QFD Methodology Application To 'UPM-Net': A Case Study.

Usability problems continue to offer a challenge to interactive system designers. One response has been an increasing emphasis on the role of users in design. The aim is to gain knowledge about users' work practice and the context of use of systems so as to achieve more effective designs. Experience has shown that it is a challenge to apply these techniques in practice, causing us to ask what are the special problems associated with involving users in design? The present work is planned to apply the QFD (Quality Function Deployment) technique to develop awareness of customers' needs. Quality Function Deployment (QFD) can be best described as a way of making the 'Voice of the Customer' throughout an organisation. It is a systematic process for capturing customer requirements and translating these into requirements that must be met throughout the 'supply chain'. The result is a new set of target values for designers, production people, and even suppliers to aim at in order to produce the output desired by customers. QFD is particularly valuable when design trade-offs are necessary to achieve the best overall solution because some requirements may conflict with others. QFD also enables a great deal information to be summarised in the form of one or more charts. These charts capture customer and product data gleaned from many sources, as well as the design parameters chosen for new product. In this way, they provide a solid foundation for further improvement in subsequent design cycles. In the present work, the system 'UPM-Net' was investigated by way of first identifying the specific users populations of the system, which are found to be of three types. One is the category of academic staffs, second one is of non-academic staffs and the third one is of students of UPM. Then the VOC: Voice of Customers was developed for which an inventory system in the form of questionnaire was evolved for collecting data from the end-user populations. The collected data were statistically analysed using SPSS (Statistical Package for Social Sciences), the results were obtained and discussed later in the light of the literature reviewed. The conclusions were based on such factors as connectivity, storage space needs, network features, technical services, user's features, and communication problems vis-a-vis UPM-Net. Finally, the scope for future research was presented. Thus one dimension of QFD i.e., VOC was established and it is hoped that such a study would help the people who are responsible for designing UPM-Net system in evolving a more user-friendly kind of UPM-Net system for future population of its end-users

Risk of uterine rupture after the partographic \u27alert\u27 line is crossed--an additional dimension in the quest towards safe motherhood in labour following caesarean section

To determine if prolonged active phase of labour is associated with increased risk of uterine scar rupture in labour following previous lower segment caesarean section, a retrospective cohort study (1988-91) was done to analyse active phase partographs of 236 patients undergoing trial of labour following caesarean section, 7 (3%) of whom had scar rupture. After onset of active phase (3 cm cervical dilatation), a 1 cm/h line was used to indicate alert . A zonal partogram was developed by dividing the active phase partographs into 5 time zones: A (area to the left of alert line), B (0-1 h after alert line), C (1-2 h after alert line), D (2-3 h after alert line) and EF (\u3e 3 h after alert line). The relative risk of uterine scar rupture was calculated for different partographic time zones. The relative risk of uterine scar rupture was 10.5 (95% confidence interval 1.3-85.5, p = 0.01) at 1 hour after crossing the alert line; 8.0 (95% confidence interval 1.6-40.3, p = 0.009) at 2 hours after crossing the alert line; and 7.0 (95% confidence interval 1.6-29, p = 0.02) at 3 hours after crossing the alert line. In women undergoing trial of labour following caesarean section, prolonged active phase of labour is associated with increased risk of uterine rupture. A zonal partogram may be helpful in assessing this risk in actively labouring women who cross the partographic alert line

Audit changes clinical practice! impact on rate of justification of hysterectomy indication

After performing a baseline audit in 1986-89, an ongoing quality assurance process was initiated in January, 1990 and all hysterectomies performed over the next 2 year period were analyzed. Hysterectomy indications were divided into two groups: one in which the uterine specimen was expected to show pathology and another in which no pathology was expected. The hysterectomy was considered justified in the former if the pathology report verified the indication or showed a significant alternate pathology. In the latter, validation criteria showing documentation of certain prerequisite diagnostic procedures performed before reverting to hysterectomy, were used to ascertain justification. The overall rate of justification in the ongoing audit was 96%, being 97% for the group where hysterectomy indication was potentially confirmable by pathologic study and 93% for the one where it was not. Comparison with baseline analysis showed that the justification rates were higher for all indications not potentially confirmable by pathologic study (93% vs 89%, p \u3c 0.05), for recurrent uterine bleeding (90% vs 83%, p \u3c 0.05) and for leiomyoma (97% vs 95%, p \u3c 0.05). The improvement was associated with less frequent use of multiple indications in the ongoing study (10% vs 16%, p \u3c 0.05). The justification rates for hysterectomy indication can be improved by prospective audit and by avoiding use of multiple indications

Functional properties of whey protein concentrate texturized at acidic pH: effect of extrusion temperature

Reactive supercritical fluid extrusion (RSCFX) process at acidic condition (pH 3.0) was used to generate texturized whey protein concentrate (TWPC) and the impacts of process temperature on product's physicochemical properties were evaluated. TWPC extruded at 50 and 70 °C formed soft-textured aggregates with high solubility than that extruded at 90 °C that formed protein aggregates with low solubility. Total free sulfhydryl contents and solubility studies in selected buffers indicated that TWPC is primarily stabilized by non-covalent interactions. Proteins texturized at 90 °C showed an increased affinity for 1-anilino-naphthalene-8-sulfonate (ANS) and a decreased affinity for cis-parinaric acid (CPA), indicating changes in protein structure. Water dispersion of TWPC at room temperature showed thickening function with pseudoplastic behavior. Secondary gelation occurred in TWPC obtained at 50 and 70 °C by heating the cold-set gels to 95 °C. TWPC texturized at 90 °C produced cold-set gels with good thermal stability. Compared to control, TWPC formed stable oil-in-water emulsions. Factors such as degree of protein denaturation and the balance of surface hydrophobicity and solubility influenced the heat- and cold-gelation and emulsifying properties of the protein ingredients. TWPC generated by low and high temperature extrusions can thus be utilized for different products requiring targeted physicochemical functionalities

Moisture effects on the bending fatigue of laminated composites

This paper investigated the effect of moisture ingress on the bending fatigue of laminated composites. An accelerated testing method was developed to investigate the correlation between composite fatigue and moisture diffusion effects. Unidirectional and cross-ply laminated CFRP composites were manufactured in autoclave, and then submerged in both fresh and seawater for various periods until moisture saturation. Quasi-static and cyclic tests were carried out in both air and wet environment, and the failure mechanisms were investigated using visual and microscopic methods. Additionally, a robust 2D Finite Element model (FEA) was developed to simulate the fatigue crack propagation based on virtual crack closure technique (VCCT), while a 3D FEA model was developed to investigate the edge effect on fatigue crack propagation. The experimental observations gave a good agreement with the FEA models. The study showed that the bending fatigue failure was due to the so-called buckling-driven delamination, and the fatigue life was reduced significantly owing to the combination of edge effect and capillary effect. The fatigue test indicated that the fatigue resistance was degraded one stress level due to the water ingress, e.g. from 80% ultimate flexural strength (UFS) to 65% UFS. Therefore, a 4-step fatigue failure theory was proposed to explain the moisture effects on the crack propagation under bending fatigue

Drug utilization study in patients visiting dermatology outpatient department in tertiary care hospital

Background: With the surge of basic and clinical research activities, and subsequent recognition of newer dermatological disorders; dermatology is now considered to be one of the most important specialties in a healthcare setup. Dermatological problem in India manifests as primary and secondary cutaneous complaints. The aim of this study was to assess current prescribing practices among physicians for dermatology patients in tertiary care hospital.Methods: A prospective, observational and cross-sectional study was conducted in Department of Pharmacology in collaboration with Department of Dermatology in a tertiary healthcare hospital. As per inclusion criteria, patients visiting Dermatology Outpatient department (OPD) from October 2018 to December 2018 were enrolled in the study.Results: The average number of drugs per encounter was 4.9. 100% of the drugs were prescribed by their generic name and those prescribed from World Health Organization (WHO) list of essential medicines were 68.9%. Analysis of polypharmacy showed maximum 11 and minimum 2 drug was prescribed. Overall analysis of the drugs showed, the most common route of administration was orally. Antihistamines, antifungals and steroids constitute the major bulk of drug prescribed.Conclusions: In our study, though polypharmacy was found but it was necessary as per the conditions. Anti-fungal, antihistamines and steroids were the most common drugs prescribed. Prescriptions with injections and steroids were less in the study population. All the drugs were prescribed by their generic name and most were present in the essential list of medicines. Use of Nonsteroidal anti-inflammatory drugs (NSAIDs) was higher in our study as compared to other studies

The effect of grandmultiparity on pregnancy related complications: The Aga Khan University experience

Background: Grandmultiparity has been associated with complications for both mother and the fetus.Objective: To evaluate if grandmultiparity is a risk factor in the presence of adequate antenatal care.Setting: A tertiary care teaching hospital.Methods: It was a retrospective study conducted in the department of Obstetrics & Gynecology at The Aga Khan University Hospital in Karachi. During this period 9253 women were delivered, out of these 143 booked grandmultiparas (GMP) served as cases. The outcome of these women was compared with 430 non-grandmultiparas (NGMP). Logistic regression model was used to adjust for potential confounders.Results: Grandmultiparas had almost three times increased risk of having postpartum hemorrhage compared to NGMP group. Similarly, there were significantly low five-minute apgars in the GMPs compared to the NGMP group. Although the neonatal intensive care admissions were three times more in the GMPs but this did not reach statistical significance due to small number of cases in both groups.Conclusion: Our study indicates that grandmultiparity is a risk factor for pregnancy in this part of the world, even in the presence of reasonable antenatal care. This may be explained on the basis of the increased age of these women. Finally, we also recommend that an age-matched study needs to be undertaken in order to determine if age is an important determinant for risk factors in grandmultiparas

Are non-diabetic women with abnormal glucose screening test at increased risk of pre-eclampsia, macrosomia and caesarian birth?

To determine, in non-diabetic women, the relationship of abnormal glucose screening test, with the incidence of pre-eclampsia, macrosomia and caesarian delivery, from 1988-92, 5646 consecutive women attending antenatal clinic were screened with a glucose challenge test (GCT) on their first visit (usually at 16-20 weeks); those with risk factors i.e., history of unexplained perinatal loss, macrosomia or family member with diabetes and an initial abnormal screening test were rescreened at 28-32 weeks, In 482 cases the GCT was abnormal (plasma glucose value was \u3e140 mg% 2 hours after 75g glucose challenge). Of these, 292 had one or more abnormal critical values at a 75g -3 hour oral glucose tolerance test (GTT) and they were treated to maintain euglycaemia. The rest (n=190) had no evidence of glucose intolerance with no abnormal values at the GTT. The subjects were divided into 3 groups based on GCT values; A, randomly selected subjects with a normal GCT (n=1000); B, those with abnormal GCT but normal GTT (n=190); and C, those with abnormal GTT (n=292). The variables studied were age, gravidity, parity, gestational age at delivery, pre-eclampsia, birth-weight and mode of delivery. The incidence of pre-eclampsia and caesarian birth varied, being the lowest in Group A (3.9% and 11.9% respectively) and then rising through group B (6.3% and 16.3% respectively) to the highest in Group C (12.6% and 26.0% respectively; test of linear trend, p\u3c0.05). For macrosomia, the incidence increased from Group A to B but there was a drop in Group C. The incidence of macrosomia was significantly higher for Group B as compared to A or C (9.5% and 3.3%,

Drug utilization study in geriatric patients visiting medicine OPD in tertiary care hospital

Background: Drug utilization study is of utmost importance in the elderly. The consumption of drug amongst elderly segment of society is maximum and many of them use at least three prescribed drugs, concurrently. One of the plausible explanation of usage of large number of medicines is prevalence of multi-morbidities as well as suffer from chronic and degenerative pathology amongst them along with the alteration of pharmacokinetics and pharmacodynamics of many drugs are altered with advanced age. Thus, the aim of this study was to assess current prescribing practices among physicians for geriatric patients in tertiary care hospital.Methods: A prospective, observational and cross-sectional study was conducted in Department of Pharmacology in collaboration with Department of Medicine in a tertiary healthcare hospital. As per inclusion criteria, patients visiting Medicine outpatient department (OPD) from 01 October 2018 to 31 December 2018 were enrolled in the study.Results: The average number of drugs per encounter was 4.1. 100% of the drugs were prescribed by their generic name and those prescribed from World Health Organization (WHO) list of essential medicines were 70.2%. Analysis of polypharmacy showed maximum 11 and minimum 1 drug was prescribed. Overall analysis of the drugs showed, the most common route of administration was orally. Drugs acting on cardiovascular system (CVS), gastrointestinal system (GI) system, analgesics and anti-inflammatory drugs and vitamins and mineral supplements constitute the major bulk of drug prescribed.Conclusions: In our study, though polypharmacy was found but it was necessary unavoidable, but was within the WHO standards of 1.6 to 4.8. Drugs acting on CVS and GI system were the most common drugs prescribed. Prescriptions with injections and steroids were less in the study population. All the drugs were prescribed by their generic name and most were present in the essential list of medicines