Search results for: customer care agents

Authors: Muhammad Kamran Asif

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MPLS stands for Multi-Protocol Label Switching. It is the technology which replaces ATM (Asynchronous Transfer Mode) and frame relay. In this paper, we have designed a full fledge small scale MPLS based service provider network core network model, which provides communication services (e.g. voice, video and data) to the customer more efficiently using label switching technique. Using MPLS VPN provides security to the customers which are either on LAN or WAN. It protects its single customer sites from being attacked by any intruder from outside world along with the provision of concept of extension of a private network over an internet. In this paper, we tried to implement a service provider network using minimum available resources i.e. five 3800 series CISCO routers comprises of service provider core, provider edge routers and customer edge routers. The customers on the one end of the network (customer side) is capable of sending any kind of data to the customers at the other end using service provider cloud which is MPLS VPN enabled. We have also done simulation and emulation for the model using GNS3 (Graphical Network Simulator-3) and achieved the real time scenarios. We have also deployed a NMS system which monitors our service provider cloud and generates alarm in case of any intrusion or malfunctioning in the network. Moreover, we have also provided a video help desk facility between customers and service provider cloud to resolve the network issues more effectively.

Keywords: MPLS, VPN, NMS, ATM, asynchronous transfer mode

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Authors: Soumitri Bag Majumder, Anindita Chaudhuri

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This exploratory study delves into the perception of job dignity among delivery agents in Kolkata, focusing on both food and grocery delivery sectors. The rapid expansion of online delivery platforms in India has led to a significant rise in the delivery service industry. Despite its growth, there is a dearth of research addressing the multifaceted challenges faced by delivery agents. This study aims to bridge this gap by shedding light on their experiences. The study’s objectives include exploring the lived experiences of delivery agents, their work-life balance, and their perception of job dignity. Using a qualitative research approach, the study will conduct semi-structured in-depth interviews with a purposive sample of 10 participants from each sector, consisting of individuals with lower socio-economic backgrounds aged between 18 and 35 years. The Three-Layer Coding framework proposed by Charmaz will guide the data analysis process, encompassing open coding, axial coding, and selective coding. Through this method, the study seeks to uncover emergent themes and patterns that illuminate the participants’ perspectives on job dignity, recognition, and the challenges they encounter. By uncovering their perceptions of job dignity and the challenges they face, the research aims to contribute to the well-being of these workers and inform relevant stakeholders for a more equitable work environment.

Keywords: delivery agents, equitable work environment, perception of job dignity, work-life balance

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Authors: M. Łęgowik-Małolepsza

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The article discusses the problem related to the use of modern information technologies to achieve pro-environmental marketing goals in business-to-customer (B2C) relationships. The topic is important and topical due to the strong social need to implement the concept of sustainable development. The aim of the article is to understand and evaluate the possibilities of implementing modern information technologies, such as Customer Relationship Management platforms (CRM), in the area of implementing marketing activities of companies operating in the Business to Customer model. In B2C relations, marketing departments struggle with problems resulting from the need for quick customer segmentation and the fragmentation of data existing in many systems, which significantly hinders the achievement of the assumed marketing goals. Therefore, the article proposes the use of modern information technology solutions in the area of marketing activities of enterprises, taking into account their pro-environmental goals. The most important results of the research carried out include an in-depth understanding of the possibilities of implementing modern information technologies to achieve marketing goals in B2C relationships. Moreover, a better understanding of the coexistence of opportunities and threats related to the implementation of marketing activities, taking into account pro-environmental goals and modern technologies, allows for more effective implementation of sustainable development management in enterprises. The methods used to achieve the goal are literature studies, descriptive analysis, and case studies. The study contributes to the discussion on the scope of application of modern information technologies in the area of B2C marketing activity, taking into account the implementation of pro-environmental goals of enterprises.

Keywords: B2C marketing activity, implementation of technologies, modern information technologies, pro-environmental activities

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Authors: Fatéma Zahra Benchara, Mohamed Youssfi, Omar Bouattane, Hassan Ouajji, Mohamed Ouadi Bensalah

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The aim of this paper is to present a distributed implementation of the Type-2 Fuzzy algorithm in a parallel and distributed computing environment based on mobile agents. The proposed algorithm is assigned to be implemented on a SPMD (Single Program Multiple Data) architecture which is based on cooperative mobile agents as AVPE (Agent Virtual Processing Element) model in order to improve the processing resources needed for performing the big data image segmentation. In this work we focused on the application of this algorithm in order to process the big data MRI (Magnetic Resonance Images) image of size (n x m). It is encapsulated on the Mobile agent team leader in order to be split into (m x n) pixels one per AVPE. Each AVPE perform and exchange the segmentation results and maintain asynchronous communication with their team leader until the convergence of this algorithm. Some interesting experimental results are obtained in terms of accuracy and efficiency analysis of the proposed implementation, thanks to the mobile agents several interesting skills introduced in this distributed computational model.

Keywords: distributed type-2 fuzzy algorithm, image processing, mobile agents, parallel and distributed computing

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Authors: Kingkan Chumjamras

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There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

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Authors: Ana Elisa Ribeiro Costa, Sónia Daniela Ferreira Miranda, João Pedro De Carvalho Pereira, João Carlos Simões Bernardo

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Elastomeric thermoplastics (TPEs) have been widely used in the footwear industry over the years. Recently this industry has been requesting materials that can combine lightweight and high abrasion resistance. Although there are blowing agents on the market to improve the lightweight, when these are incorporated into molten polymers during the extrusion or injection molding, it is necessary to have some specific processing conditions (e.g. effect of temperature and hydrodynamic stresses) to obtain good properties and acceptable surface appearance on the final products. Therefore, it is a great advantage for the compounder industry to acquire compounds that already include the blowing agents. In this way, they can be handled and processed under the same conditions as a conventional raw material. In this work, the expandable TPEs compounds, namely a TPU and a SEBS, with the incorporation of blowing agents, have been developed through a co-rotating modular twin-screw parallel extruder. Different blowing agents such as thermo-expandable microspheres and an azodicarbonamide were selected and different screw configurations and temperature profiles were evaluated since these parameters have a particular influence on the expansion inhibition of the blowing agents. Furthermore, percentages of incorporation were varied in order to investigate their influence on the final product properties. After the extrusion of these compounds, expansion was tested by the injection process. The mechanical and physical properties were characterized by different analytical methods like tensile, flexural and abrasive tests, determination of hardness and density measurement. Also, scanning electron microscopy (SEM) was performed. It was observed that it is possible to incorporate the blowing agents on the TPEs without their expansion on the extrusion process. Only with reprocessing (injection molding) did the expansion of the agents occur. These results are corroborated by SEM micrographs, which show a good distribution of blowing agents in the polymeric matrices. The other experimental results showed a good mechanical performance and its density decrease (30% for SEBS and 35% for TPU). This study suggested that it is possible to develop optimized compounds for footwear applications (e.g., sole shoes), which only will be able to expand during the injection process.

Keywords: blowing agents, expandable thermoplastic elastomeric compounds, low density, footwear applications

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Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

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Authors: Colette Malyack, Pius Egbelu

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Business-to-Customer (B2C) delivery options have improved to meet increased demand in recent years. The change in end users has forced logistics networks to focus on customer service and sentiment that would have previously been the priority of the company or organization of origin. This has led to increased pressure on logistics companies to extend traditional B2B networks into a B2C solution while accommodating additional costs, roadblocks, and customer sentiment; the result has been the creation of the omnichannel delivery network encompassing a number of traditional and modern methods of package delivery. In this paper the many solutions within the omnichannel delivery network are defined and discussed. It can be seen through this analysis that the omnichannel delivery network can be applied to reduce the complexity of package delivery and provide customers with more options. Applied correctly the result is a reduction in cost to the logistics company over time, even with an initial increase in cost to obtain the technology.

Keywords: network planning, last mile delivery, omnichannel delivery network, omnichannel logistics

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Authors: Maria Luisa T. Uayan

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The global need for qualified nurses to take care of the clients with various health needs is an incessant occurrence that persistently cause migration of nurses from developing to developed countries. The pull-push theory of migration greatly affects health care delivery systems of sending countries which is the same way affects nursing management. The exodus of nurses prepared to provide the much needed leadership at the bedside leaves the country in clusters giving health care institutions limited time to develop the next front-line managers that will assure quality patient care. This paper focuses on the extent and consequences of the massive recurring migration phenomena that is felt ONLY IN THE PHILIPPINE health care arena. It deals with the causes, problems, and effects of the cyclical loss of competent Filipina nurses in terms of emigration. Also, it will highlights the difficulties confronted by nursing service departments and health care teams when more experienced nurses set out for the “greener pastures” and patients are placed under the care of novice nurses. Fundamentally, it will emphasize the impact of suffering the loss of competent nurse managers in the Philippine health care institutions and provide contemporary recommendations on how to responsd accordingly to this very timely issue.

Keywords: Migration, Nurse Manager, Philippines

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Authors: Jyoti Singh, Ahmed Stifi, Sascha Gentes

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The process of construction significantly contributes to high level of risks, complexity and uncertainties leading to cost and time overrun, customer dissatisfaction etc. lean construction is important as it is a comprehensive system of tools and concepts focusing on moving closer to customer satisfaction by understanding the process, identifying the waste and eliminating it. The proposed work includes identification of knowledge areas from lean perspective, lean tools/concepts used in lean construction and establishing a relationship matrix between knowledge areas and lean tools/concepts, thus developing and building up a lean construction body of knowledge (LCBOK), i.e. a guide to lean construction, aiming to provide guidelines to manage individual projects and also helping construction industry to minimise waste and maximize value to the customer. In this study, we identified 8 knowledge areas and 62 lean tools/concepts from lean perspective and also one tool can help to manage two or more knowledge areas.

Keywords: knowledge areas, lean body matrix, lean construction, lean tools

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Authors: Egemen Sert, Leila Hedayatifar, Rachel A. Rigg, Amir Akhavan, Olha Buchel, Dominic Elias Saadi, Aabir Abubaker Kar, Alfredo J. Morales, Yaneer Bar-Yam

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The complexity of providing timely and cost-effective distribution of finished goods from industrial facilities to customers makes effective operational coordination difficult, yet effectiveness is crucial for maintaining customer service levels and sustaining a business. Logistics planning becomes increasingly complex with growing numbers of customers, varied geographical locations, the uncertainty of future orders, and sometimes extreme competitive pressure to reduce inventory costs. Linear optimization methods become cumbersome or intractable due to a large number of variables and nonlinear dependencies involved. Here we develop a complex systems approach to optimizing logistics networks based upon dimensional reduction methods and apply our approach to a case study of a manufacturing company. In order to characterize the complexity in customer behavior, we define a “customer space” in which individual customer behavior is described by only the two most relevant dimensions: the distance to production facilities over current transportation routes and the customer's demand frequency. These dimensions provide essential insight into the domain of effective strategies for customers; direct and indirect strategies. In the direct strategy, goods are sent to the customer directly from a production facility using box or bulk trucks. In the indirect strategy, in advance of an order by the customer, goods are shipped to an external warehouse near a customer using trains and then "last-mile" shipped by trucks when orders are placed. Each strategy applies to an area of the customer space with an indeterminate boundary between them. Specific company policies determine the location of the boundary generally. We then identify the optimal delivery strategy for each customer by constructing a detailed model of costs of transportation and temporary storage in a set of specified external warehouses. Customer spaces help give an aggregate view of customer behaviors and characteristics. They allow policymakers to compare customers and develop strategies based on the aggregate behavior of the system as a whole. In addition to optimization over existing facilities, using customer logistics and the k-means algorithm, we propose additional warehouse locations. We apply these methods to a medium-sized American manufacturing company with a particular logistics network, consisting of multiple production facilities, external warehouses, and customers along with three types of shipment methods (box truck, bulk truck and train). For the case study, our method forecasts 10.5% savings on yearly transportation costs and an additional 4.6% savings with three new warehouses.

Keywords: logistics network optimization, direct and indirect strategies, K-means algorithm, dimensional reduction

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Authors: Mostafa M. Ahmed, Kotaro Nose, Takashi Fujii, Toshiki Ayano

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The Study shed the light on the effects of employing varied curing agents (No.1-No.6): bleeding water, and sprinkling water, aqueous basic silica compound, modified acrylic resin, the emulsion of solid wax and nonionic surfactant, and water-based paraffin wax, on the properties of high-performance concrete (HPC) in comparison with the cured specimens according to the standard curing at 20 ± 3°C (JIS A 0203:2019). The specimens cured in accordance with standard curing exhibit a better compressive strength and higher freeze-thaw resistance compared to most non-standard-cured samples.

Keywords: curing agents, high-performance concrete, compressive strength, cumulative scaling, freeze-thaw resistance

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Authors: Francisca Margarita Ocran

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Underwear, and more particularly bras and panties, are defined as intimate clothing. Strictly speaking, they enhance the place of women in the public or private satchel. Therefore, women's lingerie is a complex garment with a high involvement profile, motivating consumers to buy it not only by its functional utility but also by the multisensory experience it provides them. Customer behavior models are generally based on customer data mining, and each model is designed to answer questions at a specific time. Predicting the customer experience is uncertain and difficult. Thus, knowledge of consumers' tastes in lingerie deserves to be treated as an experiential product, where the dimensions of the experience motivating consumers to buy a lingerie product and to remain faithful to it must be analyzed in detail by the manufacturers and retailers to engage and retain consumers, which is why this research aims to identify the variables that push consumers to choose their lingerie product, based on an in-depth analysis of the types of fabrics used to make lingerie. The data used in this study comes from online purchases. Machine learning approach with the use of Python programming language and Pycaret gives us a precision of 86.34%, 85.98%, and 84.55% for the three algorithms to use concerning the preference of a buyer in front of a range of lingerie. Gradient Boosting, random forest, and K Neighbors were used in this study; they are very promising and rich in the classification of preference in the textile industry.

Keywords: consumer behavior, data mining, lingerie, machine learning, preference

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Authors: Rosy Chaudhary, Pushpa Parajuli

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Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

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Authors: Nabaweesi Josephine, Namwanje Regina Germina

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Antenatal care is referred to as the totality of care given to pregnant women from conception to delivery from a certified health care setting. A number of 8 contacts is recommended throughout pregnancy, according to WHO, 2016. Antenatal services are free in Uganda courtesy of the government of Uganda, though attendance is still very low, which has continued to cause maternal and infant mortality and morbidity from preventable causes. Early booking has an advantage for proper pregnancy information sharing and pregnancy monitoring. The purpose of this study was to determine pregnant women's knowledge, attitudes, and practices towards attendance of antenatal care at Mukono General Hospital. A sample of 60 pregnant women was used, and a descriptive quantitative design was employed. Data was collected using a structured questionnaire consisting of questions about socio-demographic factors, knowledge, attitude, and practice, and this was affected using the structured interview method. Pregnant women had good practice at 90.2%, a positive attitude of 94.6%, and slightly less knowledge of 66.7%. Only 12% were knowledgeable about the number of antenatal care visits recommended, 45% had knowledge about when to initiate first antenatal care visit, and 79% had a positive attitude towards the early booking. We recommend that pregnant women are given all the necessary information regarding antenatal care with special emphasis on the recommended number of visits and when to initiate their first visit and encourage early booking in order to achieve the 8 contacts WHO policy for antenatal care since when we increase knowledge, we increase antenatal care utilization according to Anderson's behavioral model.

Keywords: ANC- antenatal care, contacts, mortality, morbidity

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Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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Authors: Elackiya Sithamparanathan

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Chemical agents used during the Sri Lankan civil war continue to threaten human and environmental health as affected areas are re-settled. Bioremediation is a cost-effective and eco-friendly approach to degrading chemical agents, and has greater public acceptance than chemical degradation. Baseline data on contaminant distribution, environmental parameters, and indigenous microbes are required before bioremediation can commence. The culture and isolate of suitable microbes and enzymes should be followed by laboratory trials, before field application and long-term monitoring of contaminant concentration, soil parameters, microbial ecology, and public health to monitor environmental and public health. As local people are not aware of the persistence of warfare chemicals and do not understand the potential impacts on human health, community awareness programs are required. Active community participation, and collaboration with international and local agencies, would contribute to the success of bioremediation and the effective removal of chemical agents in war affected areas of Sri Lanka.

Keywords: bioremediation, environmental protection, human health, war affected regions in Sri Lanka

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Authors: Mohammed Al-Yamani, Yaser Miaji

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DHL Customer Solutions and Innovation Department (CSI) have been experiencing difficulties while comparing quotes for different customers in different years. Currently, the employees are processing data by opening several loaded Excel files where the quotes are and manually copying values to another Excel Workbook where the comparison is made. This project consists of developing a new and effective database for DHL CSI department so that information is stored altogether on the same catalog. That being said, we have been assigned to find an efficient algorithm that can deal with the different formats of the Excel Workbooks to copy and store the express customer rates for core products (DOX, WPX, IMP) for comparisons purposes.

Keywords: DHL, solution design, ORACLE, EXCEL

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Authors: Mohammad Alawairdhi

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Customer Relationship Management (CRM) started gaining attention as late as the 1990s, and since then efforts are ongoing to define the domain’s precise specifications. There is yet no single agreed upon definition. However, a predominant majority perceives CRM as a mechanism for enhancing interaction with customers, thereby strengthening the relationship between a business and its clients. From the perspective of Information Technology (IT) companies, CRM systems can be viewed as facilitating software products or services to automate the marketing, selling and servicing functions of an organization. In this paper, we have proposed a Bluetooth enabled CRM system for small- and medium-scale organizations. In the proposed system, Bluetooth technology works as an automatic identification token in addition to its common use as a communication channel. The system comprises a server side accompanied by a user-interface support for both client and server sides. The system has been tested in two environments and users have expressed ease of use, convenience and understandability as major advantages of the proposed solution.

Keywords: customer relationship management, CRM, bluetooth, automatic identification token

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Authors: L. Donelle, S. Regan, R. Booth, M. Kerr, J. McMurray, D. Fitzsimmons

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Palliative home health care provision within the Canadian context is challenged by: (i) a shortage of registered nurses (RN) and RNs with palliative care expertise, (ii) an aging population, (iii) reliance on unpaid family caregivers to sustain home care services with limited support to conduct this ‘care work’, (iv) a model of healthcare that assumes client self-care, and (v) competing economic priorities. In response, an interprofessional team of service provider organizations, a software/technology provider, and health care providers developed and implemented a technology-enabled model of home care, the eShift model of palliative home care (eShift). The eShift model combines communication and documentation technology with non-traditional utilization of health human resources to meet patient needs for palliative care in the home. The purpose of this study was to investigate the structure, processes, and outcomes of the eShift model of care. Methodology: Guided by Donebedian’s evaluation framework for health care, this qualitative-descriptive study investigated the structure, processes, and outcomes care of the eShift model of palliative home care. Interviews and focus groups were conducted with health care providers (n= 45), decision-makers (n=13), technology providers (n=3) and family care givers (n=8). Interviews were recorded, transcribed, and a deductive analysis of transcripts was conducted. Study Findings (1) Structure: The eShift model consists of a remotely-situated RN using technology to direct care provision virtually to patients in their home. The remote RN is connected virtually to a health technician (an unregulated care provider) in the patient’s home using real-time communication. The health technician uses a smartphone modified with the eShift application and communicates with the RN who uses a computer with the eShift application/dashboard. Documentation and communication about patient observations and care activities occur in the eShift portal. The RN is typically accountable for four to six health technicians and patients over an 8-hour shift. The technology provider was identified as an important member of the healthcare team. Other members of the team include family members, care coordinators, nurse practitioners, physicians, and allied health. (2) Processes: Conventionally, patient needs are the focus of care; however within eShift, the patient and the family caregiver were the focus of care. Enhanced medication administration was seen as one of the most important processes, and family caregivers reported high satisfaction with the care provided. There was perceived enhanced teamwork among health care providers. (3) Outcomes: Patients were able to die at home. The eShift model enabled consistency and continuity of care, and effective management of patient symptoms and caregiver respite. Conclusion: More than a technology solution, the eShift model of care was viewed as transforming home care practice and an innovative way to resolve the shortage of palliative care nurses within home care.

Keywords: palliative home care, health information technology, patient-centred care, interprofessional health care team

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Authors: F. Bouchouka, S. Benamara

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The present work is an attempt to prepare a fresh cheese using lemon juice and lemon juice / orange juice mixture as acidifying / clotting agents. A reference cheese is obtained by acidification with commercial vinegar. The analysis performed on the final product (fat, cheese yield, sensory analysis, rheological and bacteriological properties) confirmed the technical feasibility of a natural cheese, using a lemon juice and / or lemon juice / orange juice mixture as acidifying / clotting agents. In addition, a general acceptance test allowed to select the cheese sample acidified with lemon juice as the best, compared to the two other samples (lemon juice/orange juice acidification and commercial vinegar acidification).

Keywords: clotting agent, fresh cheese, juice, lemon, orange

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Authors: Ganesh Nivrutti Akhade

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This paper attempts to develop a reliable and valid instrument of measuring Healthcare service quality in India, and also analyses the impact of demographic factor of respondent on healthcare service quality. In this research paper , extant literature survey, discussion with stakeholder of healthcare system such as patients, patients relative, administrators of hospitals, clinics, professionals and expert interviews were used to develop a attributes of healthcare service quality dimensions. A pilot study was conducted with a sample of 31 healthcare patients of private sector, public sector ,trust hospital ,primary health care centers and clinics was surveyed in the Nagpur Metropolitan Area. At the end fifteen dimensions—reliability, assurance, responsiveness, tangibility, empathy, affordability, respect, and caring, Attitude of staff, Technical competence, Appropriateness, Safety, continuity, Effectiveness, Availability, Financial support. This fifteen-dimensional model was validated through a content validity and construct validity. The proposed research model shows acceptable fit indices. Impact of these dimensions on the Overall Healthcare Service Quality and customer satisfaction are analyzed using multiple regression technique. Findings indicate that all dimensions carry significant impact on the Overall Healthcare Service Quality perceptions and customer satisfaction. However, availability and effectiveness dimensions carry the maximum impact on the Overall healthcare Service Quality .

Keywords: healthcare, service quality, factor analysis (CFA), india, service quality dimensions

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Authors: Suhathai Tosangwarn, Philip Clissett, Holly Blake

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Background: High prevalence of depression has been reported among older adults living in care homes in Thailand, associated with physical impairment, low social support, low self-esteem and particularly stigma associated with living in a care home. However, little is understood about how such stigma is experienced among Thai care home residents. This study examines residents’ perceptions of stigma and their strategies for coping with stigma. Method/Design: Case study research was used to gain an in-depth view about the stigma of residents’ perspectives and experiences from two care homes in the northeast of Thailand by conducting an in-depth interview and non-participant observation. Qualitative interviews were conducted with 30 older residents (aged >60 years), purposively sampled from both care homes. Non-participant observation was conducted in various public spaces of the care homes, including the dining room, corridors, and activities areas for approximately one to two hours per day at different times; morning and afternoon including weekdays and weekend in both care homes for one month. Thematic analysis was used to analyse the data. Results: The study identified three major themes related to the causes of stigma, the reactions towards stigma and the mitigating factors. Negative beliefs about care homes, negative attitudes, and stereotypes toward the elderly and perceptions of unequal power relations between staff and residents were the main factors precipitating stigma. Consequently, residents exhibited negative emotions and behaviours, including depressive symptoms, while living in care homes. Residents reported the use of particular coping strategies, including accessing support from the public and staff and engaging in care home activities which these helped them to cope with their perception of stigma. Conclusion: Improved understanding of the underlying factors behind perceived stigma in care home residents may help to prevent depression and reduce perceptions of stigma associated with living in a care home, by informing strategy, supportive intervention and guidelines for appropriate care for older Thai residents.

Keywords: care home, depression, older adult, stigma, Thailand

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Authors: Eri Sulyanti, Trimurti Habazar, Eti Farda Husen, Abdi Dharma, Nasril Nasir

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In this study, combination of some biocontrol agents with different mechanisms was an alternative to improve the effectiveness of the biological control agents. Single and combined applications of indigenous Pseudomonas fluorescens and Arbuscular Mychorrhizae Fungi (AM Fungi) isolates were tested to induce the resistance on susceptible Cavendish banana against F.oxysporum f. sp. cubense race 4 under greenhouse conditions. These isolates originally isolated from healthy banana rhizosphere at endemic Fusarium wilt areas in the centre of production banana in West Sumatra. These researches were conducted with Randomized Block Design with 16 treatments and 10 replications. The treatments were three indigenous isolates of Pseudomonas fluorescens (Par1-Cv, Par4-Rj1, Par2-Jt1) and 3 isolates of AM Fungi (Gl1BuA4, Gl2BuA6, and Gl1KeP3. The biocontrol agents were applied as single agents and combination two of them. This study demonstrated that the application of combination biocontrol organisms Pseudomonas fluorescens and AM Fungi provided were more effective than single application. The combination of Par1-Cv and Gl1BuA4 isolates was the most effective to control Fusarium wilt and followed by the combination of Par1-Cv and Gl2BuA6 and Par2-Jt1 and Gl1P3.

Keywords: pseudomonad fluorescens (Pf), arbuscular mychorrhizae fungi (AM Fungi) indigenous isolates, fusarium oxysporum f. sp. cubense, soil rhizosphere

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Authors: Nunila Ferreira de Oliveira, Silvana Martins Mishima

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Diabetes mellitus type 2 (DM2) prevalence, is increasing on the world, in Brazil is considered a public health problem. Treatment focuses on glycemic control depending primarily of lifestyle changes - not drug treatment (NDT), may involve drug therapy (DT) and requires continuous health monitoring. In Brazil this monitoring is performed by the Unified Health System (SUS) through Primary Health Care (PHC), which stimulate people with DM2 empowerment for care management. SUS was approved in 1988 and the PHC operationalization was strengthened with the creation of the Family Health Strategy (FHS) in 1994. Our aim was to analyze the people with DM2 participation in front of the care management health monitoring in the FHS. Qualitative research was carried out through non-participant observation of attendance of 25 people with DM2 in the FHS and interviewed at home. Ethical guidelines were followed. It was found that people with DM2 only follow professionals’ recommendations that make sense according to their own conceptions of health/disease; most of them emphasize the importance of (DT) with little emphasis on the NDT, was found great difficulty in the NDT and lack of knowledge about the disease and care. As regards monitoring the FHS, were observed therapeutic practices based on the bio medical model, although the APS search for another care perspective; NDT is not systematically accompanied by the health team and takes place a few educational activities on the DM2 in the FHS, with low user adoption. The work of the FHS is done by multidisciplinary teams, but we see the need for greater participation of nurses in clinical-care follow-up of this population and may also act in adapting to the NDT. Finally we emphasize the need for professional practices that consider the difficulties to care management by people with DM2, especially because of the NDT. It is noticed that the measures recommended by the FHS professionals are not always developed by people with DM2. We must seek the empowerment of people with DM2 to manage the form of care associated with the FHS team, seeking to reduce the incidence of complications and higher quality of life.

Keywords: diabetes mellitus, primary health care, nursing, management of care

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Authors: Omar Ramzi Jasim, Jalal Sultan Ashour

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Production Planning or Master Production Schedule (MPS) is a key interface between marketing and manufacturing, since it links customer service directly to efficient use of production resources. Mismanagement of the MPS is considered as one of fundamental problems in operation and it can potentially lead to poor customer satisfaction. In this paper, a hybrid evolutionary algorithm (ICA-GA) is presented, which integrates the merits of both imperialist competitive algorithm (ICA) and genetic algorithm (GA) for solving multi-objective MPS problems. In the presented algorithm, the colonies in each empire has be represented a small population and communicate with each other using genetic operators. By testing on 5 production scenarios, the numerical results of ICA-GA algorithm show the efficiency and capabilities of the hybrid algorithm in finding the optimum solutions. The ICA-GA solutions yield the lower inventory level and keep customer satisfaction high and the required overtime is also lower, compared with results of GA and SA in all production scenarios.

Keywords: master production scheduling, genetic algorithm, imperialist competitive algorithm, hybrid algorithm

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Authors: Lou-Hon Sun, Yu-Ming Chiu, Chen-Wei Tao, Chia-Yun Tsai

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It is common practice for many companies to ask employees to provide heart-touching service for customers and to emphasize the attitude of 'customer first'. However, services may not necessarily gain praise, and may actually be considered excessive, if customers do not appreciate such behaviors. In reality, many restaurant businesses try to provide as much service as possible without taking into account whether over-provision may lead to negative customer reception. A survey of 894 people in Britain revealed that 49 percent of respondents consider over-attentive waiters the most annoying aspect of dining out. It can be seen that merely aiming to exceed customers’ expectations without actually addressing their needs, only further distances and dissociates the standard of services from the goals of customer satisfaction itself. Over-service is defined, as 'service provided that exceeds customer expectations, or simply that customers deemed redundant, resulting in negative perception'. It was found that customers’ reactions and complaints concerning over-service are not as intense as those against service failures caused by the inability to meet expectations; consequently, it is more difficult for managers to become aware of the existence of over-service. Thus the ability to manage over-service behaviors is a significant topic for consideration. The Kano model classifies customer preferences into five categories: attractive quality attribute, one-dimensional quality attribute, must-be quality attribute, indifferent quality attribute and reverse quality attributes. The model is still very popular for researchers to explore the quality aspects and customer satisfaction. Nevertheless, several studies indicated that Kano’s model could not fully capture the nature of service quality. The concept of over-service can be used to restructure the model and provide a better understanding of the service quality construct. In this research, the structure of Kano's two-dimensional questionnaire will be used to classify the factors into different dimensions. The same questions will be used in the second questionnaire for identifying the over-service experienced of the respondents. The finding of these two questionnaires will be used to analyze the relevance between service quality classification and over-service behaviors. The subjects of this research are customers of fine dining chain restaurants. Three hundred questionnaires will be issued based on the stratified random sampling method. Items for measurement will be derived from DINESERV scale. The tangible dimension of the questionnaire will be eliminated due to this research is focused on the employee behaviors. Quality attributes of the Kano model are often regarded as an instrument for improving customer satisfaction. The concept of over-service can be used to restructure the model and provide a better understanding of service quality construct. The extension of the Kano model will not only develop a better understanding of customer needs and expectations but also enhance the management of service quality.

Keywords: consumer satisfaction, DINESERV, kano model, over-service

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Authors: Mutaz Shurahabeel Ahmed Ombada

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This paper investigates potential health and financial settlement of health information technology, this paper evaluates health care with the use of IT and other associated industries. It assesses prospective savings and costs of extensive acceptance of Electronic Medical Record Systems (EMRS), models significant to health as well as safety remuneration, and conclude that efficient EMRS execution and networking could ultimately save more than US $55 billion annually through recuperating health care effectiveness and that Health Information Technology -enabled prevention and administration of chronic disease could eventually double those savings while rising health and other social remuneration. On the contrary, this is improbable to be realized without related to significant modifications to the health care system.

Keywords: electronic medical record systems, health care economics, EMRS

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Authors: Alison C. Essary, Victor Trastek

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Introduction: The current state of the health care system in the U.S. is characterized by an unprecedented number of people living with multiple chronic conditions, unsustainable rise in health care costs, inadequate access to care, and wide variation in health outcomes throughout the country. An estimated two-thirds of Americans are living with two or more chronic conditions, contributing to 75% of all health care spending. In 2013, the School for the Science of Health Care Delivery (SHCD) was charged with redesigning the health care system through education and research. Faculty in business, law, and public policy, and thought leaders in health care delivery, administration, public health and health IT created undergraduate, graduate, and executive academic programs to address this pressing need. Faculty and students work across disciplines, and with community partners and employers to improve care delivery and increase value for patients. Methods: Curricula apply content in health care administration and operations within the clinical context. Graduate modules are team-taught by faculty across academic units to model team-based practice. Seminars, team-based assignments, faculty mentoring, and applied projects are integral to student success. Cohort-driven models enhance networking and collaboration. This observational study evaluated two years of admissions data, and one year of graduate data to assess program outcomes and inform the current graduate-level curricula. Descriptive statistics includes means, percentages. Results: Fall 2013, the program received 51 applications. The mean GPA of the entering class of 37 students was 3.38. Ninety-seven percent of the fall 2013 cohort successfully completed the program (n=35). Sixty-six percent are currently employed in the health care industry (n=23). Of the remaining 12 graduates, two successfully matriculated to medical school; one works in the original field of study; four await results on the MCAT or DAT, and five were lost to follow up. Attrition of one student was attributed to non-academic reasons. Fall 2014, the program expanded to include both on-ground and online cohorts. Applications were evenly distributed between on-ground (n=70) and online (n=68). Thirty-eight students enrolled in the on-ground program. The mean GPA was 3.95. Ninety-five percent of students successfully completed the program (n=36). Thirty-six students enrolled in the online program. The mean GPA was 3.85. Graduate outcomes are pending. Discussion: Challenges include demographic variability between online and on-ground students; yet, both profiles are similar in that students intend to become change agents in the health care system. In the past two years, on-ground applications increased by 31%, persistence to graduation is > 95%, mean GPA is 3.67, graduates report admission to six U.S. medical schools, the Mayo Medical School integrates SHCD content within their curricula, and there is national interest in collaborating on industry and academic partnerships. This places SHCD at the forefront of developing innovative curricula in order to improve high-value, patient-centered care.

Keywords: delivery science, education, health care delivery, high-value care, innovation in education, patient-centered

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Authors: Harpreet Singh

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Finding relevant information on the World Wide Web is becoming highly challenging day by day. Web usage mining is used for the extraction of relevant and useful knowledge, such as user behaviour patterns, from web access log records. Web access log records all the requests for individual files that the users have requested from the website. Web usage mining is important for Customer Relationship Management (CRM), as it can ensure customer satisfaction as far as the interaction between the customer and the organization is concerned. Web usage mining is helpful in improving website structure or design as per the user’s requirement by analyzing the access log file of a website through a log analyzer tool. The focus of this paper is to enhance the accessibility and usability of a guitar selling web site by analyzing their access log through Deep Log Analyzer tool. The results show that the maximum number of users is from the United States and that they use Opera 9.8 web browser and the Windows XP operating system.

Keywords: web usage mining, web mining, log file, data mining, deep log analyzer

Procedia PDF Downloads 220