Purpose – Today substantial investments are made to improve the bottom line and cost of quality (CoQ) is a tool that identifies weaker areas where these investments should be directed. In literature, the authors find various CoQ models and their applications but it is deficient in providing a standard format of a “Quality Cost Procedure” for a CoQ program’s company-wide deployment. A procedure was thus developed and its effectiveness was evaluated implementation. The paper aims to discuss these issues. Design/methodology/approach – CoQ program was implemented in the production department of a wood products’ manufacturer using the action research approach. Prevention, Appraisal and Failure Cost model was employed. Data collection was challenging, however, stakeholders were interviewed, data were acquired from Management Information System and various reports were reviewed for cost elements. Findings – Total CoQ as a percentage of sales was found to be 11, while as a percentage of material cost was 15 percent. It was found through the implementation that development of a quality cost procedure is highly iterative in nature and a standard format is proposed in the Appendix. This procedure worked satisfactorily and the company is confident in moving to the next phase of company-wide deployment of CoQ Program. Originality/value – A robust “Quality Cost Procedure” is developed, which not only helped the company but will serve CoQ implementers in their operational as well as tactical levels of management. CoQ implementation prior development of procedure brought conviction and accredited it. Practitioners can mold this procedure as per need, which will further enhance the body of knowledge on CoQ.
Industry 4.0 implementations integrate people, machines, data, technology, and processes and allow organizations to connect through digitization and cloud-based systems. The purpose of the present research is to realize the need and sustainability of digitization and connectivity within the quality management domain in developing countries, which is now called Quality 4.0. In previous research, several Quality 4.0 frameworks have been proposed. However, most of the frameworks are based on philosophy or require vast resources to implement. Hence, this research work proposes a framework for the implementation of Quality 4.0 in different industries. This framework is based on eleven dimensions that are the core requirements of the Quality 4.0; key variables are evaluated to gauge the maturity of the implementation of the framework. A research instrument is developed based on the variables to acquire the industry data, which are statistically analyzed to determine the maturity of implementation. It was found that scalability, culture, and app development require the most immense attention from industry to completely implement the requirements of Quality 4.0. Finally, recommendations are suggested that address the strengths, weaknesses, opportunities, and threats in transforming traditional quality management systems to the Quality 4.0 framework.
IntroductionIndividuals with schizophrenia are at a high risk of physical health comorbidities and premature mortality. Cardiovascular and metabolic causes are an important contributor. There are gaps in monitoring, documenting and managing these physical health comorbidities. Because of their condition, patients themselves may not be aware of these comorbidities and may not be able to follow a lifestyle that prevents and manages the complications. In many low-income and middle-income countries including Pakistan, the bulk of the burden of care for those struggling with schizophrenia falls on the families.ObjectivesTo determine the rate of self-reported physical health disorders and risk factors, like body mass index (BMI) and smoking, associated with cardiovascular and metabolic disorders in cases of schizophrenia compared with a group of mentally healthy controls.DesignA case-controlled, cross-sectional multicentre study of patients with schizophrenia in Pakistan.SettingsMultiple data collection sites across the country for patients, that is, public and private psychiatric OPDs (out patient departments), specialised psychiatric care facilities, and psychiatric wards of teaching and district level hospitals. Healthy controls were enrolled from the community.ParticipantsWe report a total of 6838 participants’ data with (N 3411 (49.9%)) cases of schizophrenia compared with a group of healthy controls (N 3427 (50.1%)).ResultsBMI (OR 0.98 (CI 0.97 to 0.99), p=0.0025), and the rate of smoking is higher in patients with schizophrenia than in controls. Problems with vision (OR 0.13 (0.08 to 0.2), joint pain (OR 0.18 (0.07 to 0.44)) and high cholesterol (OR 0.13 (0.05 to 0.35)) have higher reported prevalence in controls. The cases describe more physical health disorders in the category ‘other’ (OR 4.65 (3.01 to 7.18)). This captures residual disorders not listed in the questionnaire.ConclusionsParticipants with schizophrenia in comparison with controls report more disorders. The access in the ‘other’ category may be a reflection of undiagnosed disorders.
Objective: It is to compare neonatal morbidity in terms of birth trauma, respiratory distress syndrome, APGAR score in Primigravida with breech presentation delivered vaginally and emergency cesarean section. Design: Cross-sectional comparative study. Place and Duration of Study: Obstetrics and Gynaecology Unit-I, Bahawal Victoria Hospital, Bahawalpur from 1-5-2007 to 30-4-2008. Patients and Method: The study was carried out on all Primigravida with breech presentation reported through emergency in labour deliveredvaginally and by emergency cesarean section. The variable analyzed were birth trauma, respiratory distress syndrome and APGAR score at 1 and 5 minutes. Students-t test was used for comparison between means and chi square test for comparison between percentages. Significance was taken at P<0.05. Results: It was found that mean APGAR score at 1 and 5 minutes is 7.31 and 9.066 in vaginal and 8.533 and 9.644 incesarean group. Respiratory distress syndrome is more in cesarean (4.4%) than vaginal group (2.2%). Observed neonatal trauma is more in vaginal group (6.7%) than cesarean section (2.2%). Conclusion: Neonatal morbidity appears to be more in vaginal breech delivery than cesarean section for Primigravida with breech presentation at term.
Objective: To determine the effects of Sitagliptin on pre-hypertensive type-2 diabetes mellitus patients. Methods: This Quasi-Experimental study was conducted at Medical inpatient and outpatient department and Diabetic Clinic of Mayo Hospital, Lahore, from February 2019 till January 2020. A total of 146 patients were included in study. Blood pressure (BP) was recorded at baseline and then at 3, 6 and 12 months of treatment. Patients were called for follow up at 3 and 6 months, their BP was checked and haemoglobin A1c (HbA1c) was also sent to check for glycemic control. At 12 months, final follow up was called. BP and HbA1c of every patient were checked and recorded. The blood pressure values at baseline, 3 months, 6months and 12 months were comparatively analyzed by using a paired t-test and p-value of 0.05 was considered significant. Results: Total 146 patients of type-2 diabetes with HbA1c ≤ 9 % not taking sitagliptin previously were selected for this study. Mean age of the patients was 57.5±10.7 years. Total 93(63.7%) were males and 53(36.3%) females. There was statistical difference of HbA1c, systolic and diastolic blood pressure values (p<0.05) after 3 months, 6 months and 12months of sitagliptin therapy as compared to baseline. Conclusions: Sitagliptin therapy significantly decreases blood pressure and levels of HbA1c in type 2 diabetic-hypertensive patients.
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