservative treatment is recommended in the majority of cases. The physical or functional disability is resistant to well-monitored conservative treatment, which justifies a surgical alternative which imposes a well-studied reflection on the objectives to be achieved. Objective: Evaluate the indication and short and medium term contribution of surgery in the management of painful degenerative lumbar disc disease. To prove the effectiveness of surgical treatment in the management of painful lumbar degenerative disc disease. Materials and methods: This is a prospective descriptive mono-centric study without comparison group, comprising a series of 104 patients suffering from lumbar painful degenerative disc disease treated surgically. Retrospective analysis of data collected prospectively. Comparison between pre and postoperative clinical status, by pain self-assessment scores and on the impact on pre and postoperative quality of life (3, 6 to 12 months). Results: This study showed that patients who received surgical treatment had great improvements in symptoms, function and several health-related quality of life in the first year after surgery. Conclusions: The surgery had a significantly positive impact on patients' pain, disability and quality of life. Overall, 97% of the patients were satisfied.

Keywords: degenerative disc disease, intervertebral disc, several health-related quality, lumbar painful

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Authors: Chris Nelson

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Quality and excellence are qualitative topics that are usually addressed based on knowledge and past experience from leadership and those in charge of the organization. The significance of this study is to highlight the differences and similarities between these two mindsets and how an operational staff can most appropriately use them in the workplace. Quality and excellence are two words that are talked about a lot in the manufacturing world. Buzzwords such as operational excellence, quality controls, and efficiencies are discussed in the boardroom as well on the shop floor. These terms are used quite frequently and with good reasons. When a person visits their favorite local restaurant, They go because 1) they like the food and 2) the people are some of the greatest individuals to be around. With that in mind, they know they always put out quality food. They do not always go because the quality of the food is far superior than other restaurants. But the quality of ingredients always meets their expectations. When they compare them to the term excellence, they are disappointed. The food never looks like the pictures on the menu. But when have you ever been to a restaurant where the food looks the same as on the menu? For them, when evaluating which buzzword to use as a guiding star, its simple: excellence. The corporation can accomplish these goals by operating at a standard that far exceeds customer’s wants and needs.

Keywords: industrial engineering, innovation, management and technology, logistics and scheduling, six sigma

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Authors: Pawinee Sorawech

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The purpose of this study was to investigate the quality improvement of painting assignments for grade 4-6 students by using PDCA cycle. This study employed a qualitative technique. Suan Sunandha Rajabhat University and its demonstration school were selected as the area of study. An in-depth interview was utilized. The findings revealed that model of PDCA cycle was a proper model to increase the quality of painting assignments for grade 4-6 students. The six steps of improvement included: studying the PDCA model, setting up a plan, determining the scope of work, creating a strategy, developing a quality for painting assignment, and coming up with a handbook for a quality improvement of painting assignment.

Keywords: quality, painting assignments, PDCA cycle, grade 4-6 students

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Authors: Cesar Eduardo Hernández Curiel, Victor Hugo Benítez Baltazar, Jesús Horacio Pacheco Ramírez

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This paper is devoted to present the advances in the design of a prototype that is able to supervise the complex behavior of water quality parameters such as pH and temperature, via a real-time monitoring system. The current water quality tests that are performed in government water quality institutions in Mexico are carried out in problematic locations and they require taking manual samples. The water samples are then taken to the institution laboratory for examination. In order to automate this process, a water quality monitoring system based on wireless sensor networks is proposed. The system consists of a sensor node which contains one pH sensor, one temperature sensor, a microcontroller, and a ZigBee radio, and a base station composed by a ZigBee radio and a PC. The progress in this investigation shows the development of a water quality monitoring system. Due to recent events that affected water quality in Mexico, the main motivation of this study is to address water quality monitoring systems, so in the near future, a more robust, affordable, and reliable system can be deployed.

Keywords: pH measurement, water quality monitoring, wireless sensor networks, ZigBee

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Authors: Ankita Srivastava, Yogesh K. Garg

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Housing provides comforts and well being leading towards the quality of life. Earlier research had established that landscape elements enhance the residents’ quality of life through its significant experiences occur due to their presence in the housing. This paper tries to identify the preference of landscape elements that enhance residents’ quality of life living in the apartment. Hence, landscape elements that can be planned in the open spaces of housing and quality of life components were identified from the secondary data sources. Experts’ were asked to identify the quality of life components with respect to landscape elements. A questionnaire survey of residents’ living in the apartment housing in Bhopal, India was conducted. The statistical analysis of survey data facilitated to explore the preference of landscape elements for the quality of life in the apartment housing. The final ranking compiled from the experts’ opinion, residents’ perception as well as factor analysis results to have an insight of the preference of landscape elements for the quality of life living in the apartment. Preference of landscape elements present in the paper may provide an overview of planning for apartment housing that may be used by architects, planners and developers for enhancing residents’ quality of life.

Keywords: landscape elements, quality of life, residents, housing

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Authors: Purnomo Yustianto, Robin Doss, Novianto B. Kurniawan Suhardi

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Since its inception, the design activities of Service Oriented Architecture (SOA) has been guided with aspects from the Service Design Principles (SDP), such as cohesion, granularity, loose coupling, discoverability, and autonomy, etc. The goal of this paper is two folds. The first is to examine the position of SDP within the context of software quality, and the second is to reframe the aspects of SDP into a more concise terms and relations. This paper is divided into four parts, in which after the introduction, a review on related software quality is provided to determine the quality context of SDP. The third part reviews the original SDP and offers a relation model among the SDP aspects. The fourth part explores the design quality metrics available for SOA and proposes a relationship representing the design quality. Among the aspects of design principles, the cohesion and coupling aspect is determined to be the two important aspects for achieving reusability of a service.

Keywords: SOA, software quality, service design principle, reusability, cohesion, coupling

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Authors: Lucia Billeci, Gennaro Tartarisco, Maurizio Varanini

Abstract:

Fetal cardiac monitoring by fetal electrocardiogram (fECG) can provide significant clinical information about the healthy condition of the fetus. Despite this potentiality till now the use of fECG in clinical practice has been quite limited due to the difficulties in its measuring. The recovery of fECG from the signals acquired non-invasively by using electrodes placed on the maternal abdomen is a challenging task because abdominal signals are a mixture of several components and the fetal one is very weak. This paper presents an approach for fECG extraction from abdominal maternal recordings, which exploits the characteristics of pseudo-periodicity of fetal ECG. It consists of devising a quality index (fQI) for fECG and of finding the linear combinations of preprocessed abdominal signals, which maximize these fQI (quality index optimization - QIO). It aims at improving the performances of the most commonly adopted methods for fECG extraction, usually based on maternal ECG (mECG) estimating and canceling. The procedure for the fECG extraction and fetal QRS (fQRS) detection is completely unsupervised and based on the following steps: signal pre-processing; maternal ECG (mECG) extraction and maternal QRS detection; mECG component approximation and canceling by weighted principal component analysis; fECG extraction by fQI maximization and fetal QRS detection. The proposed method was compared with our previously developed procedure, which obtained the highest at the Physionet/Computing in Cardiology Challenge 2013. That procedure was based on removing the mECG from abdominal signals estimated by a principal component analysis (PCA) and applying the Independent component Analysis (ICA) on the residual signals. Both methods were developed and tuned using 69, 1 min long, abdominal measurements with fetal QRS annotation of the dataset A provided by PhysioNet/Computing in Cardiology Challenge 2013. The QIO-based and the ICA-based methods were compared in analyzing two databases of abdominal maternal ECG available on the Physionet site. The first is the Abdominal and Direct Fetal Electrocardiogram Database (ADdb) which contains the fetal QRS annotations thus allowing a quantitative performance comparison, the second is the Non-Invasive Fetal Electrocardiogram Database (NIdb), which does not contain the fetal QRS annotations so that the comparison between the two methods can be only qualitative. In particular, the comparison on NIdb was performed defining an index of quality for the fetal RR series. On the annotated database ADdb the QIO method, provided the performance indexes Sens=0.9988, PPA=0.9991, F1=0.9989 overcoming the ICA-based one, which provided Sens=0.9966, PPA=0.9972, F1=0.9969. The comparison on NIdb was performed defining an index of quality for the fetal RR series. The index of quality resulted higher for the QIO-based method compared to the ICA-based one in 35 records out 55 cases of the NIdb. The QIO-based method gave very high performances with both the databases. The results of this study foresees the application of the algorithm in a fully unsupervised way for the implementation in wearable devices for self-monitoring of fetal health.

Keywords: fetal electrocardiography, fetal QRS detection, independent component analysis (ICA), optimization, wearable

Procedia PDF Downloads 254

Authors: Chipo Mugova, Zuko Mjobo

Abstract:

The aim of this study was to evaluate the cost of quality (COQ) at a local foundry business to identify the contribution of its units and processes to quality costs within the foundry’s operations. The foundry selected for detailed case study is one of major businesses that have been targeted by the government to produce components for building and re-furbishing wagons and trains. The study aimed at identifying areas in the foundry’s processes in which investment needs to be made to reduce quality costs. This is in alignment with government’s vision of promoting local business to support local markets leading to creation of jobs, and hence reduction of unemployment rate in South Africa. The methodology adopted used cost of quality models. Results from the study indicated that internal failure costs were significantly higher than all other cost of quality categories, taking more than 60% of the business’s income.

Keywords: appraisal costs, cost of quality, failure costs, local content, prevention costs

Procedia PDF Downloads 316

Authors: Najib Ahmad Marzuki, Che Su Mustaffa, Johana Johari, Nur Haffiza Rahaman

Abstract:

The purpose of this paper is to examine the effects and relationship of stress and social support towards the quality of life among flood victims in Malaysia. A total of 764 respondents took part in the survey via random sampling. The depression, anxiety, and stress scales were utilized to measure stress while The Multidimensional Scale of Perceived Social Support was used to measure the quality of life. The findings of this study indicate that there were significant correlations between variables in the study. The findings show a significant negative relation between stress and quality of life, and significant positive correlations between support from family as well as support from friends with the quality of life. Stress and support from family were found to be significant predictors and influences the quality of life among flood victims.

Keywords: stress, social support, quality of life, flood victims

Procedia PDF Downloads 514

Authors: Leena Wanganoo

Abstract:

In this digital age with the mushrooming of online companies across the globe has led to an unprecedented new business model. The frequency of online purchasing varies across the globe, but trend shows a steep upward movement. From Generation X to the Millennial the consumer not only wants to order the product with the click of mouse but also very demanding service quality during pre to post-transaction stage. The existing research examines the impact of website quality on the on behavioral intentions in e-services customers and has not adequately recognized the quality of e-commerce logistics perceived by the customer.In order to address this gap, this study examines the relationship among the logistics service quality, satisfaction, and loyalty. Drawing upon a sample of 350 millennial customers from various regions of UAE will work within the framework of structural equation modeling (SEM). Finally, the study would use Importance-Performance analysis (IPA) to discuss the relations of the level of customers’ expected logistics service quality and level of customers’ perceived logistics serviced quality.

Keywords: logistics service quality, customer satisfaction, loyalty, electronic commerce

Procedia PDF Downloads 142