A Call for Action for Mental Health: Medical Students and Physicians' roles

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A Six Sigma and DMAIC application for the reduction of defects in a rubber gloves manufacturing process

Purpose: In this era of globalisation, as competition intensifies, providing quality products and services has become a competitive advantage and a need to ensure survival. The Six Sigma's problem-solving methodology DMAIC has been one of the several techniques used by organisations to improve the quality of their products and services. This paper aims to demonstrate the empirical application of Six Sigma and DMAIC to reduce product defects within a rubber gloves manufacturing organisation. Design/methodology/approach: The paper follows the DMAIC methodology to systematically investigate the root cause of defects and provide a solution to reduce/eliminate them. In particular, the design of experiments, hypothesis testing and two-way analysis of variance techniques were combined to statistically determine whether two key process variables, oven's temperature and conveyor's speed, had an impact on the number of defects produced, as well as to define their optimum values needed to reduce/eliminate the defects. Findings: The analysis from employing Six Sigma and DMAIC indicated that the oven's temperature and conveyor's speed influenced the amount of defective gloves produced. After optimising these two process variables, a reduction of about 50 per cent in the “leaking” gloves defect was achieved, which helped the organisation studied to reduce its defects per million opportunities from 195,095 to 83,750 and thus improve its sigma level from 2.4 to 2.9. Practical implications: This paper can be used as a guiding reference for managers and engineers to undertake specific process improvement projects, in their organisations, similar to the one presented in this paper. Originality/value: This study presents an industrial case which demonstrates how the application of Six Sigma and DMAIC can help manufacturing organisations to achieve quality improvements in their processes and thus contribute to their search for process excellence

Outcomes from an exploratory study of quality methods utilisation in Brazilian companies

This paper presents an initial study that investigates the degree of adoption of quality methods in Brazil. The research is based on an exploratory survey validated and distributed among a number of Brazilian organisations operating in a wide range of industries. The results were analysed using descriptive statistics. The study shows that many Brazilian companies are now adopting quality methods as a strategy to be globally competitive, with ISO standards being their first choice. The study also presents evidence of which methods have been more widely implemented, their importance, the results obtained, and the barriers faced during their implementation. Reasons for not using them were also investigated. The paper also identifies some key factors to successfully deploy quality improvement approaches in Brazil. This study offers academics, researchers and practitioners interested in the area of quality with some initial evidence of the adoption and development of quality methods in a fast developing country like Brazil

Pseudotumor cerebri syndrome in childhood : incidence, clinical profile and risk factors in a national prospective population-based cohort study

Aim To investigate the epidemiology, clinical profile and risk factors of pseudotumor cerebri syndrome (PTCS) in children aged 1-16 years. Methods A national prospective population-based cohort study over 25 months. Newly diagnosed PTCS cases notified via British Paediatric Surveillance Unit (BPSU) were ascertained using classical diagnostic criteria and categorised according to 2013 revised diagnostic criteria. We derived national age, sex and weight-specific annual incidence rates and assessed effects of sex and weight category. Results We identified 185 PTCS cases of which 166 also fulfilled revised diagnostic criteria. The national annual incidence (95% CI) of childhood PTCS aged 1-16 years was 0.71 (0.57- 0.87) per 100,000 population increasing with age and weight to 4.18 and 10.7 per 100,000 in obese 12-15 year old boys and girls respectively. Incidence rates under 7 years were similar in both sexes. From 7 years onwards, the incidence in girls was double that in boys, but only in overweight (including obese) children. In 12-15 year old children, an estimated 82% of the incidence of PTCS was attributable to obesity. Two subgroups of PTCS were apparent: 168 (91%) cases aged from 7 years frequently presented on medication and with headache, and were predominantly female and obese. The remaining 17 (9%) cases under 7 years often lacked these risk factors and commonly presented with new onset squint. Conclusions This uniquely largest population-based study of childhood PTCS will inform the design of future intervention studies. It suggests that weight reduction is central to the prevention of PTCS

Using big data to make better decisions in the digital economy

The question this special issue would like to address is how to harvest big data to help decision-makers to deliver better fact-based decisions aimed at improving performance or to create better strategy? This special issue focuses on the big data applications in supporting operations decisions, including advanced research on decision models and tools for the digital economy. Responds to this special issue was great and we have included many high-quality papers. We are pleased to present 13 of the best papers. The techniques presented include data mining, simulation and expert system with applications span across online reviews, food retail chain to e-health

Investigating the impact of short food supply chain on emigration: A study of Valencia community in Spain

Recent financial crisis had severe impact on many economies around the globe. In Spain, it has resulted in increasing job loss, increasing short food supply chain businesses and rise in emigration. This research investigates how direct trades between producers and consumers (short supply chain) affect decisions of those who have decided to emigrate abroad. This paper also questions whether short supply chains can be part of the solution to restrict emigration by creating employment opportunities in depressed economies such as autonomous community of Valencia in Spain. This research adopts quantitative approach and a survey strategy. The research concludes that short food supply chain (SFSC) businesses could be one of the potential solutions to address some of the issues raised by the globalization, such as the unemployment and environmental damage. In addition, data findings also show that launching an SFSC business could be a way to avoid issues associated with emigration

Strabismus and Poor Stereoacuity Associated with Kabuki Syndrome

Kabuki syndrome is characterized by long palpebral fissures, large ears, a depressed nasal tip, and skeletal anomalies associated with postnatal dwarfism and mental retardation. There have been few prior detailed descriptions of strabismus or stereopsis in these patients. We report a patient with Kabuki syndrome who showed small-angle strabismus and poor stereopsis. This case illustrates the need for patients with a diagnosis of Kabuki syndrome to have an ophthalmologic evaluation. Strabismus associated with Kabuki syndrome may have a small angle that can be easily overlooked

NMDA-receptor antibodies alter cortical microcircuit dynamics

NMDA-receptor antibodies (NMDAR-Abs) cause an autoimmune encephalitis with a diverse range of EEG abnormalities. NMDAR-Abs are believed to disrupt receptor function, but how blocking this excitatory synaptic receptor can lead to paroxysmal EEG abnormalities-or even seizures-is poorly understood. Here we show that NMDAR-Abs change intrinsic cortical connections and neuronal population dynamics to alter the spectral composition of spontaneous EEG activity and predispose brain dynamics to paroxysmal abnormalities. Based on local field potential recordings in a mouse model, we first validate a dynamic causal model of NMDAR-Ab effects on cortical microcircuitry. Using this model, we then identify the key synaptic parameters that best explain EEG paroxysms in pediatric patients with NMDAR-Ab encephalitis. Finally, we use the mouse model to show that NMDAR-Ab-related changes render microcircuitry critically susceptible to overt EEG paroxysms when these key parameters are changed, even though the same parameter fluctuations are tolerated in the in silico model of the control condition. These findings offer mechanistic insights into circuit-level dysfunction induced by NMDAR-Ab