Purpose With the exigencies of health-care service quality to actualize sustainable socio-economic and developmental aspirations, in both peripheral and core countries, this paper aims to provide empirical evidence on health-care service quality and its precursor – patients’ satisfaction, and continuous service utilization. Design/methodology/approach A total of 398 screened questionnaires were analyzed from selected hospitals of the Koforidua, Ghana. Findings from the structural equation modeling showed a significant association among perceived quality, patients’ satisfaction and tangibility. Contrary to the expectations, the results did not show a significant association among the constructs – perceived quality, safety and empathy. Again, the model fit indices collaboratively showed that the hypothesized model overwhelmingly “fit” the sample data, and further proved the predictive robustness of the model. Findings The results of the analysis demonstrate that patients were discontent with empathy and safety measures at the hospitals. However, tangible and perceived quality were identified as significant predictors of patients’ satisfaction. Originality/value There is a dearth of empirical investigations on the assessment of health-care service quality and patients’ satisfaction in developing economies such as Ghana. Therefore, the implication of the study will equip the top hierarchy of the Health System of Ghana in achieving their mission, and objectives in line with quality service delivery. In particular, MoH and GHS can embark on a routine exercise to audit the hospitals for re-accreditation, and provide CCT cameras to improve safety and security conditions at the hospitals, while enforcing the culture of receptive hospital environment to improve empathy.

Low-carbon product design is an important way to reduce greenhouse gas emission. Customer collaborative product innovation (CCPI) has become a new worldwide product design trend. Based on this popularity, we introduced CCPI into the low-carbon product design process. An essential step for implementing low carbon CCPI is to clarify key low carbon requirements of customers. This study tested a novel method for perceiving key requirements of customer collaboration low-carbon product design based on fuzzy grey relational analysis and genetic algorithm. Firstly, the study considered consumer heterogeneity, allowing different types of customers to evaluate low carbon requirements in appropriate formats that reflected their degrees of uncertainty. Then, a nonlinear optimization model was proposed to establish the information aggregation factor of customers based on the genetic algorithm. The weight of customers was obtained simultaneously. Next, the key low carbon requirements of customer were identified. Finally, the effectiveness of the proposed method was illustrated with a case related to a low carbon liquid crystal display.

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ABSTRACT. The aim of this study was to establish recheck rules of urinalysis in children by investigating the concordance rate of the results obtained using the LabUMat urine dry chemistry analyzer (referred to as dry chemistry) and the UriSed tangible composition analyzer with that of the microscopic examination. First, 1040 urine samples from children (mean age 6.5 years) were analyzed using LabUMat and UriSed analyzers, and subsequently subjected to microscopic examination. The missed detection rate was evaluated and recheck rules were established to avoid missed diagnoses of abnormal renal function. Finally, clinical validations of the recheck rules were performed on 200 additional specimens. Among the samples used to investigate the recheck rules, the samples with positive microscopic examination results accounted for 58.65% of the total, while the samples with negative results accounted for 41.35%. Of the positive samples, a major portion (>50%) were RBC positive. The samples that were WBC positive and CAST positive accounted for 23.08 and 7.69%, respectively. The concordance rate was 87.5% and the missed detection rate was 2.9%. For the validation of the recheck rules in 200 urine samples, the concordance rate was 87.5% and the missed detection rate was 2.4%. When the detection of occult blood, WBC, and protein by dry chemistry, and the detection of RBC, WBC, and CAST by the UriSed analyzer are inconsistent, or the differences between them greater than 2 levels, recheck by microscopic examination is suggested.

Rationale:Bone cement leakage is a common complication of percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) surgery and has also been reported in posterior decompression and cement-enhanced pedicle screw fixation. When bone cement leaks through the venous system, it will have serious consequences and even endanger the life of the patient, especially when the bone cement causes intracardiac embolism.Patient concerns:A 70-year-old woman developed chest tightness and decreased blood oxygen saturation following posterior decompression and cement-enhanced pedicle screw fixation.Diagnosis:After the patient was given symptomatic treatment, the symptoms were not relieved, the high-sensitivity troponin I level continued to rise, the electrocardiogram results were abnormal, and chest computed tomography (CT) revealed multiple flaky and strip-shaped dense shadows in the heart.Intervention:The patient underwent removal of foreign bodies from the heart under cardiopulmonary bypass and tricuspid valvuloplasty, removal of intracardiac bone cement, and repair of the tricuspid valve and chordae.Outcome:The patient recovered well postoperatively and was discharged from the hospital after 3 weeks. There were no intracardiac foreign bodies observed on chest CT after the operation.Lessons:For patients with cardiopulmonary discomfort after posterior decompression and bone cement-enhanced pedicle screw fixation, in view of the limitations of radiographic examination, we recommend performing chest CT examination to confirm the diagnosis. For patients with intravascular foreign body embolism, multidisciplinary team joint treatment saves lives.