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Health services continue to face economic and capacity challenges. Quality improvement (QI) methods that can improve clinical care processes are therefore needed. However, the successful use of current QI methods within hospital settings remains a challenge. There is considerable scope for improvement of elective clinical pathways, such as hip and knee replacement, and so the use and study of QI methods in such settings is warranted.

A model to manage variability was adapted for use as a QI method and deployed to improve a hip and knee replacement surgical pathway. A prospective observational study, with a mixed-methods sequential explanatory design (quantitative emphasised) that consisted of two distinct phases, was used to assess its effectiveness.

Following the use of the novel QI method and the subsequent changes to care processes, the length of hospital stay was reduced by 18%. However, the interventions to improve care process highlighted by the QI method were not fully implemented. The qualitative data revealed that staff thought the new QI method (the model to manage variability) was simple, effective, offered advantages over other QI methods and had highlighted the correct changes to make. However, they felt that contextual factors around leadership, staffing and organisational issues had prevented changes being implemented and a greater improvement being made.

The quality of QI reporting in surgery has previously been highlighted as poor and lacking in prospective and comprehensively reported mixed-methods evaluations. This study therefore not only describes and presents the results of using a novel QI method but also provides new insights in regard to important contextual factors that may influence the success of QI methods and efforts.

The purpose of this paper is to elaborate the picture of situational relevance by examining how modes of music information are viewed as situationally relevant at different stages of information-seeking processes among music students.

Empirical data of the present longitudinal study were collected in two phases by utilizing questionnaire and interview methods. Informants comprised of 14 university-level music students representing the fields of music performance, music education and music theory and composition. Modes of music information were approached through the information typology presented by Rousi, Savolainen and Vakkari.

The findings indicate that not only the modes of music information were seen as situationally relevant for different reasons by the three participating music student groups when at the beginning of their tasks, but also that the perceived situational relevance of the information modes underwent changes as their tasks progressed to focus formulation and post-focus stages.

Due to the small number of participants, further research is needed to verify the results concerning the differences in information-seeking processes between diverse music student groups.

The paper showcases that approaching music information through frameworks that classify information sources at diverse levels of abstraction enables an accurate description of information-seeking processes and illuminates context-sensitive development of situational relevance of music information of diverse modes.

The purpose of this paper is to examine the hotel growth model including hotel brand, culture and life cycle phases of the Myrtle Beach, South Carolina, the fastest growing tourism destination in the United States.

Culture reflecting consuming behaviour of low-context innovators and high-context imitators is measured by the price elasticity of demand (PED). Hotel brand reflecting guests’ hotel class is measured by the income elasticity of demand. Autoregressive distributed lag has been conducted on the Smith Travel Research data in 33 years (1989–2022) to determine the relationship among hotel brand, culture and life cycles.

Skilled labour is the key to make hotels grow. Therefore, increase room rates when hotels possess skilled professionals and decrease room rates when hotels have no skilled professionals. During the rejuvenation in Myrtle Beach (1999–2003), hoteliers increased room rates for innovators due to skilled professionals to increase revenue. Otherwise, a decrease in room rates due to lack of skilled professionals would lead to increase revenue.

(1) Although Myrtle Beach is one of the fastest growing tourism destinations in the US, it has a relatively small geographic area relative to the country. (2) Data cover over one tourist life cycle, so the time span is relatively short. Hoteliers can forecast the number of guests in different culture by changing room rates.

To optimize revenue, hoteliers can select skilled labour in professional design hotel brands which could make an increase in demand for leisure transient guests no matter what room rates increase after COVID-19 pandemic.

The study has considered the applied ethical processes regarding revenue management that would maximize both revenue and customer satisfaction when it set up an increase in room rates to compensate for professional hotel room design or it decreases room rates for low-income imitators in exploration and development.

This research highlights that (1) skilled design in the luxury hotel brand is the key for the hotel growth and (2) there is a steady state of the growth model in the destination life cycle.

The purpose of this study is to look at the challenges and successes that the case institution has had in implementing and maintaining quality assurance (QA) processes. The study also looks into the role of QA techniques in improving an institution's performance in a developing country.

The research is qualitative. Nine significant persons were interviewed, including the institution's top administration, faculty members and related staff. Data were gathered to learn more about the background, incremental changes and numerous internal and external elements that influenced how QA was approached over time.

The findings revealed the challenges and experiences of the evolution of QA practices in the case institution. The results show the changes in QA practices regarding three aspects, including people, place and program of case institutions under three phases. During phases I and II, the adoption and upgradation of QA practices were very slow; phase III showed significant improvement in all three aspects. In addition, the positive impact of QA practices is evident in improving the performance of students and teaching and nonteaching staff of the case institution.

The findings of this research could aid open and distance learning (ODL) providers in other developing nations in understanding the challenges of such a system. It may also make it easier for other ODL providers to comprehend the QA-led success in stakeholder confidence, employability and reputation.

The research will give insights into how QA procedures are used and valued in ODL in developing nations.

Fabrics with photothermal conversion functions were developed based on the introduction of shape stable composite phase change materials (CPCMs).

Acidified single-walled carbon nanotubes (SWCNTs) were selected as support material to prepare CPCMs with n-octadecane to improve the thermal conductivity and shape stability. The CPCMs were finished onto the surface of cotton fabric through the coating and screen-printing method. The chemical properties of CPCMs were characterized by Fourier transform infrared spectrometer, XRD and differential scanning calorimetry (DSC). The shape stability and thermal conductivity were also evaluated. In addition, the photothermal conversion and temperature-regulating performance of the finished fabrics were analyzed.

When the addition amount of acidified SWCNTs are 14% to the mass of n-octadecane, the best shape stability of CPCMs is obtained. DSC analysis shows that the latent heat energy storage of CPCMs is as high as 183.1 J/g. The thermal conductivity is increased by 84.4% compared with that of n-octadecane. The temperature-regulating fabrics coated with CPCMs have good photothermal conversion properties.

CPCMs with high latent heat properties are applied to the fabric surface through screen printing technology, which not only gives the fabric the photothermal conversion performance but also reflects the design of personalized patterns.

CPCMs and polydimethylsiloxane (PDMS) are mixed to make printing paste and printed cotton fabric with temperature-regulating functional is developed.

SWCNTs and n-octadecane are composited to prepare CPCMs with excellent thermal properties, which can be mixed with PDMS to make printing paste without adding other pastes. The fabric is screen-printed to obtain a personalized pattern and can be given a thermoregulatory function.

The purpose of this study is to identify the perception of workers before, during and after the implementation of changes derived from the lean manufacturing (LM) technique called value stream mapping (VSM) analysis and the causes that lead to this perception.

A qualitative methodological research design was adopted, using individual transcribed and coded interviews as the primary method of data collection.

At the beginning of the VSM changes, this study found strong denial and resistance emotional responses from workers due to the uncertainty and stress generated. The main cause of this resistance was their lack of understanding of the VSM analysis process presenting technical concepts, due to their educational level and the lack of a pre-existing organisational culture oriented toward continuous improvement. However, in the last stage of change, it is found that the workers accepted the new improvement proposals without resignation, improving their productivity and work performance because they saw and understood the improvements as effective.

This study will enable those responsible for organisations to anticipate the negative reactions that may arise from the organisational changes stemming from the implementation of VSM improvements. In addition, it adds new knowledge bases to the literature on the emotional consequences for employees during LM changes through VSM.

This study provides a qualitative analysis of the perceived emotional impact on workers that participated in LM techniques, in this case, focused on VSM analysis. It is an exploratory study that serves as a foundation for future research in the quantitative field.

This paper aims to present insights on the governance of sustainability transitions in higher education in Africa. The authors interrogate the research literatures on the governance of socio-technical transitions in water, electricity, transport and waste management, and identify barriers and enabling factors that enhance transformative practices in universities.

The analytical framework proposed in this paper combines the elements of governance network theory (GNT) and transition topology. The framework of this study is grounded in an actor-centric approach using GNT to understand networks conducive to sustainability transitions. Events and governance networks were mapped on a transition topology to visualise organisational and institutional changes over time. The study engaged students, management, academic and administrative staff in building a community of practice towards sustainability. This research is based on qualitative content analysis grounded in interview data, focus group discussions, workshops, webinars and secondary data analysis.

The findings show that the university has consolidated a sustainability vision and targets, but several factors prevent the community from achieving these targets, including hierarchical decision-making processes, a multitude of disjointed committees and fragmentation in the campus community.

This research adds to an emerging body of literature in the field of sustainability in higher education with two contributions. Firstly, the study presents a novel perspective(s) on the governance of sustainability transitions by combining the literatures on governance and sustainability transitions using a new methodological approach of transition topology to show organisational and institutional changes. Secondly, the study presents new empirical evidence for improving the governance of sustainability transitions in a diverse and highly unequal African university community in the process of (de)colonisation of knowledge and governance.

Automated driving systems (ADSs) are being developed to avoid human error and improve driving safety. However, limited focus has been given to the fallback behavior of automated vehicles, which act as a fail-safe mechanism to deal with safety issues resulting from sensor failure. Therefore, this study aims to establish a fallback control approach aimed at driving an automated vehicle to a safe parking lane under perceptive sensor malfunction.

Owing to an undetected area resulting from a front sensor malfunction, the proposed ADS first creates virtual vehicles to replace existing vehicles in the undetected area. Afterward, the virtual vehicles are assumed to perform the most hazardous driving behavior toward the host vehicle; an adaptive model predictive control algorithm is then presented to optimize the control task during the fallback procedure, avoiding potential collisions with surrounding vehicles. This fallback approach was tested in typical cases related to car-following and lane changes.

It is confirmed that the host vehicle avoid collision with the surrounding vehicles during the fallback procedure, revealing that the proposed method is effective for the test scenarios.

This study presents a model for the path-planning problem regarding an automated vehicle under perceptive sensor failure, and it proposes an original path-planning approach based on virtual vehicle scheme to improve the safety of an automated vehicle during a fallback procedure. This proposal gives a different view on the fallback safety problem from the normal strategy, in which the mode is switched to manual if a driver is available or the vehicle is instantly stopped.