Relationship of service quality and hospital accreditation on patient's satisfaction and loyalty

Patient loyalty and its attributes are significant concerns for healthcare industries. A lot research has been done on this issue in numerous contexts but such research in the Malaysian healthcare industry is still scarce. This study investigated the relationship between service quality, hospital accreditation on customer satisfaction and customer loyalty in the Malaysian healthcare industry. The research examined five factors of service quality: responsiveness, assurance, tangibility, empathy, reliability. This study utilized nonprobability convenient sampling to gather the data from 20 private hospitals that promote medical tourism in Klang Valley, Malaysia. A total of 378 medical tourists participated in the survey. Statistical tests carried out include descriptive statistics, internal consistency, reliability and validity. Correlation analysis was also conducted to determine the relationships of the variables. In addition, the analysis also included the PLS Structural Equation Modeling (SEM). The main finding shows that service quality and customer satisfaction have a direct effect on customer loyalty. Also, the findings show there is a positive relationship between service quality and customer satisfaction, service quality and customer loyalty, hospital accreditation on customer satisfaction, and customer satisfaction on customer loyalty. However, hospital accreditation has no positive effect on patient loyalty. The findings of this study are useful to managers, board of directors and stakeholders of private hospitals to understand influential factors on patients' satisfaction and loyalty

International Medical Tourists’ Behavioral Intention: An Empirical Study in Malaysia

A few studies have examined the effect of hospital service quality, hospital accreditation, destination image on patient satisfaction and patient loyalty in a tourism context. The purpose of this study is to evaluate the effect of medical patients’ behavioural intention in Malaysia. A total of 360 questionnaire were distributed and quantitative techniques were used to test the hypotheses within the structural equation modelling (SEM) using SmartPLS software. Our statistical results support the positive effect of hospital service quality, destination image and patient satisfaction on patient loyalty. Hospital accreditation didn’t have positive impact on patient loyalty. The research contribution, implication, and limitation are discussed. Keywords: hospital service quality, destination image, hospital accreditation, patient satisfaction, patients’ loyalty

Evaluation of the Clinical and Laboratory Status of Pregnant Women with COVID-19

AbstractIntroduction: The prevalence of the COVID-19 virus has been very high, so that in a short period of time, due to its contagiousness, it has infected a large number of people around the world. Pregnant women are more sensitive to infectious diseases than the general population and are especially at risk of respiratory diseases and severe pneumonia. Considering the importance of mother and fetus management, assessment and management of pregnant women infected with COVID-19, the present study was conducted with the aim of investigating the clinical and laboratory status of pregnant women infected with SARS‐CoV‐2 referring to Imam Hassan and Bentolhoda hospital in Bojnurd.Methods: In this cross-sectional study, pregnant women with COVID-19 referred to Imam Hassan and Bentolhoda Hospital in Bojnurd between March 2020 and the beginning of Desember 2021 were studied. In order to collect information, an information form containing demographic and obstetric characteristics, evaluation of symptoms (fever, cough, abdominal pain, bloody secretions, rupture of fetal membranes in term pregnancy, chest tightness, asthma, fatigue, loss of appetite, headache, nausea and vomiting), laboratory status and outcomes pregnancy and childbirth was used. Statistical analysis was done with SPSS 24 software.Results: The age range of the studied women was 15-48 years and the average gestational age was 26.21±9.4 weeks. The type of delivery in 46.2% was normal vaginal delivery, 53.8% was cesarean section. LBW, admission to NICU, need for resuscitation, meconium-stained AF were 5.71%, 4.76%, 3.80%, 0.95%, respectively. The average number of referrals to the hospital due to COVID-19 in the studied women was 1.6 ± 1.1 times, the average number of days in the hospital was 5.1 ± 3.1 days, and the average number of days in the intensive care unit was 4.08±2.1 days. The most common clinical symptoms in the studied women were related to cough (76.19), dyspnea (72.38), fever (56.19), and myalgia (33.33).Conclusions: Based on the results obtained from this study, clinical symptoms and laboratory results in pregnant women with COVID-19 are similar to infected adults. Common symptoms of COVID-19 disease in pregnant women included fever, cough, and myalgia

A Cross-layer Method for Scheduling and Routing Real-time Traffic Flow in Industrial IoT. Journal of Telecommunications and Information Technology, 2023, nr 3

In the Industrial Internet of Things, a wide variety of sensors are distributed all over the environment to monitor data collection, thereby allowing industrial processes to be monitored more efficiently. One of the fundamental goals of IIoT is to provide the highest level of reliability while simultaneously increasing network lifetime, reducing power consumption, and preventing delays. 6TiSCH is a popular communication standard relied upon in IIoT. The aim of the present study is to propose an inter-layer method that simultaneously considers network scheduling and routing processes based on TSCH and RPL approaches in multi-sink environments. The proposed method is intended to address the limitations of IIoT and meet the requirements of field-specific applications

Evaluation of bax, bcl-2, p21 and p53 genes expression variations on cerebellum of BALB/c mice before and after birth under mobile phone radiation exposure

Objective(s): The increasing rate of over using cell phones has been considerable in youths and pregnant women. We examined the effect of mobile phones radiation on genes expression variation on cerebellum of BALB/c mice before and after of the birth. Materials and Methods: In this study, amobile phone jammer, which is an instrument to prevent receiving signals between cellular phonesand base transceiver stations (two frequencies 900 and 1800 MHz) for exposure was used and twelve pregnant mice (BALB/c) divided into two groups (n=6), first group irradiated in pregnancy period (19th day), the second group did not irradiate in pregnancy period. After childbirth, offspring wereclassified into four groups (n=4):Group1: control, Group 2: B1 (Irradiated after birth), Group 3: B2 (Irradiated in pregnancy period and after birth), Group 4: B3 (Irradiated in pregnancy period). When maturity was completed (8-10 weeks old), mice were dissected and cerebellum was isolated. The expression level of bax, bcl-2, p21 and p53 genes examined by real-time reverse transcription polymerase chain reaction (Real-Time RT- PCR). Results: The data showed that mobile phone radio waves were ineffective on the expression level of bcl-2 and p53 genes) P>0.05(. Also gene expression level of bax decreased and gene expression level of p21 increased comparing to the control group (

Aortic Valve Area and Strain Measurements by Cardiac MRI and Transthoracic Echocardiography in Severe Aortic Stenosis with Normal Left Ventricular Function

Background: Transthoracic echocardiography (TTE) is the recommended imaging technique for the evaluation of patients with aortic stenosis (AS). However, in cases with inconclusive findings, cardiac magnetic resonance (CMR) planimetry is used to grade AS severity. This study aimed to compare the results derived from TTE and CMR in patients with severe AS with normal left ventricular (LV) function.Methods: In a prospective study, 20 patients with severe AS were recruited and data derived from TTE and CMR modalities were compared with the archived records of 28 age- and sex-matched healthy controls. The data included aortic valve area (AVA), MRI-derived biventricular global strains, and TTE-derived global longitudinal strain (GLS). SPSS software was used to analyze the data with independent samples t test, intraclass correlation coefficient (ICC), and Pearson correlation. P<0.05 was considered statistically significant.Results: An excellent agreement was found in AVA values derived from CMR and TTE with an average ICC of 0.932 (95% CI=0.829-0.973). There was a significant difference in LV-GLS, LV global radial strain (GRS), right ventricular (RV) GRS, and RV global circumferential strain between the groups. A good correlation was found between CMR- and TTE-derived GLS with an average ICC of 0.721 (95% C=0.255-0.896). The mean aortic valve pressure gradient in TTE had a significant inverse linear correlation with LV-GRS in CMR (r=-0.537). All P values were <0.05.Conclusion: There was a good agreement between AVA and strain values derived from cardiac MRI and TTE. The myocardial strain was impaired in patients with severe AS and normal LV function and correlated with disease severity

Olfactory function following open rhinoplasty: A 6-month follow-up study

<p>Abstract</p> <p>Background</p> <p>Patients undergoing any type of nasal surgery may experience degrees of postoperative olfactory dysfunction. We sought to investigate "when" the olfactory function recovers to its preoperative levels.</p> <p>Methods</p> <p>In this cohort design, 40 of 65 esthetic open rhinoplasty candidates with equal gender distribution, who met the inclusion criteria, were assessed for their olfactory function using the Smell Identification Test (SIT) with 40 familiar odors in sniffing bottles. All the patients were evaluated for the SIT scores preoperatively and postoperatively (at week 1, week 6, and month 6).</p> <p>Results</p> <p>At postoperative week one, 87.5% of the patients had anosmia, and the rest exhibited at least moderate levels of hyposmia. The anosmia, which was the dominant pattern at postoperative week 1, resolved and converted to various levels of hyposmia, so that no one at postoperative week 6 showed any such complain. At postoperative week six, 85% of the subjects experienced degrees of hyposmia, almost all being mild to moderate. At postoperative six month, the olfactory function had already reverted to the preoperative levels: no anosmia or moderate to severe hyposmia. A repeated ANOVA was indicative of significant differences in the olfactory function at the different time points. According to our post hoc Benfronney, the preoperative scores had a significant difference with those at postoperative week 1, week 6, but not with the ones at month 6.</p> <p>Conclusion</p> <p>Esthetic open rhinoplasty may be accompanied by some degrees of postoperative olfactory dysfunction. Patients need a time interval of 6 weeks to 6 months to fully recover their baseline olfactory function.</p

Non-invasive hemodynamic monitoring in critical care units: Review article

ABStRAct Aims and backgrounds : Hemodynamic monitoring of critical patients in intensive care units is the cornerstone of care. It constitutes an extensive part of care and is helpful in determination of the causes and the response to treatment of hemodynamic instability. The aim of this review article is to evaluate non invasive hemodynamic monitoring in critical care units. Materials and Methods: 61 articles were allocated to this study with the time frame covered from 1890 to 2010. The references of this review article were obtained from Pubmed, Elsevier, Google scholar, Elsevier mason, Science direct, and JAMA. The authors have also used the keywords including: cardiac output, non-invasive, intensive care unit, oxygenation, upstream, downstream markers,hemodynamic monitoring, minimally invasive methods, and circulatory shock. Findings: The results of this study show that the desirable and premium monitoring of serious patients in intensive care units have yet remained as a challenge. Awareness of cardiac output which is the most important indicator of cardiac function is of vital importance for deciding on the method of clinical management, selecting treatment method, clinical assessment, and prognosis of the patients suffering from cardiac problems. conclusions: A lot of such studies show that the Non-invasive monitoring system of cardiac output is easier, safer, cheaper, and more effective than the invasive monitoring system .If this method is used properly,it could reduce the mortality and morbidity rate

A Cross-layer Method for Scheduling and Routing Real-time Traffic Flow in Industrial IoT

In the Industrial Internet of Things, a wide variety of sensors are distributed all over the environment to monitor data collection, thereby allowing industrial processes to be monitored more efficiently. One of the fundamental goals of IIoT is to provide the highest level of reliability while simultaneously increasing network lifetime, reducing power consumption, and preventing delays. 6TiSCH is a popular communication standard relied upon in IIoT. The aim of the present study is to propose an inter-layer method that simultaneously considers network scheduling and routing processes based on TSCH and RPL approaches in multi-sink environments. The proposed method is intended to address the limitations of IIoT and meet the requirements of field-specific applications