How service quality affects the customer satisfaction: Case study of electric train service (ETS)

Service quality played the important role and it affected to the customer satisfaction.Service quality has become a distinct and important aspect of the product and service offering.In this study, we investigated the effects of service quality on customer satisfaction in electric train service (ETS) industry Malaysia, focusing on the five dimensions in service quality which is tangible, responsiveness, assurance, reliability and empathy.We use questionnaire to collect the data from ETS passenger at northern region Malaysia KTMB station.The hypotheses on the causal relationships among service quality and customer satisfaction were tested by using IBM SPSS Statistics version 23 statistical technique.The results show negative correlation between the customer satisfaction and five dimensions in service quality.This study helps ETS to know about their customer satisfaction and can help they improve their service quality if there got any weaknesses. Future research needs to be done to investigate in details about this stud

Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia

Stress-induced hyperglycemia is common in critically ill patients, but there is uncertainty about what constitutes an optimal blood glucose target range for glycemic control. Furthermore, to reduce the rate of hyperglycemic and hypoglycemic events, model-based glycemic control protocols have been introduced, such as the stochastic targeted (STAR) glycemic control protocol. This protocol has been used in the intensive care units of Christchurch and Gyulà Hospital since 2010, and in Malaysia since 2017. In this study, we analyzed the adaptability of the protocol and identified the blood glucose target range most favorable for use in the Malaysian population. Virtual simulation results are presented for two clinical cohorts: one receiving treatment by the STAR protocol itself and the other receiving intensive insulin therapy by the sliding scale method. Performance and safety were analyzed using five clinical target ranges, and best control was simulated at a target range of 6.0–10.0 mmol/L. This target range had the best balance of performance, with the lowest risk of hypoglycemia and the lowest requirement for nursing interventions. The result is encouraging as the STAR protocol is suitable to provide better and safer glycemic control while using a target range that is already widely used in Malaysian intensive care units

Performance of stochastic targeted blood glucose control protocol by virtual trials in the Malaysian intensive care unit

Background and objective: Blood glucose variability is common in healthcare and it is not related or influ- enced by diabetes mellitus. To minimise the risk of high blood glucose in critically ill patients, Stochastic Targeted Blood Glucose Control Protocol is used in intensive care unit at hospitals worldwide. Thus, this study focuses on the performance of stochastic modelling protocol in comparison to the current blood glucose management protocols in the Malaysian intensive care unit. Also, this study is to assess the ef- fectiveness of Stochastic Targeted Blood Glucose Control Protocol when it is applied to a cohort of diabetic patients. Methods: Retrospective data from 210 patients were obtained from a general hospital in Malaysia from May 2014 until June 2015, where 123 patients were having comorbid diabetes mellitus. The comparison of blood glucose control protocol performance between both protocol simulations was conducted through blood glucose fitted with physiological modelling on top of virtual trial simulations, mean calculation of simulation error and several graphical comparisons using stochastic modelling. Results: Stochastic Targeted Blood Glucose Control Protocol reduces hyperglycaemia by 16% in diabetic and 9% in nondiabetic cohorts. The protocol helps to control blood glucose level in the targeted range of 4.0–10.0 mmol/L for 71.8% in diabetic and 82.7% in nondiabetic cohorts, besides minimising the treatment hour up to 71 h for 123 diabetic patients and 39 h for 87 nondiabetic patients. Conclusion: It is concluded that Stochastic Targeted Blood Glucose Control Protocol is good in reducing hyperglycaemia as compared to the current blood glucose management protocol in the Malaysian inten- sive care unit. Hence, the current Malaysian intensive care unit protocols need to be modified to enhance their performance, especially in the integration of insulin and nutrition intervention in decreasing the hyperglycaemia incidences. Improvement in Stochastic Targeted Blood Glucose Control Protocol in terms of u en model is also a must to adapt with the diabetic cohort

Levels and diagnostic value of model-based insulin sensitivity in sepsis: a preliminary study

Background and Aims: Currently, there is a lack of real time metric with high sensitivity and specificity to diagnose sepsis. Insulin sensitivity (SI) may be determined in real time using mathematical glucose insulin models; however, its effectiveness as a diagnostic test of sepsis is unknown. Our aims were to determine the levels and diagnostic value of model based SI for identification of sepsis in critically ill patients. Materials and Methods: In this retrospective, cohort study, we analysed SI levels in septic (n = 18) and nonseptic (n = 20) patients at 1 (baseline), 4, 8, 12, 16, 20, and 24 h of their Intensive Care Unit admission. Patients with diabetes mellitus Type I or Type II were excluded from the study. The SI levels were derived by fitting the blood glucose levels, insulin infusion and glucose input rates into the Intensive Control of insulin Nutrition Glucose model. Results: The median SI levels were significantly lower in the sepsis than in the nonsepsis at all follow up time points. The areas under the receiver operating characteristic curve of the model based SI at baseline for discriminating sepsis from nonsepsis was 0.814 (95% confidence interval, 0.675–0.953). The optimal cut-off point of the SI test was 1.573 × 10-4 L/mu/min. At this cut-off point, the sensitivity was 77.8%, specificity was 75%, positive predictive value was 73.7%, and negative predictive value was 78.9%. Conclusions: Model based SI ruled in and ruled out sepsis with fairly high sensitivity and specificity in our critically ill nondiabetic patients. These findings can be used as a foundation for further, prospective investigation in this area

The effects of insulin infusion protocol on the glycemic level of the intensive care patients

Insulin infusion protocol is the standard protocol that has been practiced in Malaysia's intensive care unit (ICU) for controlling the hyperglycemia. Multiple sliding scale method of the insulin infusion protocol may drive conflict in selecting an appropriate scale to be applied to the patient. The objective of this paper is to analyse the blood glucose outcome of eight sliding scales insulin infusion protocol adopted in the Universiti Sains Malaysia Hospital (HUSM). A retrospective data of 78 ICU patients of HUSM were fitted using a validated glucose-insulin system to identify insulin sensitivity profiles of the patients. Then, these SI profiles were simulated on various scale protocols. The results obtained from this study showed that among eight scales, Scale 4 had the highest percentage of BG within the HUSM's target of 6.0-10.0 mmol/L. Scale 1 had the highest percentage of BG for the BG measurement more than 10.0 mmol/L while Scale 8 had the highest percentage of BG measurement of less than 6.0 mmol/L. However, none of the scale shown better performance than the current clinical practice. Furthermore, all of the eight scales had a more substantial number of BG measurement compared to the clinical. This study shows that Scale 2 and Scale 3 result in a similar outcome. Similarly, Scale 5 is almost the same as Scale 6. Thus, at least two sets of scale can be combined to reduce the number of scales. The reduction of scales consequently avoid confusion and helps the clinician in selecting the appropriate scale to be applied to the patients. From this study, it can be concluded that the HUSM protocol is a combination of scales. The scales may be shifted from one to another scale depending on patient condition and clinician judgement. A proper guideline for the scale shifting seems necessary to allow optimum glycemic management in the ICU

Model-based glycemic control in a Malaysian intensive care unit: performance and safety study

Background: Stress-induced hyperglycemia is common in critically ill patients. A few forms of model-based glycemic control have been introduced to reduce this phenomena and among them is the automated STAR protocol which has been used in the Christchurch and Gyulá hospitals’ intensive care units (ICUs) since 2010. Methods: This article presents the pilot trial assessment of STAR protocol which has been implemented in the International Islamic University Malaysia Medical Centre (IIUMMC) Hospital ICU since December 2017. One hundred and forty-two patients who received STAR treatment for more than 20 hours were used in the assessment. The initial results are presented to discuss the ability to adopt and adapt the model-based control framework in a Malaysian environment by analyzing its performance and safety. Results: Overall, 60.7% of blood glucose measurements were in the target band. Only 0.78% and 0.02% of cohort measurements were below 4.0 mmol/L and 2.2 mmol/L (the limitsfor mild and severe hypoglycemia, respectively). Treatment preference-wise, the clinical staff were favorable of longer intervention options when available. However, 1 hourly treatments were still used in 73.7% of cases. Conclusion: The protocol succeeded in achieving patient-specific glycemic control while maintaining safety and was trusted by nurses to reduce workload. Its lower performance results, however, give the indication for modification in some of the control settings to better fit the Malaysian environment. © 2019 Abu-Samah et al

Inaugural edu-action journey with cooperative behavior (Ta’awun) of mKitchen® students in free food for the needy

This book narrates the inaugural edu-action journey with cooperative behaviour (ta’awun) in free food for the needy people at IIUM mKitchen® with Sri Mutiara Teguh Enterprise (cafeteria vendor at Mahallah Aminah IIUM Gombak). The main objective of the project is to transform Mahallah kitchen as a platform to provide free food, to up skill in food-preneurship, to create new employment opportunities, to give empowerment and to nurture entrepreneurship (3Es) among students. Ta’awun refers to cooperative behaviour among the participants, the sponsors, and the beneficiaries in initiating, planning, sponsoring, executing and evaluating the mKitchen® project at Sri Mutiara Teguh Enterprise, Mahallah Aminah. The journey officially started on 1 July 2021 with various student development entities at IIUM. After providing a 4-day online training on business model and plan, financial modelling, and digital marketing, the steering committee has decided to provide the real experience to the students. In conjunction with Malaysia Day on 16 September 2021, the students proposed for cooking and distributing free food to the needy as part of the first proof-of-concept for mKitchen students with the “Keluarga Malaysia” spirit. Nevertheless, the project has to adhere to movement restriction by the authority to prevent the spread of coronavirus disease (COVID-19). The second proof-of-concept is cooking food based on mKitchen students’ business plan

A Journey of Ta’awun (Cooperative Behaviour) in Edu-Action at IIUM Mkitchen® and Masjid al-Syakirin Gombak (MASG)

This book narrates the journey of ta’awun (cooperative behaviour) at IIUM Mkitchen® project with Masjid Al-Syakirin Gombak (MASG). The main objective of the project is transform the mosque as a platform to provide free food, to up skill in foodpreneurship, to create new employment opportunities, to give empowerment and to nurture entrepreneurship (3Es) for poor and needy people in the surrounding area of it. Ta’awun refers to cooperative behaviour among the participants, the sponsors, and the beneficiaries in initiating, planning, sponsoring, executing and evaluating the Mkitchen® project at Masjid Al-Syakirin Gombak (MASG). The journey officially started on 24th January 2021 through its first meeting among the interested as well as committed members. After executing two events, the project was continued with a full scale project for a month. The project has secured its proof of concept (POC). Nevertheless, the project has been continued with a small scale due to the movement restriction by the authority to prevent the spread of coronavirus disease (COVID-19)

Decision support for parenteral nutrition supplementation in ICU using model-based glycemic control protocol

Nutrition therapy is part of the standard care given to all critically ill patients. In general, nutrition is administered as enteral nutrition (EN) and/or parenteral nutrition (PN). PN is given if the patients have contraindications to EN or as supplement if daily energy requirement cannot be achieved by EN alone. PN can be given as partial (dextrose solution only) or complete (include all macro- and micro-nutrients). The mode of nutrition therapy is influenced by several factors which include the need to maintain normoglycemia. A simulation is done to find the appropriate time to introduce PN while the patients are already on EN. In this context, a virtual study was conducted on 66 retrospectives critically ill patients’ data using clinically validated insulin-nutrition model and Stochastic TARgeted (STAR) protocol. The results suggested that this protocol benefited critically ill patients in two-fold. This approach is not only useful in controlling per-patient normoglycemic level, but also able to recognize the time for PN supplement when patients become hypoglycemic. This serves as a potential decision support in the intensive care environment when healthcare providers faced with the complexity of dynamics between good glycemic control and optimized nutrition therapy

STAR protocol for critically ill patients in Malaysia: ICU staff survey and human factor assessment

Since 2001, various glycemic control (GC) studies have been conducted to reduce dysglycemia in critically ill patients. To prove their effectiveness, each proposed GC approach requires not only patient clinical results, but also users assessments. This paper presents International Islamic University Malaysia Medical Centre intensive care unit (ICU) staff perceptions and assessments of human factors of Stochastic Targeted (STAR) protocol usage based on a Malaysian pilot trial to analyze the users responses to the protocol in the Malaysian set-up. STAR protocol is a model-based and automated GC that accounts for the individual patient s metabolic variability. The ICU staff feedback on STAR trial was based on 13 survey questions. The survey demonstrated that 87.5% of ICU staff agreed that STAR protocol improved patient s outcome, and is user friendly. Human factor assessment quantifies the different interventions recorded from STAR historical and manual bedside records for a total of 31 diabetes mellitus (DM) and non-diabetes mellitus (NDM) patients. During a total of 6168 hours in ICU stays, the percentage of compliance in blood glucose (BG) measurements, insulin infusion, and nutrition administered for DM and NDM cohorts were 97.3%/97.2%, 74.1%/70.3% and 65%/71.2%, respectively. © 2019 Institute of Electronics and Information Engineers. All rights reserved