Measuring Service Quality Dimensions: an Empirical Study of Private Hospitals in Jaffna District, Sri Lanka

The quality of hospitals services has a significant impact on customer satisfaction of healthcare in private hospitals of Jaffna District in Sri Lanka. The objective of the study is to assess the important dimensions of service quality in the services offered by private hospitals and to understand the factors that influence service quality in private hospitals. The findings of this study could provide useful information as to how hospitals could better manage their services to enhance their service quality. A questionnaire survey was conducted on 250 patients those availed health services from a private hospital in Jaffna District. Service quality were measured based on customer satisfaction levels by using a questionnaire which was consist the service quality dimensions of tangible, reliability, responsiveness, assurance, empathy, and communication. The research findings indicated that all factors have positive correlations and the relationship among variables is significant. And further more Jaffna district private hospitals’ patients rated the reliability dimension the most important of all, followed by tangibles, assurance, empathy, responsiveness, whereas the communication dimension rated least important of all. By considering these findings, the hospital will make the patients satisfied with its services, and in turn improve their willingness to recommend the hospitals' services to others. Keywords: Service quality, SERVQUAL model, Customer perception, Private hospital

An Evaluation of Inventory Management Practices Impact on Return on Asset: A Study on Beverage, Food and Tobacco Sector Listed Companies of Sri Lanka

Inventory is a vital part of current assets mainly in manufacturing and business concerns. Huge funds are committed to inventories as to ensure smooth flow of production and to meet consumer demand. Inventory management plays a crucial role in balancing the benefits and cost associated with holding inventory. Effective and efficient inventory management goes a long way in survival of a business firm. Inventory management practices effects on return on asset of the companies in beverage food and tobacco sector in Sri Lanka Colombo stock exchange at a great scope. A panel data from 2012 to 2016 was gathered for the analysis from the annual reports of 20 beverage food and tobacco sector firms considered. The multiple regression model was applied in the data analysis to find out the relationship between inventory management practices and return on asset. The variables used include inventory conversion period, operating cycle, current ratio, cash conversion cycle and return on assets. The results provide a significant positive relationship between inventory conversion periods and return on asset. In addition to that, cash conversion cycle was found significant negative relationship with the profitability measures of return on asset. Keywords: Inventory Management; Beverage Food and Tobacco sector; Return on asset DOI: 10.7176/RJFA/11-14-02 Publication date:July 31st 202

Facial Expression Recognition Based on Radon and Discrete Wavelet Transform using Support Vector Machines

Extracting facial features remains a difficult task because of unpredictable of facial features largely due to variations in pixel intensities and subtle changes of facial features. The Radon transform inherits rotational and translational properties that are capable of preserving pixel intensities variations and also is used to derive the directional features. Thus, this paper presents a new pattern framework for facial expression recognition based on Radon and wavelet transform using Support Vector Machines classifier to recognize the seven facial emotions. Firstly, the pre-processed facial images are projected into Radon space via Radon transform at a specified angle. Then, the obtained Radon space or sinogram that represent the facial emotions is subjected to wavelet transform. In this framework, the Radon space is decomposed into four sub-band at a different level of decomposition. The approximate coefficients sub-band are independently extracted and used as intrinsic features to recognize the facial emotion. To reduce the data dimensionality, principal component analysis (PCA) is applied to the extracted features. Then, the Support Vector Machines (SVM) classifier is adopted as a classifier to classify seven (anger, disgust, fear, happiness, neutral, sadness and surprise) facial emotions. To evaluate the effectiveness of the proposed method, the JAFFE database has been employed. Experimental results show that the proposed method has achieved 93.89% accuracy

Fabrication and surface functionalization of electrospun polystyrene submicron fibers with controllable surface roughness

Polystyrene (PS) submicron fibers of 14 wt% concentration were fabricated by electrospinning using dimethylformamide (DMF)–tetrahydrofuran (THF) solvent system. The surface morphology of PS fibers was modified from smooth to rough by changing the mixing ratio of DMF and THF in the spinning solution. The electrospun PS fibers with smooth and rough surfaces were then amidomethylated by treating with N-hydroxymethyl-2-chloroacetamide. PS fibers with higher roughness incorporated more amidomethyl functional groups on their surface, as confirmed by XPS analysis. This observation was further supported by BET adsorption isotherm results which showed a significant increase in specific surface area of rough PS electrospun fibers. Interestingly, amidomethylation has altered rough electrospun PS submicron fibers from extremely hydrophobic to hydrophilic. These chemically modified electrospun PS fibers with controllable surface roughness and wettability may be utilized as a carrier for proteins, mainly enzymes and antibodies, by covalent linkage through amino groups attached to their surface

Expression of fatty acid and triacylglycerol synthesis genes in interspecific hybrids of oil palm

© 2020, The Author(s). Evaluation of transcriptome data in combination with QTL information has been applied in many crops to study the expression of genes responsible for specific phenotypes. In oil palm, the mesocarp oil extracted from E. oleifera × E. guineensis interspecific hybrids is known to have lower palmitic acid (C16:0) content compared to pure African palms. The present study demonstrates the effectiveness of transcriptome data in revealing the expression profiles of genes in the fatty acid (FA) and triacylglycerol (TAG) biosynthesis processes in interspecific hybrids. The transcriptome assembly yielded 43,920 putative genes of which a large proportion were homologous to known genes in the public databases. Most of the genes encoding key enzymes involved in the FA and TAG synthesis pathways were identified. Of these, 27, including two candidate genes located within the QTL associated with C16:0 content, showed differential expression between developmental stages, populations and/or palms with contrasting C16:0 content. Further evaluation using quantitative real-time PCR revealed that differentially expressed patterns are generally consistent with those observed in the transcriptome data. Our results also suggest that different isoforms are likely to be responsible for some of the variation observed in FA composition of interspecific hybrids

Error estimates for the discretization of the velocity tracking problem

In this paper we are continuing our work (Casas and Chrysafinos, SIAM J Numer Anal 50(5):2281–2306, 2012), concerning a priori error estimates for the velocity tracking of two-dimensional evolutionary Navier–Stokes flows. The controls are of distributed type, and subject to point-wise control constraints. The discretization scheme of the state and adjoint equations is based on a discontinuous time-stepping scheme (in time) combined with conforming finite elements (in space) for the velocity and pressure. Provided that the time and space discretization parameters, t and h respectively, satisfy t = Ch2, error estimates of order O(h2) and O(h 3/2 – 2/p ) with p > 3 depending on the regularity of the target and the initial velocity, are proved for the difference between the locally optimal controls and their discrete approximations, when the controls are discretized by the variational discretization approach and by using piecewise-linear functions in space respectively. Both results are based on new duality arguments for the evolutionary Navier–Stokes equations

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

A multicentre, randomised controlled trial to compare the clinical and cost-effectiveness of Lee Silverman Voice Treatment versus standard NHS Speech and Language Therapy versus control in Parkinson’s disease: a study protocol for a randomised controlled trial

Abstract: Background: Parkinson’s disease (PD) affects approximately 145,519 people in the UK. Speech impairments are common with a reported prevalence of 68%, which increase physical and mental demands during conversation, reliance on family and/or carers, and the likelihood of social withdrawal reducing quality of life. In the UK, two approaches to Speech and Language Therapy (SLT) intervention are commonly available: National Health Service (NHS) SLT or Lee Silverman Voice Treatment (LSVT LOUD®). NHS SLT is tailored to the individuals’ needs per local practice typically consisting of six to eight weekly sessions; LSVT LOUD® comprises 16 sessions of individual treatment with home-based practice over 4 weeks. The evidence-base for their effectiveness is inconclusive. Methods/design: PD COMM is a phase III, multicentre, three-arm, unblinded, randomised controlled trial. Five hundred and forty-six people with idiopathic PD, reporting speech or voice problems will be enrolled. We will exclude those with a diagnosis of dementia, laryngeal pathology or those who have received SLT for speech problems in the previous 2 years. Following informed consent and completion of baseline assessments, participants will be randomised in a 1:1:1 ratio to no-intervention control, NHS SLT or LSVT LOUD® via a central computer-generated programme, using a minimisation procedure with a random element, to ensure allocation concealment. Participants randomised to the intervention groups will start treatment within 4 (NHS SLT) or 7 (LSVT LOUD®) weeks of randomisation. Primary outcome: Voice Handicap Index (VHI) total score at 3 months. Secondary outcomes include: VHI subscales, Parkinson’s Disease Questionnaire-39; Questionnaire on Acquired Speech Disorders; EuroQol-5D-5 L; ICECAP-O; resource utilisation; adverse events and carer quality of life. Mixed-methods process and health economic evaluations will take place alongside the trial. Assessments will be completed before randomisation and at 3, 6 and 12 months after randomisation. The trial started in December 2015 and will run for 77 months. Recruitment will take place in approximately 42 sites around the UK. Discussion: The trial will test the hypothesis that SLT is effective for the treatment of speech or voice problems in people with PD compared to no SLT. It will further test whether NHS SLT or LSVT LOUD® provide greater benefit and determine the cost-effectiveness of both interventions. Trial registration: International Standard Randomised Controlled Trials Number (ISRCTN) Registry, ID: 12421382. Registered on 18 April 2016