Development of a quantification model for the cost of loss of image with customer complaints

Despite the difficulty in measuring hidden quality costs, we must be aware not only of their existence, but also of their importance. Not surprisingly, they have been the causative factor in the closure of many companies because they are doubly dangerous. One the one hand, they represent very significant quantities of money and, on the other, they remain hidden, like the submerged portion of an iceberg [Campanella, J. (1999). Principles of Quality Costs: Principles, Implementation and Use. Milwaukee, WI: ASQ Quality Press]. Possibly one of the most harmful hidden quality costs, and most difficult to quantify, is the cost of loss of image (CLI) a company suffers because of faults detected by its customers. This paper develops an original tool that, with the use of fuzzy logic as an alternative to probabilistic theory, is capable of facilitating the quantification of the CLI in any company from the observation of its customer complaints. Once the theoretical model is presented, we proceed with its experimentation, making use of a case study as research methodology

The evaluation performance for commercial banks by intuitionistic fuzzy numbers: the case of Spain

In a globalized world, the banking sector has been forced to advance not only in financial performance, but also in non-financial performance, especially in sustainability criteria. For this purpose, multicriteria decision methods are especially suited to evaluate efficiency and to make a stable ranking of the most outstanding banks in the Spanish financial system. However, we are aware of the difficulties involved due to the inherent uncertainty and subjectivity of this process. For this reason, the use of fuzzy models is proposed, especially intuitionistic fuzzy numbers combined with the Analytic Hierarchy Process and the TOPSIS. The combination of financial criteria based on the CAMELS rating system with non-financial sustainability criteria makes it possible to order the Spanish banking system based on global efficiency. The most relevant contributions are: first, the use of intuitionistic fuzzy numbers in the performance evaluation process, whereby the quality of the information available can be quantified; and the most important one, a simplification of the process in the implementation of the intuitionistic fuzzy TOPSIS. Finally, through a sensibility analysis, it is possible to isolate the relevance of the sustainability process to obtain the global performance evaluation

How environmental certification can affect the value of organizations? The case of Forest Stewardship Council certification

Forest certification appeared in the 1990's as a way to deal with forest deterioration. Currently, however, public opposition can limit its effectiveness. Business policy makers should analyze how Forest Stewardship Council (FSC) certification can affect the value of companies. Yet, the relation between financial performance and forest certification systems is a subject which has not been explored to a great extent, and the measures used for evaluating financial performance in published studies are not based on business valuation. In this study, Spanish companies with FSC certification are valuated under the premises of implementation and non-implementation of FSC certification. Given the uncertainty inherent in the second option, the use of fuzzy mathematics has been considered a suitable tool. According to the results obtained, it can be concluded that regardless of size or business sector, FSC certification is effective in increasing the value of companies. The pap er offers economic arguments for managers to become more environmentally responsible

A novel approach to improve the bank ranking process: an empirical study in Spain

In this paper, a novel approach to the bank ranking process based on the possibilistic theory is proposed. Through this new method, the sensitivity of the results can be improved. Several methods are applied in order to rank the financial performance of Spanish Banks. Methods such as the Fuzzy Analytic Hierarchy Process (FAHP) and fuzzy TOPSIS are integrated in the proposed model. Criteria and sub-criteria weights are computed based on the judgments of experts using FAHP. These weights and financial indicators are inputs of the fuzzy TOPSIS methods for ranking the banks. The financial ratios are based on the CAMEL rating system criteria. Moreover, the results from the application of several distance measurements (Vertex, Hamming and Euclidean) in fuzzy TOPSIS as well as a new measure based on the possibilistic theory are compared. Finally, the results obtained applying fuzzy TOPSIS show that they vary depending on the separate measure, so it is necessary to have different measures to be able to correct decision making

Oral immunogenicity in mice and sows of enterotoxigenic escherichia coli outer-membrane vesicles incorporated into zein-based nanoparticles

Enterotoxigenic Escherichia coli (ETEC) strains are a major cause of illness and death in neonatal and recently weaned pigs. The immune protection of the piglets derives from maternal colostrum, since this species does not receive maternal antibodies through the placenta. In the present study, outer membrane vesicles (OMVs) obtained from main ETEC strains involved in piglet infection (F4 and F18 serotypes), encapsulated into zein nanoparticles coated with Gantrez®® AN-mannosamine conjugate, were used to orally immunize mice and pregnant sows. Loaded nanoparticles were homogeneous and spherical in a shape, with a size of 220–280 nm. The diffusion of nanoparticles through porcine intestinal mucus barrier was assessed by a Multiple Particle Tracking technique, showing that these particles were able to diffuse efficiently (1.3% diffusion coefficient), validating their oral use. BALB/c mice were either orally immunized with free OMVs or encapsulated into nanoparticles (100 µg OMVs/mouse). Results indicated that a single dose of loaded nanoparticles was able to elicit higher levels of serum specific IgG1, IgG2a and IgA, as well as intestinal IgA, with respect to the free antigens. In addition, nanoparticles induced an increase in levels of IL-2, IL-4 and IFN-γ with respect to the administration of free OMVs. Orally immunized pregnant sows with the same formulation elicited colostrum-, serum- (IgG, IgA or IgM) and fecal- (IgA) specific antibodies and, what is most relevant, offspring suckling piglets presented specific IgG in serum. Further studies are needed to determine the infection protective capacity of this new oral subunit vaccin

Evaluation of nanoparticles as oral vehicles for immunotherapy against experimental peanut allergy

The aim of this work was to evaluate the potential application of an original oral immunotherapy, based on the use of nanoparticles, against an experimentally induced peanut allergy. In this context, a roasted peanut extract, containing the main allergenic proteins, were encapsulated into poly(anhydride) nanoparticles. The resulting peanut-loaded nanoparticles (PE-NP) displayed a mean size of about 150 nm and a significantly lower surface hydrophobicity than empty nanoparticles (NP). This low hydrophobicity correlated well with a higher in vitro diffusion in pig intestinal mucus than NP and an important in vivo capability to reach the intestinal epithelium and Peyer’s patches. The immunotherapeutic capability of PE-NP was evaluated in a model of pre-sensitized CDI mice to peanut. After completing therapy of three doses of peanut extract, either free or encapsulated into nanoparticles, mice underwent an intraperitoneal challenge. Anaphylaxis was evaluated by means of assessment of symptom scores and mouse mast cell protease-1 levels (mMCPT-1). PE-NP treatment was associated with significant lower levels of mMCPT-1, and a significant survival rate after challenge, confirming the protective effect of this formulation against the challenge. In summary, this nanoparticle-based formulation might be a valuable strategy for peanut-specific immunotherapy

Rationale and methods of the multicenter randomised trial of a heart failure management programme among geriatric patients (HF-Geriatrics)

<p>Abstract</p> <p>Background</p> <p>Disease management programmes (DMPs) have been shown to reduce hospital readmissions and mortality in adults with heart failure (HF), but their effectiveness in elderly patients or in those with major comorbidity is unknown. The Multicenter Randomised Trial of a Heart Failure Management Programme among Geriatric Patients (HF-Geriatrics) assesses the effectiveness of a DMP in elderly patients with HF and major comorbidity.</p> <p>Methods/Design</p> <p>Clinical trial in 700 patients aged ≥ 75 years admitted with a primary diagnosis of HF in the acute care unit of eight geriatric services in Spain. Each patient should meet at least one of the following comorbidty criteria: Charlson index ≥ 3, dependence in ≥ 2 activities of daily living, treatment with ≥ 5 drugs, active treatment for ≥ 3 diseases, recent emergency hospitalization, severe visual or hearing loss, cognitive impairment, Parkinson's disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), anaemia, or constitutional syndrome. Half of the patients will be randomly assigned to a 1-year DMP led by a case manager and the other half to usual care. The DMP consists of an educational programme for patients and caregivers on the management of HF, COPD (knowledge of the disease, smoking cessation, immunizations, use of inhaled medication, recognition of exacerbations), diabetes (knowledge of the disease, symptoms of hyperglycaemia and hypoglycaemia, self-adjustment of insulin, foot care) and depression (knowledge of the disease, diagnosis and treatment). It also includes close monitoring of the symptoms of decompensation and optimisation of treatment compliance. The main outcome variables are quality of life, hospital readmissions, and overall mortality during a 12-month follow-up.</p> <p>Discussion</p> <p>The physiological changes, lower life expectancy, comorbidity and low health literacy associated with aging may influence the effectiveness of DMPs in HF. The HF-Geriatrics study will provide direct evidence on the effect of a DMP in elderly patients with HF and high comorbidty, and will reduce the need to extrapolate the results of clinical trials in adults to elderly patients.</p> <p>Trial registration</p> <p>(ClinicalTrials.gov number, <a href="http://www.clinicaltrials.gov/ct2/show/NCT01076465">NCT01076465</a>).</p

Roflumilast in moderate-to-severe chronic obstructive pulmonary disease treated with longacting bronchodilators: two randomised clinical trials

Background Patients with chronic obstructive pulmonary disease (COPD) have few options for treatment. The efficacy and safety of the phosphodiesterase-4 inhibitor roflumilast have been investigated in studies of patients with moderate-to-severe COPD, but not in those concomitantly treated with longacting inhaled bronchodilators. The effect of roflumilast on lung function in patients with COPD that is moderate to severe who are already being treated with salmeterol or tiotropium was investigated. Methods In two double-blind, multicentre studies done in an outpatient setting, after a 4-week run-in, patients older than 40 years with moderate-to-severe COPD were randomly assigned to oral roflumilast 500 mu g or placebo once a day for 24 weeks, in addition to salmeterol (M2-127 study) or tiotropium (M2-128 study). The primary endpoint was change in prebronchodilator forced expiratory volume in 1s (FEV(1)). Analysis was by intention to treat. The studies are registered with ClinicalTrials.gov, number NCT00313209 for M2-127, and NCT00424268 for M2-128. Findings In the salmeterol plus roflumilast trial, 466 patients were assigned to and treated with roflumilast and 467 with placebo; in the tiotropium plus roflumilast trial, 371 patients were assigned to and treated with roflumilast and 372 with placebo. Compared with placebo, roflumilast consistently improved mean prebronchodilator FEV(1) by 49 mL (p<0.0001) in patients treated with salmeterol, and 80 mL (p<0.0001) in those treated with tiotropium. Similar improvement in postbronchodilator FEV(1) was noted in both groups. Furthermore, roflumilast had beneficial effects on other lung function measurements and on selected patient-reported outcomes in both groups. Nausea, diarrhoea, weight loss, and, to a lesser extent, headache were more frequent in patients in the roflumilast groups. These adverse events were associated with increased patient withdrawal. Interpretation Roflumilast improves lung function in patients with COPD treated with salmeterol or tiotropium, and could become an important treatment for these patients

The Financial Valuation Risk in Pepper Production: The Use of Decoupled Net Present Value

Greenhouse peppers are one of the most important crops globally. However, as in any production activity, especially agricultural, they are subject to important risk factors such as price fluctuations, pests, or the use of bad quality water. This article aims to evaluate the viability of these types of crops by using discounted cash flows. Risk evaluation has been carried out through the analysis of pepper plantations for 2016 and 2017. The traditional application of this tool has significant limitations, such as the discount rate to be used or the estimation of future cash flows. However, by using discount functions that decrease over time in combination with decoupled net present value, these limitations are expected to improve. The use of decoupled net present value has permitted an increase in the accuracy and quantification of risks, isolating the main risks such as price drops (EUR 3720 ha&minus;1 year&minus;1) and structural risks (EUR 1622 &euro; ha&minus;1 year&minus;1). The use of decreasing discount functions has permitted a more realistic investment estimation. Finally, the sensitivity analysis shows that decoupled net present value (DNPV) is little affected by changes in interest rates in contrast to traditional net present value (NPV)