Impact of Flexibility on Patient Satisfaction and Behavioral Intention: A Critical Reassessment and Model Development

In the anticipation of demand fluctuations, services cannot be inventoried and hence it creates a difficult problem in marketing of services. The inability to meet customers (patients) requirements in healthcare context has more serious consequences than other service sectors. In order to meet patient requirements in the current uncertain environment, healthcare organizations are seeking ways for improved service delivery. Flexibility provides a mechanism for reducing variability in service encounters and improved performance. Flexibility is defined as the ability of the organization to cope with changing circumstances or instability caused by the environment. Patient satisfaction is an important performance outcome of healthcare organizations. However, the paucity of information exists in healthcare delivery context to examine the impact of flexibility on patient satisfaction and behavioral intention. The present study is an attempt to develop a conceptual foundation for investigating overall impact of flexibility on patient satisfaction and behavioral intention. Several dimensions of flexibility in healthcare context are examined and proposed to have a significant impact on patient satisfaction and intention. Furthermore, the study involves a critical examination of determinants of patient satisfaction and development of a comprehensive view the relationship between flexibility, patient satisfaction and behavioral intention. Finally, theoretical contributions and implications for healthcare professionals are suggested from flexibility perspective.

Sound Selection for Gesture Sonification and Manipulation of Virtual Objects

New sensors and technologies – such as microphones, touchscreens or infrared sensors – are currently making their appearance in the automotive sector, introducing new kinds of Human-Machine Interfaces (HMIs). The interactions with such tools might be cognitively expensive, thus unsuitable for driving tasks. It could for instance be dangerous to use touchscreens with a visual feedback while driving, as it distracts the driver’s visual attention away from the road. Furthermore, new technologies in car cockpits modify the interactions of the users with the central system. In particular, touchscreens are preferred to arrays of buttons for space improvement and design purposes. However, the buttons’ tactile feedback is no more available to the driver, which makes such interfaces more difficult to manipulate while driving. Gestures combined with an auditory feedback might therefore constitute an interesting alternative to interact with the HMI. Indeed, gestures can be performed without vision, which means that the driver’s visual attention can be totally dedicated to the driving task. In fact, the auditory feedback can both inform the driver with respect to the task performed on the interface and on the performed gesture, which might constitute a possible solution to the lack of tactile information. As audition is a relatively unused sense in automotive contexts, gesture sonification can contribute to reducing the cognitive load thanks to the proposed multisensory exploitation. Our approach consists in using a virtual object (VO) to sonify the consequences of the gesture rather than the gesture itself. This approach is motivated by an ecological point of view: Gestures do not make sound, but their consequences do. In this experiment, the aim was to identify efficient sound strategies, to transmit dynamic information of VOs to users through sound. The swipe gesture was chosen for this purpose, as it is commonly used in current and new interfaces. We chose two VO parameters to sonify, the hand-VO distance and the VO velocity. Two kinds of sound parameters can be chosen to sonify the VO behavior: Spectral or temporal parameters. Pitch and brightness were tested as spectral parameters, and amplitude modulation as a temporal parameter. Performances showed a positive effect of sound compared to a no-sound situation, revealing the usefulness of sounds to accomplish the task.

Comparison of Regime Transition between Ellipsoidal and Spherical Particle Assemblies in a Model Shear Cell

This paper presents a numerical investigation of regime transition of flow of ellipsoidal particles and a comparison with that of spherical particle assembly. Particle assemblies constituting spherical and ellipsoidal particle of 2.5:1 aspect ratio are examined at separate instances in similar flow conditions in a shear cell model that is numerically developed based on the discrete element method. Correlations among elastically scaled stress, kinetically scaled stress, coordination number and volume fraction are investigated, and show important similarities and differences for the spherical and ellipsoidal particle assemblies. In particular, volume fractions at points of regime transition are identified for both types of particles. It is found that compared with spherical particle assembly, ellipsoidal particle assembly has higher volume fraction for the quasistatic to intermediate regime transition and lower volume fraction for the intermediate to inertial regime transition. Finally, the relationship between coordination number and volume fraction shows strikingly distinct features for the two cases, suggesting that different from spherical particles, the effect of the shear rate on the coordination number is not significant for ellipsoidal particles. This work provides a glimpse of currently running work on one of the most attractive scopes of research in this field and has a wide prospect in understanding rheology of more complex shaped particles in light of the strong basis of simpler spherical particle rheology.

A Framework for Investigating Reverse Logistics Capability of E-Tailers

Environmental concern and consumer rights have entailed e-tailers to adopt better strategies to facilitate product returns from customers. As the demand for reverse logistics (RL) continues to grow, little is known about what motivates e-tailers to enhance their RL capabilities and about the role RL capabilities plays in enabling e-tailers to achieve better customer satisfaction and economic performance. Based on resource-based theory and institutional theory, this article proposes that the following factors play a critical role in influencing the RL capability of e-tailers: (a) Financial resource commitment to RL, (b) managerial resource commitment to RL, and (c) institutional pressure to implement RL. Based on the role of these factors, the study provides a framework and propositions that serve to guide future research addressing the link among resources, institutional pressure, and RL capability.

The Effect of Impact on the Knee Joint Due to the Shocks during Double Impact Phase of Gait Cycle

The major contributor to the human locomotion is the knee flexion and extension. During heel strike, a huge amount of energy is transmitted through the leg towards knee joint, which in fact is damped at heel and leg muscles. During high shocks, although it is damped to a certain extent, the balance force transmits towards knee joint which could damage the knee. Due to the vital function of the knee joint, it should be protected against damage due to additional load acting on it. This work concentrates on the development of spring mass damper system which exactly replicates the stiffness at the heel and muscles and the objective function is optimized to minimize the force acting at the knee joint. Further, the data collected using force plate are put into the model to verify its integrity and are found to be in good agreement.

The Impact of Cooperative Learning on Numerical Methods Course

Numerical Methods is a course that can be conducted using workshops and group discussion. This study has been implemented on undergraduate students of level two at the Faculty of Engineering, International Islamic University Malaysia. The Numerical Method course has been delivered to two Sections 1 and 2 with 44 and 22 students in each section, respectively. Systematic steps have been followed to apply the student centered learning approach in teaching Numerical Method course. Initially, the instructor has chosen the topic which was Euler’s Method to solve Ordinary Differential Equations (ODE) to be learned. The students were then divided into groups with five members in each group. Initial instructions have been given to the group members to prepare their subtopics before meeting members from other groups to discuss the subtopics in an expert group inside the classroom. For the time assigned for the classroom discussion, the setting of the classroom was rearranged to accommodate the student centered learning approach. Teacher strength was by monitoring the process of learning inside and outside the class. The students have been assessed during the migrating to the expert groups, recording of a video explanation outside the classroom and during the final examination. Euler’s Method to solve the ODE was set as part of Question 3(b) in the final exam. It is observed that none of the students from both sections obtained a zero grade in Q3(b), compared to Q3(a) and Q3(c). Also, for Section 1(44 students), 29 students obtained the full mark of 7/7, while only 10 obtained 7/7 for Q3(a) and no students obtained 6/6 for Q3(c). Finally, we can recommend that the Numerical Method course be moved toward more student-centered Learning classrooms where the students will be engaged in group discussion rather than having a teacher one man show.

Current Deflecting Wall: A Promising Structure for Minimising Siltation in Semi-Enclosed Docks

Many estuarine harbours in the world are facing the problem of siltation in docks, channel entrances, etc. The harbours in India are not an exception and require maintenance dredging to achieve navigable depths for keeping them operable. Hence, dredging is inevitable and is a costly affair. The heavy siltation in docks in well mixed tide dominated estuaries is mainly due to settlement of cohesive sediments in suspension. As such there is a need to have a permanent solution for minimising the siltation in such docks to alter the hydrodynamic flow field responsible for siltation by constructing structures outside the dock. One of such docks on the west coast of India, wherein siltation of about 2.5-3 m/annum prevails, was considered to understand the hydrodynamic flow field responsible for siltation. The dock is situated in such a region where macro type of semi-diurnal tide (range of about 5m) prevails. In order to change the flow field responsible for siltation inside the dock, suitability of Current Deflecting Wall (CDW) outside the dock was studied, which will minimise the sediment exchange rate and siltation in the dock. The well calibrated physical tidal model was used to understand the flow field during various phases of tide for the existing dock in Mumbai harbour. At the harbour entrance where the tidal flux exchanges in/out of the dock, measurements on water level and current were made to estimate the sediment transport capacity. The distorted scaled model (1:400 (H) & 1:80 (V)) of Mumbai area was used to study the tidal flow phenomenon, wherein tides are generated by automatic tide generator. Hydraulic model studies carried out under the existing condition (without CDW) reveal that, during initial hours of flood tide, flow hugs the docks breakwater and part of flow which enters the dock forms number of eddies of varying sizes inside the basin, while remaining part of flow bypasses the entrance of dock. During ebb, flow direction reverses, and part of the flow re-enters the dock from outside and creates eddies at its entrance. These eddies do not allow water/sediment-mass to come out and result in settlement of sediments in dock both due to eddies and more retention of sediment. At latter hours, current strength outside the dock entrance reduces and allows the water-mass of dock to come out. In order to improve flow field inside the dockyard, two CDWs of length 300 m and 40 m were proposed outside the dock breakwater and inline to Pier-wall at dock entrance. Model studies reveal that, during flood, major flow gets deflected away from the entrance and no eddies are formed inside the dock, while during ebb flow does not re-enter the dock, and sediment flux immediately starts emptying it during initial hours of ebb. This reduces not only the entry of sediment in dock by about 40% but also the deposition by about 42% due to less retention. Thus, CDW is a promising solution to significantly reduce siltation in dock.

Analysis of Stress and Strain in Head Based Control of Cooperative Robots through Tetraplegics

Industrial robots as part of highly automated manufacturing are recently developed to cooperative (light-weight) robots. This offers the opportunity of using them as assistance robots and to improve the participation in professional life of disabled or handicapped people such as tetraplegics. Robots under development are located within a cooperation area together with the working person at the same workplace. This cooperation area is an area where the robot and the working person can perform tasks at the same time. Thus, working people and robots are operating in the immediate proximity. Considering the physical restrictions and the limited mobility of tetraplegics, a hands-free robot control could be an appropriate approach for a cooperative assistance robot. To meet these requirements, the research project MeRoSy (human-robot synergy) develops methods for cooperative assistance robots based on the measurement of head movements of the working person. One research objective is to improve the participation in professional life of people with disabilities and, in particular, mobility impaired persons (e.g. wheelchair users or tetraplegics), whose participation in a self-determined working life is denied. This raises the research question, how a human-robot cooperation workplace can be designed for hands-free robot control. Here, the example of a library scenario is demonstrated. In this paper, an empirical study that focuses on the impact of head movement related stress is presented. 12 test subjects with tetraplegia participated in the study. Tetraplegia also known as quadriplegia is the worst type of spinal cord injury. In the experiment, three various basic head movements were examined. Data of the head posture were collected by a motion capture system; muscle activity was measured via surface electromyography and the subjective mental stress was assessed via a mental effort questionnaire. The muscle activity was measured for the sternocleidomastoid (SCM), the upper trapezius (UT) or trapezius pars descendens, and the splenius capitis (SPL) muscle. For this purpose, six non-invasive surface electromyography sensors were mounted on the head and neck area. An analysis of variance shows differentiated muscular strains depending on the type of head movement. Systematically investigating the influence of different basic head movements on the resulting strain is an important issue to relate the research results to other scenarios. At the end of this paper, a conclusion will be drawn and an outlook of future work will be presented.

Linguistic Competence Analysis and the Development of Speaking Instructional Material

Linguistic oral competence plays a vital role in attaining effective communication. Since the English language is considered as universally used language and has a high demand skill needed in the work-place, mastery is the expected output from learners. To achieve this, learners should be given integrated differentiated tasks which help them develop and strengthen the expected skills. This study aimed to develop speaking instructional supplementary material to enhance the English linguistic competence of Grade 9 students in areas of pronunciation, intonation and stress, voice projection, diction and fluency. A descriptive analysis was utilized to analyze the speaking level of performance of the students in order to employ appropriate strategies. There were two sets of respondents: 178 Grade 9 students selected through a stratified sampling and chosen at random. The other set comprised English teachers who evaluated the usefulness of the devised teaching materials. A teacher conducted a speaking test and activities were employed to analyze the speaking needs of students. Observation and recordings were also used to evaluate the students’ performance. The findings revealed that the English pronunciation of the students was slightly unclear at times, but generally fair. There were lapses but generally they rated moderate in intonation and stress, because of other language interference. In terms of voice projection, students have erratic high volume pitch. For diction, the students’ ability to produce comprehensible language is limited, and as to fluency, the choice of vocabulary and use of structure were severely limited. Based on the students’ speaking needs analyses, the supplementary material devised was based on Nunan’s IM model, incorporating context of daily life and global work settings, considering the principle that language is best learned in the actual meaningful situation. To widen the mastery of skill, a rich learning environment, filled with a variety instructional material tends to foster faster acquisition of the requisite skills for sustained learning and development. The role of IM is to encourage information to stick in the learners’ mind, as what is seen is understood more than what is heard. Teachers say they found the IM “very useful.” This implied that English teachers could adopt the materials to improve the speaking skills of students. Further, teachers should provide varied opportunities for students to get involved in real life situations where they could take turns in asking and answering questions and share information related to the activities. This would minimize anxiety among students in the use of the English language.

Solid Dispersions of Cefixime Using β-Cyclodextrin: Characterization and in vitro Evaluation

Cefixime, a BCS class II drug, is insoluble in water but freely soluble in acetone and in alcohol. The aqueous solubility of cefixime in water is poor and exhibits exceptionally slow and intrinsic dissolution rate. In the present study, cefixime and β-Cyclodextrin (β-CD) solid dispersions were prepared with a view to study the effect and influence of β-CD on the solubility and dissolution rate of this poorly aqueous soluble drug. Phase solubility profile revealed that the solubility of cefixime was increased in the presence of β-CD and was classified as AL-type. Effect of variable, such as drug:carrier ratio, was studied. Physical characterization of the solid dispersion was characterized by Fourier transform infrared spectroscopy (FT-IR) and Differential scanning calorimetry (DSC). These studies revealed that a distinct loss of drug crystallinity in the solid molecular dispersions is ostensibly accounting for enhancement of dissolution rate in distilled water. The drug release from the prepared solid dispersion exhibited a first order kinetics. Solid dispersions of cefixime showed a 6.77 times fold increase in dissolution rate over the pure drug.

Teaching Material, Books, Publications versus the Practice: Myths and Truths about Installation and Use of Downhole Safety Valve

The paper is related to the safety of oil wells and environmental preservation on the planet, because they require great attention and commitment from oil companies and people who work with these equipments. This must occur from drilling the well until it is abandoned in order to safeguard the environment and prevent possible damage. The project had as main objective the constitution resulting from comparatives made among books, articles and publications with information gathered in technical visits to operational bases of Petrobras. After the visits, the information from methods of utilization and present managements, which were not available before, became available to the general audience. As a result, it is observed a huge flux of incorrect and out-of-date information that comprehends not only bibliographic archives, but also academic resources and materials. During the gathering of more in-depth information on the manufacturing, assembling, and use aspects of DHSVs, several issues that were previously known as correct, customary issues were discovered to be uncertain and outdated. Information of great importance resulted in affirmations about subjects as the depth of the valve installation that was before installed to 30 meters from the seabed (mud line). Despite this, the installation should vary in conformity to the ideal depth to escape from area with the biggest tendency to hydrates formation according to the temperature and pressure. Regarding to valves with nitrogen chamber, in accordance with books, they have their utilization linked to water line ≥ 700 meters, but in Brazilian exploratory fields, their use occurs from 600 meters of water line. The valves used in Brazilian fields are able to be inserted to the production column and self-equalizing, but the use of screwed valve in the column of production and equalizing is predominant. Although these valves are more expensive to acquire, they are more reliable, efficient, with a bigger shelf life and they do not cause restriction to the fluid flux. It follows that based on researches and theoretical information confronted to usual forms used in fields, the present project is important and relevant. This project will be used as source of actualization and information equalization that connects academic environment and real situations in exploratory situations and also taking into consideration the enrichment of precise and easy to understand information to future researches and academic upgrading.

Influence of Measurement System on Negative Bias Temperature Instability Characterization: Fast BTI vs Conventional BTI vs Fast Wafer Level Reliability

Negative Bias Temperature Instability (NBTI) is one of the critical degradation mechanisms in semiconductor device reliability that causes shift in the threshold voltage (Vth). However, thorough understanding of this reliability failure mechanism is still unachievable due to a recovery characteristic known as NBTI recovery. This paper will demonstrate the severity of NBTI recovery as well as one of the effective methods used to mitigate, which is the minimization of measurement system delays. Comparison was done in between two measurement systems that have significant differences in measurement delays to show how NBTI recovery causes result deviations and how fast measurement systems can mitigate NBTI recovery. Another method to minimize NBTI recovery without the influence of measurement system known as Fast Wafer Level Reliability (FWLR) NBTI was also done to be used as reference.

Probiotics’ Antibacterial Activity on Beef and Camel Minced Meat at Altered Ranges of Temperature

Because of their inhibitory effects, selected probiotic Lactobacilli may be used as antimicrobial against some hazardous microorganisms responsible for spoilage of fresh minced beef (cattle) minced meat and camel minced meat. Lactic acid bacteria were isolated from camel meat. These included 10 isolates; 1 Lactobacillus fermenti, 4 Lactobacillus plantarum, 4 Lactobacillus pulgaricus, 3 Lactobacillus acidophilus and 1 Lactobacillus brevis. The most efficient inhibitory organism was Lactobacillus plantarum which can be used as a propiotic with antibacterial activity. All microbiological analyses were made at the time 0, first day and the second day at altered ranges of temperature [4±2 ⁰C (chilling temperature), 25±2 ⁰C, and 38±2 ⁰C]. Results showed a significant decrease of pH 6.2 to 5.1 within variant types of meat, in addition to reduction of Total Bacterial Count, Enterococci, Bacillus cereus and Escherichia coli together with the stability of Coliforms and absence of Staphylococcus aureus.

Professionals’ Collaboration on Strengthening the Teaching of History

This paper discusses the shared effort of teaching history in K-12 schools, community colleges, four-year colleges and universities to develop students' understanding of the history and habits of thought history. This study presents and discusses the problems of K-12 schools in colleges and universities, and the establishment of secondary school principals. This study also shows that the changing nature of practice can define new trends and affect the history professional in the classroom. There are many problems that historians and teachers of college faculty share in the history of high school teachers. History teachers can and should do better to get students in the classroom. History provides valuable insights into the information and embedded solid-state analysis models that are conflicting on the planet and are quickly changing exceptionally valuable. The survey results can reflect the history teaching in Malaysia.

Effects of Incident Angle and Distance on Visible Light Communication

Visible Light Communication (VLC) provides wireless communication features in illumination systems. One of the key applications is to recognize the user location by indoor illuminators such as light emitting diodes. For localization of individual receivers in these systems, we usually assume that receivers and transmitters are placed in parallel. However, it is difficult to satisfy this assumption because the receivers move randomly in real case. It is necessary to analyze the case when transmitter is not placed perfectly parallel to receiver. It is also important to identify changes on optical gain by the tilted angles and distances of them against the illuminators. In this paper, we simulate optical gain for various cases where the tilt of the receiver and the distance change. Then, we identified changing patterns of optical gains according to tilted angles of a receiver and distance. These results can help many VLC applications understand the extent of the location errors with regard to optical gains of the receivers and identify the root cause.

Jamun Juice Extraction Using Commercial Enzymes and Optimization of the Treatment with the Help of Physicochemical, Nutritional and Sensory Properties

Jamun (Syzygium cuminii L.) is one of the important indigenous minor fruit with high medicinal value. The jamun cultivation is unorganized and there is huge loss of this fruit every year. The perishable nature of the fruit makes its postharvest management further difficult. Due to the strong cell wall structure of pectin-protein bonds and hard seeds, extraction of juice becomes difficult. Enzymatic treatment has been commercially used for improvement of juice quality with high yield. The objective of the study was to optimize the best treatment method for juice extraction. Enzymes (Pectinase and Tannase) from different stains had been used and for each enzyme, best result obtained by using response surface methodology. Optimization had been done on the basis of physicochemical property, nutritional property, sensory quality and cost estimation. According to quality aspect, cost analysis and sensory evaluation, the optimizing enzymatic treatment was obtained by Pectinase from Aspergillus aculeatus strain. The optimum condition for the treatment was 44 oC with 80 minute with a concentration of 0.05% (w/w). At these conditions, 75% of yield with turbidity of 32.21NTU, clarity of 74.39%T, polyphenol content of 115.31 mg GAE/g, protein content of 102.43 mg/g have been obtained with a significant difference in overall acceptability.

Biosynthesis of Silver-Phosphate Nanoparticles Using the Extracellular Polymeric Substance of Sporosarcina pasteurii

Silver ions (Ag+) and their compounds are consequentially toxic to microorganisms, showing biocidal effects on many species of bacteria. Silver-phosphate (or silver orthophosphate) is one of these compounds, which is famous for its antimicrobial effect and catalysis application. In the present study, a green method was presented to synthesis silver-phosphate nanoparticles using Sporosarcina pasteurii. The composition of the biosynthesized nanoparticles was identified as Ag3PO4 using X-ray Diffraction (XRD) and Energy Dispersive Spectroscopy (EDS). Also, Fourier Transform Infrared (FTIR) spectroscopy showed that Ag3PO4 nanoparticles was synthesized in the presence of biosurfactants, enzymes, and proteins. In addition, UV-Vis adsorption of the produced colloidal suspension approved the results of XRD and FTIR analyses. Finally, Transmission Electron Microscope (TEM) images indicated that the size of the nanoparticles was about 20 nm.

Development of Energy Benchmarks Using Mandatory Energy and Emissions Reporting Data: Ontario Post-Secondary Residences

Governments are playing an increasingly active role in reducing carbon emissions, and a key strategy has been the introduction of mandatory energy disclosure policies. These policies have resulted in a significant amount of publicly available data, providing researchers with a unique opportunity to develop location-specific energy and carbon emission benchmarks from this data set, which can then be used to develop building archetypes and used to inform urban energy models. This study presents the development of such a benchmark using the public reporting data. The data from Ontario’s Ministry of Energy for Post-Secondary Educational Institutions are being used to develop a series of building archetype dynamic building loads and energy benchmarks to fill a gap in the currently available building database. This paper presents the development of a benchmark for college and university residences within ASHRAE climate zone 6 areas in Ontario using the mandatory disclosure energy and greenhouse gas emissions data. The methodology presented includes data cleaning, statistical analysis, and benchmark development, and lessons learned from this investigation are presented and discussed to inform the development of future energy benchmarks from this larger data set. The key findings from this initial benchmarking study are: (1) the importance of careful data screening and outlier identification to develop a valid dataset; (2) the key features used to develop a model of the data are building age, size, and occupancy schedules and these can be used to estimate energy consumption; and (3) policy changes affecting the primary energy generation significantly affected greenhouse gas emissions, and consideration of these factors was critical to evaluate the validity of the reported data.

Multi-Criteria Optimization of High-Temperature Reversed Starter-Generator

The paper presents another structural scheme of high-temperature starter-generator with external rotor to be installed on High Pressure Shaft (HPS) of aircraft engines (AE) to implement More Electrical Engine concept. The basic materials to make this starter-generator (SG) were selected and justified. Multi-criteria optimization of the developed structural scheme was performed using a genetic algorithm and Pareto method. The optimum (in Pareto terms) active length and thickness of permanent magnets of SG were selected as a result of the optimization. Using the dimensions obtained, allowed to reduce the weight of the designed SG by 10 kg relative to a base option at constant thermal loads. Multidisciplinary computer simulation was performed on the basis of the optimum geometric dimensions, which proved performance efficiency of the design. We further plan to make a full-scale sample of SG of HPS and publish the results of its experimental research.

Production Optimization through Ejector Installation at ESA Platform Offshore North West Java Field

The offshore facilities condition of Pertamina Hulu Energi Offshore North West Java (PHE ONWJ) varies greatly from place to place, depending on the characteristics of the presently installed facilities. In some locations, such as ESA platform, gas trap is mainly caused by the occurrence of flash gas phenomenon which is known as mechanical-physical separation process of multiphase flow. Consequently, the presence of gas trap at main oil line would accumulate on certain areas result in a reduced oil stream throughout the pipeline. Any presence of discrete gaseous along continuous oil flow represents a unique flow condition under certain specific volume fraction and velocity field. From gas lift source, a benefit line is used as a motive flow for ejector which is designed to generate a syphon effect to minimize the gas trap phenomenon. Therefore, the ejector’s exhaust stream will flow to the designated point without interfering other systems.