Quality Complaints Research Articles

Establishment of a Practical Approach for Characterizing the Source of Particulates in Water Distribution Systems

Water quality complaints related to particulate matter and discolored water can be troublesome for water utilities in terms of follow-up investigations and implementation of appropriate actions because particulate matter can enter from a variety of sources; moreover, physicochemical processes can affect the water quality during the purification and transportation processes. The origin of particulates can be attributed to sources such as background organic/inorganic materials from water sources, water treatment plants, water distribution pipelines that have deteriorated, and rehabilitation activities in the water distribution systems. In this study, a practical method is proposed for tracing particulate sources. The method entails collecting information related to hydraulic, water quality, and structural conditions, employing a network flow-path model, and establishing a database of physicochemical properties for tubercles and slimes. The proposed method was implemented within two city water distribution systems that were located in Korea. These applications were conducted to demonstrate the practical applicability of the method for providing solutions to customer complaints. The results of the field studies indicated that the proposed method would be feasible for investigating the sources of particulates and for preparing appropriate action plans for complaints related to particulate matter.

One-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas-a technical report.

BackgroundBinostril endoscopic transsphenoidal approach (BETA) provides sufficient manipulation space and wide endoscopic vision, although it increases the trauma of nose. Mononostril endoscopic transsphenoidal approach (META) has minimal trauma of nose, at the expense of space within the operation. We describe a one-and-a-half nostril endoscopic transsphenoidal approach (OETA) that combines the advantages of BETA and META.MethodsWe introduced OETA for pituitary adenomas with a detailed technical description. A retrospective analysis was also performed on 57 consecutive patients who underwent one-and-a-half nostril endoscopic transsphenoidal surgery between March 2014 and June 2015 at Jinling hospital.ResultsThe gross total resection rate was 79%. The gross complete resection rate of Knosp grade 3 tumors were 63.6, and 27.3% in grade 4 tumors. Postoperative hormone remission was achieved in 14 out of 18 (77.8%) patients with secreting adenomas. Postoperative abnormal visual function improvement was achieved in 23 out of 32 patients (73%) with preoperative visual dysfunction. The overall intra-operative CSF leak was 17.5%, with the postoperative CSF leak decreased to 3.5% after the sellar reconstruction with the unilateral “rescue” nasoseptal flap procedure. The main sinonasal complaints 2 weeks after surgery were: loss of sense of smell (28%), decrease in sense of taste (4%), trouble breathing during the day (18%), thick nasal discharge (36%), post nasal discharge (8%), dried nasal material (6%), and headache (6%). Three months after surgery, there were no reports of decrease of taste, post nasal discharge, or dried nasal material. Other complaints were decreased significantly. Six months after surgery, the main complaints of sinonasal quality of life were negligible, and overall health status was near complete recovery to preoperative status.ConclusionsThe one-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas is a simple and reliable technique. It provides not only a sufficient surgical corridor for a 2-surgeon/4 or 3-hands technique, but also ensures minimal invasion of the nasal canal.

Russian public transport system: the customers’ feedback on the service provision

A considerable demand on gaining an inside knowledge on customers’ perceptions of the service quality and subsequent complaint behavior in case of failure has defined the aim of this research paper. In this paper we analyse the pattern of customer complaint behavior in a widely used and widespread type of service—public transportation. Given the fact that the city of Kaliningrad is about to undergo a series of extensive qualitative improvements, driven by the federal investments allocated for major sporting and cultural events, this empirical research will have a considerable practical value. Research results suggest that customers tend to set the quality bar for the public transportation based on the personal best service performance experienced, generally received in large touristic centres and capital cities in Europe, hence inadvertently placing the provincial city of Kaliningrad at a disadvantage. There are three types of causes for the negative critical incidents identified, largely affecting the subsequent reaction of a dissatisfied customer. The passenger’s intention to engage in complaint behavior is greatly influenced by the amount of effort required, the costs associated with filing a complaint, and a perceived probability of ‘success’. Though, a considerable discrepancy is found between the probable reaction of a respondent and the actual steps taken in case of a real incident. A negative word-of-mouth remains one of the widely used modes of complaint behavior, whereas employees resist customers’ complaints, since complaints are perceived as personal insult.

Self-perception, complaints and vocal quality among undergraduate students enrolled in a Pedagogy course.

To compare the vocal self-perception and vocal complaints reported by two groups of students of the pedagogy course (freshmen and graduates); to relate the vocal self-perception to the vocal complaints for these groups; and to compare the voice quality of the students from these groups through perceptual auditory assessment and acoustic analysis. Initially, 89 students from the pedagogy course answered a questionnaire about self-perceived voice quality and vocal complaints. In a second phase, auditory-perceptual evaluation and acoustic analyses of 48 participants were made through voice recordings of sustained vowel emission and poem reading. The most reported vocal complaints were fatigue while using the voice, sore throat, effort to speak, irritation or burning in the throat, hoarseness, tightness in the neck, and variations of voice throughout the day. There was a higher occurrence of complaints from graduates than from freshmen, with significant differences for four of the nine complaints. It was also possible to observe the relationship between vocal self-perception and complaints reported by these students. No significant differences were observed in the results of auditory-perceptual evaluation; however, some graduates had their voices evaluated with higher severity of deviation of normalcy. During acoustic analysis no difference was observed between groups. The increase in vocal demand by the graduates may have caused the greatest number and diversity of vocal complaints, and several of them are related to the self-assessment of voice quality. The auditory-perceptual evaluation and acoustic analysis showed no deviations in their voice.

Associations of a Short Sleep Duration, Insufficient Sleep, and Insomnia with Self-Rated Health among Nurses.

Epidemiological evidence suggests that sleep duration and poor sleep are associated with mortality, as well as with a wide range of negative health outcomes. However, few studies have examined the association between sleep and self-rated health, particularly through the combination of sleep complaints. The objective of this study was to examine whether self-rated health is associated with sleep complaints, considering the combination of sleep duration, insomnia, and sleep sufficiency. This cross-sectional study was performed in the 18 largest public hospitals in the city of Rio de Janeiro, Brazil. A total of 2518 female nurses answered a self-filled multidimensional questionnaire. The adjusted odds ratios and 95% confidence intervals (CIs) estimated the chance of poor self-rated health in the presence of different combinations of sleep duration and quality. Compared with women who reported adequate sleep duration with no sleep quality complaints (reference group), the odds ratios (95% CI) for poor self-rated health were 1.79 (1.27–2.24) for those who reported only insufficient sleep, 1.85 (0.94–3.66) for only a short sleep duration, and 3.12 (1.94–5.01) for only insomnia. Compared with those who expressed all three complaints (short sleep duration, insomnia, and insufficient sleep), the odds ratio for poor self-rated health was 4.49 (3.25–6.22). Differences in the magnitude of the associations were observed, depending on the combination of sleep complaints. Because self-rated health is a consistent predictor of morbidity, these results reinforce the increasing awareness of the role of sleep in health and disease. Our findings contribute to the recognition of sleep as a public health matter that deserves to be better understood and addressed by policymakers.

Introducing remote physical rehabilitation for patients with chronic disorders by means of telemedicine

This study involved an evaluation of a telemedicine service implemented as a partial replacement of a physical outpatient rehabilitation program. The telemedicine service was an exercise-based tele-rehabilitation service facilitating remote physical rehabilitation for patients suffering from chronic lower back pain or pulmonary disease. Effectiveness was evaluated with multiple outcomes on quality (complaints, disability and physical condition) and access (usability, satisfaction and motivational character of the service). Patients referred by their rehabilitation physician to a physical outpatient rehabilitation program between October 2009 and May 2010 were asked to participate in the control group. Patients referred to the program between June 2010 and December 2011 were asked to participate in the intervention group. The control group received the conventional rehabilitation program. The intervention group received the rehabilitation program in which telemedicine was used as partial replacement of face to face care. Instead of 3 visits per week to the clinic as was being carried out in conventional care, patients visited the outpatient rehabilitation clinic for 2 days and they were instructed to exercise at least 1 day in their own environment using the exercise-based tele-rehabilitation service. One hundred and eighteen patients were included in this study: 38 patients in the control group and 80 patients in the intervention group. Both groups equally benefit from the outpatient rehabilitation program. There were no significant differences between the groups. The usability (system usability scale sore of 71.2 (SD 15.0; n = 47), satisfaction (average rate 6.0 (SD 2.0; n = 55), and level of motivation of the exercise-based tele-rehabilitation service were sufficient, but slightly disappointing. The telemedicine supported the outpatient rehabilitation program as partial replacement of face to face care was as effective as the conventional outpatient rehabilitation program.

Taste and odour and public perceptions: what do our customers really think about their drinking water?

Customers primarily perceive the safety of drinking water on aesthetic qualities. Chlorine, geosmin and 2-methylisoborneol (2-MIB) are common causes of taste and odour complaints in Australia. Variance in customer preference, perception, cultural differences and individual experiences make regulation of these, in the form of guidelines, challenging to establish. Here, analysis of historical water quality and customer complaint data showed the use of customer complaints as an indicator of deteriorating water quality is not robust. The use of a modified Flavour Ratings Assessment showed a statistical decrease in customer acceptance from control samples when chlorine concentration in drinking water increased above 0.2 mg/L and when geosmin or 2-MIB concentration was greater than 10 ng/L. However, geosmin was only rated ‘unacceptable’ at 30 ng/L while chlorine and 2-MIB were not rated ‘unacceptable’ for the range tested. For all samples, including ‘blanks', customers indicated a greater tendency to complain in a social setting rather than formally to their water provider.

Sleep and musculoskeletal complaints among elite athletes of Santa Catarina

BACKGROUND AND OBJECTIVES: There are many physiological processes going on during sleep which are important for physical and emotional balance and especially for motor function, essential for athletes' performance. This study aimed at investigating associations between sleep duration and quality and musculoskeletal complaints among elite athletes of the state of Santa Catarina. METHODS: Four hundred and fifty-two athletes from various sports have been investigated on issues related to sleep (duration, quality) and musculoskeletal complaints in body parts through the Pittsburgh Sleep Quality Index and the Nordic Musculoskeletal Questionnaire, respectively. The association between sleep and muscle pain was analyzed by Spearman's correlation of “number of painful body parts” and “Pittsburgh Sleep Quality Index scores”. RESULTS: Mean age of athletes was 21.16 years (5.82), being 61.1% females and 38% with poor sleep quality and association between the amount of nighttime awakenings with nocturnal pain (p <0.001). There has been high prevalence of musculoskeletal pain, more evident on knees, shoulders, ankle/feet and low back. The number of painful parts was correlated (r=0.216) with higher Pittsburgh Sleep Quality Index scores (p<0.001). CONCLUSION: Athletes had high prevalence of poor sleep quality and musculoskeletal pain complaints, especially on knee, shoulders, back and ankle/feet. The correlation between poor sleep quality and pain was more evident as the number of affected body parts increased. Athletes with poorer sleep quality had more pain as compared to those with sleep duration changes, suggesting that musculoskeletal complaints are associated to athletes' sleep quality rather than to sleep duration.

Sleep quality and health complaints among nursing students.

Sleep quality and health complaints among nursing students.

Complaints of Poor Sleep and Risk of Traffic Accidents: A Population-Based Case-Control Study.

IntroductionThis study aimed to determine the sleepiness-related factors associated with road traffic accidents.MethodsA population based case-control study was conducted in 2 French agglomerations. 272 road accident cases hospitalized in emergency units and 272 control drivers matched by time of day and randomly stopped by police forces were included in the study. Odds ratios were calculated for the risk of road traffic accidents.ResultsAs expected, the main predictive factor for road traffic accidents was having a sleep episode at the wheel just before the accident (OR 9.97, CI 95%: 1.57–63.50, p<0.05). The increased risk of traffic accidents was 3.35 times higher in subjects who reported very poor quality sleep during the last 3 months (CI 95%: 1.30–8.63, p<0.05), 1.69 times higher in subjects reporting sleeping 6 hours or fewer per night during the last 3 months (CI 95%: 1.00–2.85, p<0.05), 2.02 times higher in subjects reporting symptoms of anxiety or nervousness in the previous day (CI 95%: 1.03–3.97, p<0.05), and 3.29 times higher in subjects reporting taking more than 2 medications in the last 24 h (CI 95%: 1.14–9.44, p<0.05). Chronic daytime sleepiness measured by the Epworth Sleepiness Scale, expressed heavy snoring and nocturnal leg movements did not explain traffic accidents.ConclusionPhysicians should be attentive to complaints of poor sleep quality and quantity, symptoms of anxiety-nervousness and/or drug consumption in regular car drivers.

In Search of Motivation for the Business Survey Response Task

Abstract Increasing reluctance of businesses to participate in surveys often leads to declining or low response rates, poor data quality and burden complaints, and suggests that a driving force, that is, the motivation for participation and accurate and timely response, is insufficient or lacking. Inspiration for ways to remedy this situation has already been sought in the psychological theory of self-determination; previous research has favored enhancement of intrinsic motivation compared to extrinsic motivation. Traditionally however, enhancing extrinsic motivation has been pervasive in business surveys. We therefore review this theory in the context of business surveys using empirical data from the Netherlands and Slovenia, and suggest that extrinsic motivation calls for at least as much attention as intrinsic motivation, that other sources of motivation may be relevant besides those stemming from the three fundamental psychological needs (competence, autonomy and relatedness), and that other approaches may have the potential to better explain some aspects of motivation in business surveys (e.g., implicit motives). We conclude with suggestions that survey organizations can consider when attempting to improve business survey response behavior.

상수관망에서 발생하는 이물질의 성분분석

Abstract : Customers water quality complaints by foreign substance in local water service can be able to call the main cause bring the distrust for tap water and inhibiting the rate of drinking water. In this study, foreign substances were collected in the target region. Foreign objects were subjected to qualitative and quantitative analysis of compounds and elements components to reveal the cause of detection. Also, resolve the complaints by foreign substance and improve the reliability for tap water providing high quality water supply scheme. Collected substances at the water quality complaint area were included in inorganic compounds due to internal corrosion and aging pipeline, as well as organic compounds containing a large amount of carbon (C) and oxygen (O) component. To decide and reduce for foreign substance, objective assessment of pipe condition in target area was required. Key Words : Foreign Substance, Water Quality Complaints, Tap Water, Inorganic Compounds, Organic Compounds

Economies of scale and scope in Australian urban water utilities

This paper estimates economies of scale and scope for 55 major Australian urban utilities over the period 2005/06 to 2008/09. The models used specify operating and capital costs as a function of chemical and microbiological compliance, water losses, water quality and service, water main breaks, total connected properties, and urban water supplied. The input variables used to help determine water utility costs include the density of properties served and the sourcing of water from bulk suppliers, groundwater, recycling and surface water. In terms of economies of scale, the evidence suggests strong economies of scale at relatively low levels of output (50–75% of current mean output). In terms of product-specific economies of scale (increasing the scale of a specific output in isolation), there is substantially stronger evidence that the operating costs of urban water utilities would benefit from increasing scale with regard to chemical compliance, water quality and service complaints, and the number of connected properties. In contrast, capital costs would benefit from scale increases with regard to the management of water losses and water main breaks. For economies of scope, it is clear that there are substantial cost benefits from the joint production of treated quality water delivered across a network with minimal water losses and main breaks. The main cost advantage at all levels of output is decreasing water losses, and this would benefit both operating and capital costs.

Preparing for revalidation

Abstract Since December 2012 all doctors who wish to retain a license to practice have to revalidate every 5 years. This applies to equally to all doctors in paediatric practice including consultant paediatricians, SSASG doctors and trainees. Practitioners have to demonstrate that they meet generic standards as applied to their post in the GMC's Good Medical Practice to retain a license to practice. Paediatricians must demonstrate that they meet the GMC-approved RCPCH standards by submitting appropriate supporting information to annual appraisal. Revalidation will require five completed, signed annual appraisals; which will contain five personal development plans, evidence of 5 years of continuing professional development activities (including evidence of learning such as reflective notes), multisource feedback by colleagues, multisource feedback by patients, involvement in quality improvement activities (e.g. audit), and research, publications, outcome data, complaints and critical incidents and of compliance with clinical governance procedures. Trainees will revalidate first 5 years after full registration and then when they obtain the certificate of completion of training (CCT). Their Responsible Officer (RO) will be the Postgraduate Dean. Trainees must submit an annual Form R before their ARCP, with a declaration of involvement in any serious untoward incidents (SUIs) and include a reflective note on each SUI in their portfolio.

Penerapan Metode Servqual Pada Skala Likert Untuk Mendapatkan Kualitas Pelayanan Kepuasan Pelanggan

It is very important to identify and fulfill customer requirements with the highest possible quality. Several tools, methods and techniques have been used to assess service requirements and quality. ServQual is one of the most widely used quality tools to measure service quality. Based on the research results, analysis of customer satisfaction using the ServQual method on object A has been carried out which includes service quality, product quality and customer complaints to produce an ideal analysis value. On the service quality dimension, the gap results are obtained that are still not satisfactory enough on the service quality dimension on object A, but from the Empathy dimension it is quite satisfying with the acquisition of Tangible = -0.0877, Reliability = -0.0965, Responsiveness = -0.079, Assurance = - 0.0877, and Empathy = 0.17544. In the dimension of service quality, the results of the gap are that the product quality of Object A is very satisfying for the user, but from the Reliability dimension it is not satisfactory enough with the acquisition of Performance = 0.175439, Durability = 0.105263, Specification = 0.105263, Features = 0.105263, Reliability = -0.1579, Aesthetics = 0.192982, Perceived quality = 0.36842. On the dimensions of user complaints, the gap results show that user complaints are not satisfactory with the acquisition of customer complaints = -0.16667.

138 Depiction of anatomic structures of relevance for scoring of cystic fibrosis changes by chest tomosynthesis and computed tomography

Sleep disorders are common in CF patients. Pediatric studies are contradictory. Being aware of the incidence of respiratory sleep disturbance (RSD) and clinical and respiratory function predictive factors is essential. We aimed to identify sleep disturbances in CF children and determine associated spirometric indices as severity predictors. In-lab polysomnography (PSG) followed by spirometry was carried out in CF children, 6 to 18 y. Baseline SpO2 was assessed. A questionnaire was applied. Descriptive statistics and comparative tests were performed. Significance level was set at 5%. Thirty-three subjects were included [16 males (48.5%); median age 12 y (6−18); average BMI z-score −0.35 (dp 0.78)]. 29 patients (87.9%) had sleep quality and/or RSD complaints. Sleep efficiency was reduced and sleep latency and wake after sleep increased. N1, N2, N3, REM and awakenings were normal. The A/HI was 0.6/h (dp 0.9); mean RDI: 6.6 (dp 5.2). Mean wake SpO2 [97% (dp 1.1)] and sleep SpO2 [95% (dp 2.7)] were normal; mean ODI was 2.36; minSpO2 was 89% (dp 4.1). TcCO2 was normal. 51.5% of patients had nocturnal cough. There was a statistically significant difference between the waking and sleep SpO2 (r = 0.326, p = 0.064). FEV1 was associated with sleep SpO2 (r = 0.528, p = 0.002). PSG data significantly correlate with the questionnaire for night awakenings and wake after sleep (p = 0.985) and difficulty breathing during sleep and RDI (p = 0.722). Most children had sleep complaints. The subjective assessment of sleep correlates with PSG findings. These mild respiratory disease children had scarce nocturnal SpO2 events, associated with disease severity assessed by spirometry. The association between SpO2 awake and mean sleep SpO2 indicates a possible risk predictor for nocturnal desaturation.

Application of Six Sigma Methodology in Production Organization

In the last years and also due to today's economic situation and crises in the world, each organization is looking for a continuous improvement of processes and business performance. The major task of each production organization or services is the saving of money, which is lost because of scrap, long cycle times, wrong process maps and inventory differences. The goal of this article is to describe the implementation of Six Sigma in a production organization focusing on the production of interior parts for the automotive industry. During the summer time, there was delamination between thermoplastic foil and plastic substrate, which caused increasing of scrap, additional substandard works as well as the risk of quality complaints from customer. Six Sigma and DMAIC cycle were used to find root causes and to implement permanent corrective actions to remove this kind of problem from production.

Predictive factors of subjective sleep quality and insomnia complaint in patients with stroke: implications for clinical practice

The complaints regarding sleep problems have not been well identified after a stroke. The aim of this study was to investigate the predictive factors of sleep quality and insomnia complaints in patients with stroke. A total of 70 subjects, 40 patients (57 ± 7 years) and 30 healthy controls (52 ± 6 years) assessed by the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Habits Questionnaire took part in the study. The data were analyzed using the chi-square test, the Student's t-test and logistic regression analysis. On average, the patients showed poor sleep quality (patients: 6.3 ± 3.5; controls: 3.9 ± 2.2; p= 0.002) and insomnia complaint was the most prevalent (patients: 37.5%; controls: 6.7%; p= 0.007). The absence of insomnia complaint (OR= 0.120; 95%CI= 0.017-0.873; p= 0.036) and the decreased latency of sleep (OR= 0.120; 95%CI= 0.017-0.873; p= 0.036) were the protective factors of sleep quality. Female sex (OR= 11.098; 95%CI= 1.167-105.559; p= 0.036) and fragmented sleep (OR= 32.040; 95%CI= 3.236-317.261; p= 0.003) were the risk factors for insomnia complaint. We suggest that complaints of poor sleep quality and insomnia should be given priority assessment during clinical diagnosis of sleep disorders in stroke.

Social Stressors at Work, Sleep Quality and Psychosomatic Health Complaints—A Longitudinal Ambulatory Field Study

There is increasing evidence that occupational stress increases psychosomatic health complaints in the long run. However, the underlying mechanisms are still unclear. The present longitudinal actigraphy field study investigated the role of sleep quality--objectively assessed sleep-onset latency, sleep efficiency and sleep fragmentation, and subjectively assessed sleep quality--as a mediator in the relationship between stressful work conditions at time 1 and psychosomatic health complaints at time 2. A longitudinal hierarchical regression analysis revealed that social stressors at work were positively related to objectively assessed sleep fragmentation and to psychosomatic health complaints. Moreover, objectively assessed sleep fragmentation mediated the effect of social stressors at work on psychosomatic health complaints. Contrary to our expectations, social stressors at work were not related to other sleep quality parameters (i.e. sleep-onset latency, sleep efficiency and subjectively assessed sleep quality) during follow-up. Sleep fragmentation is discussed as an important consequence of social stressors at work that increase the risk of psychosomatic health complaints in the long run.

Application of metabolomics to understanding biofilms in water distribution systems: a pilot study

Biofilms formed in pipes are known to contribute to waterborne diseases, accelerate corrosion and cause aesthetic taste and odour issues within the potable water supply network. This paper describes a pilot study, undertaken to assess the potential of using metabolomics to monitor bacterial activity in biofilms of an urban water network. Using samples from a water mains flushing programme, it was found that a profile of intracellular and extracellular metabolites associated with microbial activity could be obtained by analysing samples using gas chromatography mass spectrometry. Chemometric analysis of the chromatograms in conjunction with data from the mass spectrometer showed that it is possible to differentiate between biofilms from different pipe materials and planktonic bacteria. This research demonstrates that metabolomics has the potential for investigating biofilms and other microbial activity within water networks, and could provide a means for enhancing monitoring programmes, understanding the source of water quality complaints, and optimising water network management strategies.