Quality as a strategy to improve customer satisfaction : a six sigma approach.

Thesis (MBA)-University of Natal, Durban, 2003.In the face of increased competition compounded by globalisation, the challenge facing many South African companies is the need to develop a competitive advantage that will secure and grow its market share. This study explores the concept of customer satisfaction as the means to create that competitive advantage. Customers today are more demanding and are exposed to wider choices. The challenge facing management is to define strategies to "delight customers" - customers do not just want to be pleased they want to be delighted, they want to feel that the company exists to ensure that their expectations are not only met, but exceeded. This study further explores quality as a strategy to enhance customer satisfaction. The Six Sigma approach to quality management has been chosen as the focus. This study has been based on a medium sized South African Information Technology (IT) company, called Business Connexion. The IT industry is characterised by many challenges, the most significant being that it is currently in a slow growth phase after being in a boom in the late 1990s. The management of IT companies, today need to develop strategies to retain their customers and to attract new ones. The challenge facing Business Connexion, who is a relatively new entrant to the market, is to develop a competitive advantage that will put it ahead of its competitors who come in the form of large internationally listed companies. This study explores the option of Business Connexion defining its differentiator based on the capacity to offer its customers a superior quality service at a price lower than that of its competitors. The Six Sigma approach is suggested because it focuses on the elements such as: defining customer needs, creating processes to meet and exceed customer expectations, investigating methods to reduce costs and creating a quality-focused culture within the company. These elements are critical to achieving competitive advantage

Lead poisoning in shooting-range workers in Gauteng Province, South Africa: Two case studies

Background. Lead exposure constitutes a major public health concern globally. Relative to developed nations, lead exposure is understudied and poorly addressed in Africa, and there is a dearth of information available to inform lead poisoning prevention strategies, even in highrisk groups such as workers in shooting ranges who are potentially exposed to lead daily.Methods. Two workers at a private shooting range in Gauteng, South Africa (SA), had blood lead levels and exposure histories taken.Results. Workers had highly elevated blood lead levels and clinical symptoms associated with elevated blood lead levels.Conclusion. Workers in private SA shooting ranges are vulnerable to lead exposure and poisoning, and scaled-up action is required to protect them and their families, as well as shooting-range users, from lead and the related health risks

The prevalence of intentional and unintentional injuries in selected Johannesburg housing settlements

Intentional and unintentional injuries were reported to be the second leading cause of Disability Adjusted Life Years in South Africa in 2000. We present household experiences of such injuries in 5 impoverished housing settlements in Johannesburg, Gauteng Province. Data for this study were extracted from the database of the Health, Environment and Development (HEAD) project. The incidence of reported intentional injuries was determined to be double that of unintentional injuries. Households in the Hospital Hill and Riverlea settlements reported the highest prevalence of stabbing and gunshot incidents. We concluded that impoverished South African neighbourhoods bear a high burden of intentional injury; surveillance mechanisms are  required to inform prevention strategies at an individual, a community and a societal level.S Afr Med J 2011;101:835-838

A cross-sectional survey investigating women's information sources, behaviour, expectations, knowledge and level of satisfaction on advice received about diet and supplements before and during pregnancy

Background The reported long-term effects of poor maternal nutrition and uptake of recommended supplements before and during pregnancy was the impetus behind this study. Our objectives were to investigate and understand women’s expectations, knowledge, behaviour and information sources used regarding the use of nutrition and vitamin supplements before and during pregnancy. Methods A cross-sectional survey using a self-administered questionnaire was undertaken. A purposive sampling technique was used. Women attending the antenatal clinic at Croydon University Hospital during 2015 were invited to take part in the study. The data was analysed using descriptive statistics, paired sample T-tests and Chi-squared tests, with the level of significance set at 5% (p < 0.05). Results A total of 133 pregnant women completed the survey. Analysis of the results showed that women are currently using electronic resources (33%, n = 42) rather than healthcare professionals (19%, n = 25) as an information source before pregnancy. Women who sourced information through the internet were significantly more likely to take folic acid (p = 0.006) and vitamin D (p = 0.004) before pregnancy. Women preferred to receive information from the antenatal clinic (62%, n = 83), internet (46%, n = 61) and from mobile applications (27%, n = 36). Although women believed they had sufficient knowledge (60%, n = 80) and had received adequate advice (53%, n = 70) concerning the correct supplements to take, this was not demonstrated in their behaviour, with only a small number of women (37%, n = 49) taking a folic acid supplement before pregnancy. Women mistakenly perceived the timing of supplement advice as correct, with only a small number of women (18%, n = 23) considering the advice on supplements as too late. Conclusions Despite the small sample size, this study demonstrated that women did not receive timely and/or accurate advice to enable them to take the recommended supplements at the optimal time. Women had the misconception that they understood the correct use of pregnancy supplements. This misunderstanding may be prevented by providing women intending to become pregnant with a structured, approved electronic source of information that improves their supplements uptake

Assessments and improvement of filter media cleanliness in rapid gravity sand filters

Introduction: Rapid sand filtration is an essential unit process in the water purification process. It captures and removes coagulated and flocculated material and other suspended matter not removed during the preceding treatment processes. The pores in the filter bed gradually become clogged and the media progressively collects deposit through the continuous use and life of the filter. During normal operations cleaning is initiated by excessive head loss, deterioration in filtrate quality or when the predetermined time for a filter run has elapsed. Air scour, to remove deposit from filter media by vigorous agitation, and wash water, to remove this deposit from the filter bed, are applied. The combined action of air and water should quickly return the media to its original perfectly clean state for the cycle to continue. However, on inspection it is often found that filter sand on purification plants is unacceptably dirty and backwash systems are clearly incapable of cleaning the media to its initial state of cleanliness. It is at times possible to relate the dirty filter media to faulty designs or poor operating procedures, but often the reasons for the media deterioration remain elusive and the media becomes dirtier the longer it is in use. As there was an almost complete lack of published or agreed upon procedures to measure the cleanliness of filter media, rudimentary methods for measuring filter media cleanliness and backwash efficiency were developed. Thereafter filter media from full-scale treatment plants was analyzed with these methods at regular intervals to establish some benchmarks for these determinants. These methods were also applied during the laboratory and pilot plant phases of the project

The influence of contemporary and emerging factors on blood lead concentrations among young males in conflict with the law: a case study from a middle-income country

IntroductionScientific evidence shows that contemporary and emerging factors contribute to high blood lead concentrations in different populations. The study aimed to determine blood lead concentrations and risk factors associated with high blood lead concentrations among young males in conflict with the law.MethodsA cross-sectional analytical study was conducted among 192 conveniently selected participants from two youth secure (correctional) facilities in Gauteng Province, South Africa.ResultsThe study's overall blood lead concentration median was 3.30 μg/dl, ranging from 0.85 to 48.11 μg/dl. Young males born outside of South Africa (median = 8.78 μg/dl) and in villages (median = 4.95 μg/dl), working before coming to the facility (median = 5.23 μg/dl) and involvement in illegal mining (median = 9.00 μg/dl) had high blood lead concentrations in this study. Contemporary and emerging risk factors such as being born outside the country (AOR: 3.10, 95%CI: 1.01–1.88), involvement in illegal mining activities (AOR: 1.36, 95%CI: 1.14–1.91) and staying in a house with peeling paint on the outside (AOR: 2.26, 95%CI: 1.12–4.30) were found to influence blood lead concentration.DiscussionThe study findings show that contemporary (co-existing) and emerging factors influence blood lead concentrations. Therefore, there is a need to investigate these factors further in communities that may be affected. Lastly, there is a need for a holistic approach involving multiple sectors to introduce human lead concentration screening and preventive programmes

A Case of Emmonsiosis in an HIV-Infected Child

Opportunistic fungal infections can cause significant morbidity and mortality in immunocompromised patients. We describe a paediatric case of an unusual disseminated fungal infection. A three-year-old HIV-infected child with severe immunosuppression (CD4+ T-cell count 12 × 106/L) was admitted to hospital with pneumonia, gastroenteritis and herpes gingivostomatitis. Despite antibacterial and antiviral therapy, he experienced high fevers and developed an erythematous maculopapular rash and abdominal tenderness. The child’s condition progressively worsened during the admission. A thermally dimorphic fungus was cultured from bone marrow and identified as an Emmonsia species on DNA sequencing. The patient made a good recovery on amphotericin B deoxycholate and antiretroviral therapy. Itraconazole was continued for a minimum of 12 months, allowing for immune reconstitution to occur. This case is the first documented description of disseminated disease caused by a novel Emmonsia species in an HIV-infected child in South Africa

La educación inclusiva frente a las desigualdades sociales: un estado de la cuestion y algunas reflexiones geograficas

Este artículo establece un estado de la cuestión e la educación inclusiva en el mundo y sugiere algunas reflexiones al respecto. El primer apartado recuerda las conexiones ineludibles entre las preocupaciones educativas por la educación inclusiva y las preocupaciones más generales por la desigualdad. El segundo consigna los criterios de búsqueda de las publicaciones académicas, y observa dos grandes temas en sus contenidos: sobre todo, el cambio interno de las escuelas atrae las miradas, pero en segundo plano también el entorno territorial despierta algunas inquietudes. El tercero anota los criterios de búsqueda de la documentación del Banco Mundial, la OCDE y la UNESCO. En este ámbito los simposios de la Oficina Internacional de la Educación de UNESCO revelan una interpretación dispar, aunque convergente, del concepto de educación inclusiva en las distintas regiones mundiales. Asimismo, todas las publicaciones oficiales muestran una atención prioritaria a las dinámicas internas de las escuelas, puesto que apenas algunas esbozan ciertas relaciones entre la educación inclusiva y las políticas públicas. El último apartado adelanta varios argumentos a favor de una mayor consideración de las escalas local y estatal de la educación inclusiva. Las principales razones para atender a la dimensión local provienen de la causalidad acumulativa de las privaciones sociales, de la necesidad de articular la acción de las escuelas y de la posibilidad de abrir un espacio significativo para la participación ciudadana. Asimismo, las principales razones para atender a la dimensión estatal surgen de las posibles sinergias entre la educación inclusiva y la expansión educativa (p. ej. ¿es correlativo el avance de la escolarización en los distintos ciclos escolares?) como también entre la educación inclusiva y la protección social (p. ej. ¿tienen una implicación pedagógica consistente las abundantes condiciones educativas de las transferencias sociales?

Genetic variation of the HIV-1 subtype C transmitted/founder viruses long terminal repeat elements and the impact on transcription activation potential and clinical disease outcomes

A genetic bottleneck is a hallmark of HIV-1 transmission such that only very few viral strains, termed transmitted/founder (T/F) variants establish infection in a newly infected host. Phenotypic characteristics of these variants may determine the subsequent course of disease. The HIV-15' long terminal repeat (LTR) promoter drives viral gene transcription and is genetically identical to the 3' LTR. We hypothesized that HIV-1 subtype C (HIV-1C) T/F virus LTR genetic variation is a determinant of transcriptional activation potential and clinical disease outcome. The 3'LTR was amplified from plasma samples of 41 study participants acutely infected with HIV-1C (Fiebig stages I and V/VI). Paired longitudinal samples were also available at one year post-infection for 31 of the 41 participants. 3' LTR amplicons were cloned into a pGL3-basic luciferase expression vector, and transfected alone or together with Transactivator of transcription (tat) into Jurkat cells in the absence or presence of cell activators (TNF-α, PMA, Prostratin and SAHA). Inter-patient T/F LTR sequence diversity was 5.7% (Renge: 2-12) with subsequent intrahost viral evolution observed in 48.4% of the participants analyzed at 12 months post-infection. T/F LTR variants exhibited differential basal transcriptional activity, with significantly higher Tat-mediated transcriptional activity compared to basal (p<0.001). Basal and Tat-mediated T/F LTR transcriptional activity showed significant positive correlation with contemporaneous viral loads and negative correlation with CD4 T cell counts (p<0.05) during acute infection respectively. Furthermore, Tat-mediated T/F LTR transcriptional activity significanly correlated positively with viral load set point and viral load; and negatively with CD4 T cell counts at one year post infection (all p<0.05). Lastly, PMA, Prostratin, TNF-α and SAHA cell stimulation resulted in enhanced yet heterologous transcriptional activation of different T/F LTR variants. Our data suggest that T/F LTR variants may influence viral transcriptional activity, disease outcomes and sensitivity to cell activation, with potential implications for therapeutic interventions

Stereoselective synthesis towards unnatural proline-based amino acids

A catalytic diastereoselective Mannich reaction promoted by chiral bifunctional urea-type organocatalysts has been developed. Treatment of N-Boc-3-ketoproline with N-Boc-aldimines under mild conditions afforded the corresponding unnatural proline based amino acid derivatives with excellent diastereoselectivities (up to 99:1) and enantioselectivities (up to 97% ee). The relative configuration of the chiral reaction products was deduced by the comparsion of the experimentally observed ECD spectra to that obtained theorectically