Aplikasi 6 Sigma Dalam Menurunkan Malfunction Defect Di Pengetesan Elektrikal (Ac Transient Test) Pada Tahapan Pengembangan Produk Blu-ray Disc Player (Studi Kasus Di Perusahaan Manufaktur Elektronik)

. The research helds inelectrical product manufacturing company, focus of theproduct is Blu-ray Disc Player. The dominant problem caused by electrical test at the productdevelopment process is Malfunction at AC Transient test where contribution is 83% fromtotal electrical problem. Main objectives of this research are to determine the vital factors andprovide optimal solution to reduce/elimate these problem at development stage. The problemsolving methodology using Six Sigma DMAIC and DOE .The analysis indicated that linefilter value and spark gap distance in the PCB SMPS are vital factors that influence themalfunction defective as AC Transient test result. The design of experiment (DOE) techniqueuse to define the optimum values of vital factor‟s needed to reduce/eliminate the defect. As aresult, a reduction of malfunction defective at AC Transient test was achieved, from 125000ppm to 0 ppm and thus improve its Sigma level from 2.65 to 6

ASSESSMENT OF RISK FACTORS ASSOC0IATED WITH ACUTE RESPIRATORY INFECTIONS (ARIS) AMONG CHILDREN UNDER 5 YEARS OF AGE, PAKISTAN

Introduction: Acute respiratory infections account for approximately 6% of the total global burden of disease; almost double the proportion compared with the other communicable diseases. Aims: To investigate the link between risk factors & ARIs in Pakistani pediatric population under 5 with different socio-demographic profiles. Methods: Research was conducted as a cross-sectional study, utilizing the Pakistan DHS 2017-18 data, after ethical approval for the utilization of the dataset. Study variables were defined as age and gender of the child, place of residence, maternal education, wealth index, breastfeeding, and the immunization status of the child. Sample size (n = 39,799) was determined as per the inclusion and exclusion criteria. Prevalence of ARIs was estimated and the association between ARIs and socio-demographic factor and child’s immunization was examined. Results: Out of 39,799 children, 51.6% were males, 21.0 % were aged 36 – 47 months, 73.7% were the rural residents, 23% belonged to lowest wealth index quintiles. The mothers of 43.7% children were illiterate and 55.7% of the children were breastfed. ARIs proportion among the sample was 14.3%. Significant association was observed between ARIs and age (p=0.000), gender of the child (p=0.001), residence (p=0.000), economic deprivation (p=0.000), maternal education (p=0.000) and breastfeeding (p=0.000), vitamin A administration (p=0.021), BCG (p=0.008), pentavalent (p=0.008), measles (p=0.000), and pneumococcal vaccination (p=0.020). Conclusion: Socio-demographic characteristics, i.e., age and gender of the child, accommodation, economic deprivation, maternal education, breast-feeding and poor vaccination uptake were observed to be positively correlated with ARIs among children under 5 years of age in Pakistan

Support and Assessment for Fall Emergency Referrals (SAFER 1) trial protocol. Computerised on-scene decision support for emergency ambulance staff to assess and plan care for older people who have fallen: evaluation of costs and benefits using a pragmatic cluster randomised trial

Background: Many emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital attendance. The SAFER 1 trial will assess the costs and benefits of a new healthcare technology - hand-held computers with computerised clinical decision support (CCDS) software - to help paramedics decide who needs hospital attendance, and who can be safely left at home with referral to community falls services. Methods/Design: Pragmatic cluster randomised trial with a qualitative component. We shall allocate 72 paramedics ('clusters') at random between receiving the intervention and a control group delivering care as usual, of whom we expect 60 to complete the trial. Patients are eligible if they are aged 65 or older, live in the study area but not in residential care, and are attended by a study paramedic following an emergency call for a fall. Seven to 10 days after the index fall we shall offer patients the opportunity to opt out of further follow up. Continuing participants will receive questionnaires after one and 6 months, and we shall monitor their routine clinical data for 6 months. We shall interview 20 of these patients in depth. We shall conduct focus groups or semi-structured interviews with paramedics and other stakeholders. The primary outcome is the interval to the first subsequent reported fall (or death). We shall analyse this and other measures of outcome, process and cost by 'intention to treat'. We shall analyse qualitative data thematically. Discussion: Since the SAFER 1 trial received funding in August 2006, implementation has come to terms with ambulance service reorganisation and a new national electronic patient record in England. In response to these hurdles the research team has adapted the research design, including aspects of the intervention, to meet the needs of the ambulance services. In conclusion this complex emergency care trial will provide rigorous evidence on the clinical and cost effectiveness of CCDS for paramedics in the care of older people who have fallen

The Cost-Effectiveness of Home Assessment and Modification to Reduce Falls in the Elderly: A Decision-Analytic Modelling Approach

A modelling exercise was conducted to assess the cost effectiveness of home assessment and modification to reduce falls in the elderly. The model was designed to simulate the costs and consequences of a fall to the elderly over a one year period. The model was developed using the results of published studies related to falls and injuries in the elderly. The intervention was assumed to reduce the fall incidence in the intervention group. The cost effectiveness of the proposed intervention was measured in terms of incremental cost per fall prevented and injury prevented. The model predicted that the home assessment and modification to reduce fall in the elderly would incur an incremental cost $17,210 for a fall-injury prevented

Improving diabetes and pre-diabetes detection in the uk: insights from hba1c screening in an acute hospital’s emergency department

Introduction Many individuals in the community have undiagnosed glucose intolerance, type 2 diabetes (T2D), and pre-diabetes (Pre-DM). This study explored screening for unknown glucose intolerance in the emergency department (ED) in an acute hospital. Methods 1382 persons attending the ED without T2D were screened using HbA1c. T2D and Pre-DM were classified using American Diabetes Association (ADA) and National Institute for Health and Care Excellence (NICE) criteria. The Finnish Diabetes Risk Score (FINDRISC) was calculated in all patients. Results According to NICE criteria, 80.1% (1107 individuals) exhibited normal glucose tolerance, 11.6% (160 individuals) exhibited pre-diabetes, and 8.3% (115 individuals) exhibited diabetes. Each unit increase in FINDRISC score, using multinomial regression, corresponded to an 8% (5–12%; p < 0.001) higher risk for pre-diabetes and a 16% (10–23%; p < 0.001) higher risk for diabetes (NICE). The risk remained elevated even after adjusting for age, sex, and ethnicity. South-Asians had higher glucose intolerance rates than white British (34.8% versus 18.5%) using the NICE criteria, and even greater at 50.0% versus 37.6% using ADA criteria. The adjusted relative risk of having pre-diabetes in people of color compared with white British individuals was 1.77 (1.04–3.00; p = 0.034, ADA) and 2.84 (1.41–5.65; p = 0.003, NICE). The multinomial relative-risk ratio (RRRs) for having diabetes by ethnicity was 2.97 (1.73–5.08; p < 0.0001, ADA) and 2.80 (1.59–4.94; p < 0.0001, NICE). Conclusions Routine HbA1c screening in the ED, with FINDRISC scoring, successfully identifies individuals with diabetes and pre-diabetes. This approach could enable early intervention, particularly in groups at higher risk of glucose intolerance. Trial registration ClinicalTrials.gov identifier, NCT04653545

Developing a new response to non-urgent emergency calls : evaluation of a nurse and paramedic partnership intervention

Original article can be found at: http://journals.cambridge.org/action/login Copyright Cambridge University Press DOI: 10.1017/S1463423608000765Aim To evaluate a new service development whereby a nurse and a paramedic working in partnership attended non-urgent emergency calls. Background The demand for emergency ambulance services both nationally (in the UK) and internationally has been steadily increasing. A large proportion of calls made to the emergency ambulance service are classified as non-urgent. An alternative response to these calls may release the standard ambulance service to attend more urgent calls. A pilot project was initiated in order to provide an alternative response to non-urgent emergency calls in an Ambulance Trust in England with support from the local Primary Care Trust. This alternative response comprised a district nurse or an emergency nurse practitioner dispatched with a paramedic to visit low-priority emergency calls. The pilot service was trialled during a 15-week period in 2003–2004. Methods This paper evaluates the cost effectiveness of the pilot service by examining both the resource use and the outcomes of the service. Findings It was found that introducing this service to the current provision would increase the overall cost to the ambulance services. However, a reduction in conveyance rate to the hospital was observed as people could be treated on-scene. A reduction in conveyance rate to the hospital would lead to reduced admissions to accident and emergency departments and subsequent hospitalization. This paper provides an indication that further development of this type of service has the potential to be cost effective, if the wider health care economy is considered, as the cost savings made in secondary care could more than balance the costs to the Ambulance Services in providing such a servicePeer reviewe

Paramedics and nurses in partnership: perceptions of a new response to low-priority ambulance calls

Original article can be found at: http://www.sciencedirect.com/science/journal/09652302 Copyright Elsevier Ltd. DOI : 10.1016/j.aaen.2007.09.001Peer reviewe

Harmonics Analysis of Inverter Circuits on Smart Grid System

Abstract Smart Grid System has Harmonics Distortions. Caused when switching inverters convert DC current into AC that lowers power quality and affects power generation system. Interference occurs in sinusoidal wavelengths of voltage or system currents that have frequency multiples of fundamental frequencies. Therefore, analysis is required based on IEEE Std 519-2014 standard which is for 20kV Bus voltage has a limit value of 3% for VIHD and 5% for VTHD, using ETAP software was conducted simulating the condition of the non-grid bus system has a VTHD value of 4.9%, while the on-grid system conditions that have inverters for buses have a VTHD value of 5.81%, and simulations before passive filters are installed in the 5th order (f = 250 Hz) with a VTHD value of 6.33%; VIHD 4.82% after installing passive filter VTHD value 1.88 %; VIHD 0.00 %, while in the 7th order (f=350 Hz) the VTHD value is 6.33%; VIHD3.33 % after installing passive filter VTHD value 1.88%; VIHD 0.00%. The passive filter used is a single tuned passive filter. Change the PF (Power Factor) value before filtering is installed on the distribution bus = 82.9%, after the passive filter installed is 88.1%.</jats:p