Comprehensive Quality Measurement Research Articles

Source apportionment of fine secondary inorganic aerosol over the Pearl River Delta region using a hybrid method

As one of the largest agglomerations of cities in the world, the infrastructure and living conditions of the residents in the Pearl River Delta (PRD) have significantly improved since the late 1970s. However, as a two-sided sword, the boosting of economic growth has inevitably exerted adverse effects on the environment in this region. To further understand the current fine particulate matter (PM2.5) pollution sources in this region and formulate an effective future air pollution control strategy for it, a hybrid source apportionment method was applied to adjust source estimates of secondary inorganic aerosols (SIAs) [particulate sulfate (SO42−), nitrate (NO3−), and ammonium (NH4+)] by combining Comprehensive Air Quality Model Extensions and measurement data from 19 sampling sites covering the PRD region in 2015. After correction by the hybrid method, the normalized mean errors for the three major species SO42−, NO3−, and NH4+ in PM2.5 simulated by the model decreased from 0.412, 1.261, and 0.401 to 0.321, 0.565, and 0.130, respectively. Tianhu, Taishan, Taipa Grande, whose secondary inorganic aerosol concentration variations are −48.33%, −40.59%, and 39.10% after adjustment, respectively, are the three top sites with the most substantial modification. Our study revealed that the emissions outside the PRD region are still the most important contributor to the three components after the correction. In most Hong Kong sites, the adjusted mobile source is subordinate to the cross-boundary transport and became the largest endogenous source.In contrast to that in Hong Kong, preceded only by super-regional sources, the outstanding contributor to SIAs in Guangdong and Macao is the area source. Our results indicated that besides collaborative control measures, the Hong Kong and Guangdong government should emphasize the emissions from motor vehicles and residential sources, respectively. Overall, this hybrid source apportionment approach can narrow down the discrepancy between simulation results and observational data. Thus, it is a potentially reliable method to provide a more solid theoretical foundation for formulating air pollution control measures.

Measuring communication quality in the Neonatal Intensive Care Unit.

High quality communication between providers and parents of seriously ill neonatal patients is vital and yet poorly understood. Feudtner summarized five challenges and seven priorities to the study and advancement of pediatric palliative care. Improvement of communication is a priority, while lack of specification and measurement of outcomes relevant to the pediatric population remains a challenge. Specifically, measurement of communication quality in pediatrics, and especially neonatology, is problematic. We conducted a focused review of this topic which we hope will serve to support further research. We reviewed the current literature in Pubmed and searched the Palliative Care Research Cooperative (PCRC) instrument library. We found five validated instruments which met our criteria, relied on patient or surrogate report, and were developed to measure quality of communication and/or satisfaction with communication with adult patients or their surrogates. Our Pubmed search yielded 249 unique results, only two of which met our inclusion criteria. We conclude that development and exhaustive testing of a validated, comprehensive measure of communication quality for the neonatal population is needed. Without such a measure, it will be difficult to advance the field and achieve high quality prognostic communication for the parents of seriously ill babies. Measurement of communication quality in pediatrics, and especially neonatology, is problematic, understudied, and yet critical to the advancement of the field. There has not been an overview of existing measures of communication quality in the NICU published, nor has there been a comprehensive discussion of this important topic. Our paper provides such an overview and initiates such a discussion. We present a narrative review of existing measures of communication quality in the NICU in order to highlight the need for further study.

Towards achieving environmental sustainability: environmental quality versus economic growth in a developing economy on ecological footprint via dynamic simulations of ARDL.

Studies have shown that factors like trade, urbanization, and economic growth may increase the ecological footprint (EFP) since ecological distortions are mainly human-induced. Therefore, this study explores the effect of economic growth and urbanization on the EFP, accounting for foreign direct investment and trade in Nigeria, using data from 1977 to 2016. This study used the EFP variable as against the CO2 emissions used in the previous studies since the former is a more comprehensive and extensive measure of environmental quality. We apply the novel dynamic autoregressive distributed lag (ARDL) simulations for model estimation, the Bayer and Hanck J Time Ser Anal 34: 83-95, (2013) combined cointegration, and the ARDL bounds test for cointegration. Although the results affirmed the presence of long-run relationship among the variables, economic growth deteriorates the environment in the short run, while urbanization exacts no harmful impact. In the long run, FDI and trade deteriorate the environment while economic growth adds to environmental quality. It is recommended that policymakers strengthen the existing environmental regulations to curtail harmful trade and provide rural infrastructures to abate urban anomaly.

Relative validity and reliability of a diet risk score (DRS) for clinical practice

IntroductionAdherence to cardioprotective dietary patterns can reduce risk for developing cardiometabolic disease. Rates of diet assessment and counselling by physicians are low. Use of a diet screener that rapidly identifies...

The influence of renewable energy use, human capital, and trade on environmental quality in South Africa: multiple structural breaks cointegration approach.

Recent economic and environmental literature suggests that the current state of energy use in South Africa amidst rapid growing population is unsustainable. Researchers in this area mostly focus on the effect of fossil energy use on carbon (CO2) emission, which represents only an aspect of environmental quality. In contrast, the current study evaluates the influence of renewable energy use, human capital, and trade on ecological footprint--a more comprehensive measure of environmental quality. To this end, the study employs multiple structural breaks cointegration tests (Maki cointegration tests), dynamic unrestricted error correction model through Autoregressive Distributed Lag (ARDL) model, and VECM Granger causality tests. The results of the Maki cointegration tests reveal the existence of a cointegration between the variables in all the models with evidence of multiple structural breaks. Further, the ARDL results divulge that an increase in renewable energy use, human capital, and trade improves environmental quality through a decrease in ecological footprint, while an increase in income stimulates ecological footprint. Moreover, causal relationship is found, running from all the variables to renewable energy and trade flow in the long run, while in the short run, economic growth causes ecological footprint. Trade is found to Granger-cause human capital, while human capital causes renewable energy. Additionally, human capital, renewable energy, and economic growth are predictors of trade. The study therefore recommends South African policymakers to consider the importance of renewable energy, human capital development, and trade as a policy option to reduce ecological footprint and improve environmental quality.

The Type 1 Diabetes Composite Score: An Innovative Metric for Measuring Patient Care Outcomes Beyond Hemoglobin A1c.

Introduction:Patient outcomes resulting from optimal type 1 diabetes (T1D) care have historically focused on driving a single metric, hemoglobin A1c. Our objectives were to design, build, and launch an aggregate clinical indicator that comprehensively reflects patient management status beyond hemoglobin A1c alone. This project aimed to show proof-of-principle that an aggregate score comprised of T1D outcome metrics could be built to track quality performance.Methods:We established an electronic medical record-based diabetes registry and utilized its population health modules to design and build this diabetes care metric. Elements representing optimal diabetes management, as defined by current guidelines and expert opinion, were identified. Nine elements fall into categories of management tools, care assessments, and complications risk. The Type 1 Diabetes Composite Score (T1DCS) aggregates these outcome measures to reflect the overall diabetes care status for each patient. Higher scores suggest better management and overall improved patient health.Results:We launched this metric build in November 2018 and applied the scoring to our T1D population (≈1,900 patients). The T1DCS quickly provides a summary of current diabetes management status. T1DCS viewed over the registry cohort demonstrates a normal distribution, and scores improved from March to September 2019, reflecting better care and outcomes, and illustrating the potential to track program effectiveness.Conclusions:The T1DCS is a useful metric to evaluate the clinical status of T1D patients, assess the capability of a clinical program to achieve optimal diabetes outcomes, identify patient diversity opportunities, and document outcome improvement as a novel comprehensive quality measure.

The effects of probation stipulations on employment quality among people on probation

There is minimal evidence to suggest that mandating people on probation to adhere to various stipulations reduces their likelihood to recidivate. There is evidence to suggest that having a job decreases the likelihood of recidivism. The effect probation stipulations have on a person on probation’s employment quality is unknown. This study (n = 96) explores correlations between probation stipulations and employment quality among people on probation in Rhode Island. This is a quantitative cross-sectional study, with people on probation completing surveys offered in probation offices in the Providence, RI area. The survey measures how many stipulations participants were mandated to attend, the details of their employment, and a variety of control variables (such as substance use and mental health disruption). Data were analyzed using SPSS v. 23. Pearson’s correlations were done to identify significant correlations. Linear regressions were then conducted to further assess the relationship between stipulations per month and overall job quality. Results suggest that probation stipulations were negatively correlated with overall job quality. Relationships, though significant, were not substantive, as effect sizes were minimal to moderate. Further research, with a larger sample size, a more comprehensive measurement of job quality, and conducted longitudinally may better explain correlations uncovered.

Effects of Long-Term Successive Rotations, Clear-Cutting and Stand Age of Prince Rupprecht’s larch (Larix principis-rupprechtii Mayr) on Soil Quality

A decline in soil quality is a major factor contributing to the degradation of forest ecological function. Vegetation plays a vital role in maintaining soil quality; however, the influence of plantation length on soil quality remains unclear. In this study, we collected soil samples in Northern China using a space-for-time substitution method. Soil were collected from control grassland; a clear-cutting site; 16-year-old (young, first, and second generation), 28-year-old (immature, first, and second generation), and 44-year-old (mature, first generation) Larix principis-rupprechtii Mayr stands in May, July, and September 2016. We measured soil physical and chemical properties, microbial communities, and enzymatic activities. We selected soil bulk density, non-capillary porosity, volume humidity, soil organic carbon and activity of polyphenol oxidase to calculate a soil quality index (SQI) for each site. Our data indicated that clear-cutting greatly decreased soil quality of Larix principis-rupprechtii forests but returning the harvesting residues to the forest floor could reduce the negative impact of clear-cutting on soil quality. The soil quality improved significantly by prolonging the cultivation cycle and it took about 39 years for the first-generation forest to restore soil quality to the level of the control plot. Our study confirms that SQI provides a comprehensive measurement of soil quality with the identification of a minimum data set. Comparing SQI with other soil quality indicators would help us to optimize the method for assessing soil quality.

Higher education service quality, student satisfaction and loyalty

Purpose The purpose of this study is to validate the higher education service quality (HESQUAL) scale using a confirmatory approach and test an improved structural model that predicts student loyalty from image, perceived value, satisfaction and service quality. In addition to validating the HESQUAL scale using a confirmatory approach, two other main limitations in the extant literature are addressed. Design/methodology/approach The model is tested using data collected from 501 students enrolled in different higher education institutions in Mauritius. A two-stage approach to structural equation modeling is used whereby the measurement model is first tested using confirmatory factor analysis and followed by the assessment of the structural model. Findings Importantly, results indicate that student satisfaction is influenced by technical service quality, image and perceived value, but not by functional service quality. Both dimensions of service quality however are significant predictors of image and perceived value. The study uses a comprehensive measure of service quality and demonstrates that it is worthwhile to consider functional service quality as higher-order model and clearly distinguish between functional and technical quality, as both the technical and functional aspects play an important role in shaping students’ perceptions and behaviors. Originality/value First, in the existing literature, service quality has not been considered as a second-order factor model in structural models of student satisfaction and loyalty, thus lacking either precision or parsimony. Second, the transformative quality aspect of higher education has been largely neglected in previous research testing such predictive models. The model delineates service quality into the functional and transformative (technical) aspects and treats functional service quality as a second-order factor comprising nine sub-dimensions.

Evaluation of Regional Air Quality Models over Sydney and Australia: Part 1—Meteorological Model Comparison

The ability of meteorological models to accurately characterise regional meteorology plays a crucial role in the performance of photochemical simulations of air pollution. As part of the research funded by the Australian government’s Department of the Environment Clean Air and Urban Landscape hub, this study set out to complete an intercomparison of air quality models over the Sydney region. This intercomparison would test existing modelling capabilities, identify any problems and provide the necessary validation of models in the region. The first component of the intercomparison study was to assess the ability of the models to reproduce meteorological observations, since it is a significant driver of air quality. To evaluate the meteorological component of these air quality modelling systems, seven different simulations based on varying configurations of inputs, integrations and physical parameterizations of two meteorological models (the Weather Research and Forecasting (WRF) and Conformal Cubic Atmospheric Model (CCAM)) were examined. The modelling was conducted for three periods coinciding with comprehensive air quality measurement campaigns (the Sydney Particle Studies (SPS) 1 and 2 and the Measurement of Urban, Marine and Biogenic Air (MUMBA)). The analysis focuses on meteorological variables (temperature, mixing ratio of water, wind (via wind speed and zonal wind components), precipitation and planetary boundary layer height), that are relevant to air quality. The surface meteorology simulations were evaluated against observations from seven Bureau of Meteorology (BoM) Automatic Weather Stations through composite diurnal plots, Taylor plots and paired mean bias plots. Simulated vertical profiles of temperature, mixing ratio of water and wind (via wind speed and zonal wind components) were assessed through comparison with radiosonde data from the Sydney Airport BoM site. The statistical comparisons with observations identified systematic overestimations of wind speeds that were more pronounced overnight. The temperature was well simulated, with biases generally between ±2 °C and the largest biases seen overnight (up to 4 °C). The models tend to have a drier lower atmosphere than observed, implying that better representations of soil moisture and surface moisture fluxes would improve the subsequent air quality simulations. On average the models captured local-scale meteorological features, like the sea breeze, which is a critical feature driving ozone formation in the Sydney Basin. The overall performance and model biases were generally within the recommended benchmark values (e.g., ±1 °C mean bias in temperature, ±1 g/kg mean bias of water vapour mixing ratio and ±1.5 m s−1 mean bias of wind speed) except at either end of the scale, where the bias tends to be larger. The model biases reported here are similar to those seen in other model intercomparisons.

Effects of groundwater metal contaminant spatial distribution on overlaying kriged maps.

Groundwater is a major source of drinking water for many Canadians, and contamination by heavy metals poses a significant risk to people and the environment. In this study, three water quality indices are studied in the vicinity of an unlined landfill in a semiarid climate. The study investigates indices using geostatistical analysis and ordinary kriging. This study employs a novel coupling technique in order to compare the index-based maps to a groundwater quality map from overlapping heavy metal kriged maps. A total of 11 heavy metals were evaluated in preliminary analysis, but only four (Mn, As, Fe, and U) had higher concentrations than allowable limits in some or all of the monitoring wells at the site. Results from mean-based classification of indices suggest the aquifer in proximity to the landfill has been impacted by metal contaminants. Kriged maps show that the spatial variations of Mn and U are similar, while results of Fe and As are also similar. However, the two sets of maps have distinctly different patterns. Maps for indices show an elevated plateau extending from the unlined landfill to the southeast corner, implying that the landfill may have negatively impacted groundwater quality. A groundwater quality map is developed by overlaying the heavy metal maps. The resulting map shows that the north and west parts of the study have lower groundwater pollution with respect to metal contaminants. The groundwater quality map may be more applicable for practitioners who need comprehensive water quality measurement.

Racial Disparities in Readmission Rates among Patients Discharged to Skilled Nursing Facilities.

Prior studies have reported mixed findings about the existence of racial disparities in readmission rates among Medicare Advantage beneficiaries, but these studies used data from one state, focused on black-white disparities, and did not focus on patients discharged to skilled nursing facilities (SNFs). The objective of the study was to characterize racial and ethnic disparities in rates of 30-day rehospitalization directly from SNFs among fee-for-service and Medicare Advantage patients. A cross-sectional study of admissions to SNFs in 2015 was conducted. SNFs across the United States. The sample included 1 500 334 white, 213 848 African American, and 99 781 Hispanic Medicare patients who were admitted to 13 375 SNFs. The main outcome of interest was readmission, identified as patients sent back to any hospital directly from the SNF within 30 days of admission, as indicated on the Minimum Data Set discharge assessment. Overall readmission rates for fee-for-service patients were 16.7% (95% confidence interval [CI] = 16.7%-16.8%) for whites, 18.8% (95% CI = 18.7%-19.0%) for African Americans, and 17.4% (95% CI = 17.1%-17.7%) for Hispanics. Readmission rates in Medicare Advantage were 14.7% (95% CI = 14.5%-14.8%) for whites, 16.8% (95% CI = 16.6%-17.1%) for African Americans, and 15.3% (95% CI = 14.9%-15.6%) for Hispanics. We also found that African Americans had about 1% higher readmission rates than whites, even when they received care within the same SNF. No statistically significant differences were found in the magnitude of within-SNF racial disparities in Medicare Advantage compared with Medicare fee-for-service. We found racial disparities in readmission rates even within the same facility for both Medicare Advantage and fee-for-service beneficiaries. Intervention to reduce disparities in readmission rates, as well as more comprehensive quality measures that incorporate outcomes for Medicare Advantage enrollees, are needed. J Am Geriatr Soc 67:1672-1679, 2019.

Assessment the Quality of Delivered Care for People with Atherosclerosis by Comprehensive Quality Measurement in Healthcare (CQMH) Model in Imam Reza Hospital Affiliated To Mashhad University of Medical Sciences In 2017

Assessment the Quality of Delivered Care for People with Atherosclerosis by Comprehensive Quality Measurement in Healthcare (CQMH) Model in Imam Reza Hospital Affiliated To Mashhad University of Medical Sciences In 2017

Assessment the Quality of Delivered Care for People with Atherosclerosis by Comprehensive Quality Measurement in Healthcare (CQMH) Model in Imam Reza Hospital Affiliated To Mashhad University of Medical Sciences In 2017

Assessment the Quality of Delivered Care for People with Atherosclerosis by Comprehensive Quality Measurement in Healthcare (CQMH) Model in Imam Reza Hospital Affiliated To Mashhad University of Medical Sciences In 2017

Adult Education, the Use of Information and Communication Technologies and Their Impact on Elderly’s Quality of Life: A Case Study

In recent years, there has been a growing interest among scholars on Information and Communication Technologies (ICTs) and their beneficial effects on elderly wellbeing; almost all contributions support the positive impact of ICTs among older population because their use has been demonstrated to enhance social participation and psychosocial wellbeing. This paper contributes to the extant literature by using a specific and comprehensive measure of quality of life, the WHOQol-Bref, on a sample of 341 individuals attending the University of Third Age in an Italian town. Through different model specifications, we are able to demonstrate the positive impact of ICTs’ use on elderly quality of life. Results corroborate the findings of existing literature and provide insight on possible policy measures framed in an active aging approach.

Constructing Item Banks for Measuring Quality of Life in Refractive Error

Existing patient-reported outcome instruments in refractive error are paper-based questionnaires. They are not comprehensive and psychometrically robust. This study has identified the content of the refractive error-specific item banks that aim to provide comprehensive and scientific measurement of refractive error-specific quality of life. The purpose of this study was to identify minimally representative, optimally informative, and efficient sets of items for measuring quality of life in people with refractive error. First, items were identified from existing patient-reported outcome instruments. Second, items were developed from qualitative studies with people with refractive error (48 and 101 in-depth interviews in Australia and Nepal, respectively). Third, classification and selection of items were done based on a set of systematic criteria using an iterative process of binning and winnowing. The resulting items underwent cognitive testing with people with refractive error in Australia and in Nepal. Each step was guided by an expert panel consensus. We retrieved 792 items from the existing patient-reported outcome instruments. From the interviews conducted in Australia, a total of 2367 comments were coded into 807 initial items. Similarly, from the interviews conducted in Nepal, 3477 comments were coded into 914 initial items. After binning and winnowing, followed by cognitive testing, a final set of items comprising 337 items for the Item-pool (Australia) and 308 items for the Item-pool (Nepal), both spanning 12 domains, was obtained. Forty-seven percent of items were common across the two item pools. In the Item-pool (Nepal), 65% items were common for corrected and uncorrected refractive error. We identified the content of two different sets of item banks to comprehensively measure the impact of refractive error on quality of life for people in Australia and Nepal, which may be applicable to high-income country settings and low- and middle-income country settings, respectively. Future work aims to develop computer-adaptive testing system to administer the item banks, resulting in useful measurement tools for researchers, clinicians, and policy planners.

Video quality assessment based on motion structure partition similarity of spatiotemporal slice images

Video quality assessment (VQA) is becoming increasingly important as a comprehensive measure of video quality. This paper proposes a full-reference VQA (FR-VQA) algorithm based on the motion structure partition similarity of spatiotemporal slice (STS) images. To achieve this objective, a number of FR-image quality assessment algorithms were applied slice by slice to video STS images to compare their performance of detecting structure similarity of STS images. The algorithm that performed the best was selected to detect the similarity between motion-partitioning STS images. Next, as motion objects in the video sequence were found to have different influences on the prediction performance in terms of moving speed and track, the STS images were divided into simple and complex motion regions, and their contributions to the VQA task determined. Consequently, a promising effective and efficient VQA model, called STS-MSPS, is also proposed. Experimental evaluations conducted based on various annotated VQA databases indicate that the proposed STS-MSPS achieves state-of-the-art prediction performances in terms of correlations with subjective evaluation and statistical significance tests. This paper also shows that STS images by themselves provide sufficient information for VQA tasks and that the proposed complex motion region of an STS image is predominantly responsible for yielding a high-precision model.

Impact of acquisition and interpretation on total inter-observer variability in echocardiography: results from the quality assurance program of the STAAB cohort study.

Variability related to image acquisition and interpretation is an important issue of echocardiography in clinical trials. Nevertheless, there is no broadly accepted standard method for quality assessment of echocardiography in clinical research reports. We present analyses based on the echocardiography quality-assurance program of the ongoing STAAB cohort study (characteristics and course of heart failure stages A-B and determinants of progression). In 43 healthy individuals (mean age 50 ± 14years; 18 females), duplicate echocardiography scans were acquired and mutually interpreted by one of three trained sonographers and an EACVI certified physician, respectively. Acquisition (AcV), interpretation (InV), and inter-observer variability (IOV; i.e., variability between the acquisition-interpretation sequences of two different observers), were determined for selected M-mode, B-mode, and Doppler parameters. We calculated Bland-Altman upper 95% limits of absolute differences, implying that 95% of measurement differences were smaller/equal to the given value: e.g. LV end-diastolic volume (mL): 25.0, 25.0, 27.9; septal e' velocity (cm/s): 3.03, 1.25, 3.58. Further, 90, 85, and 80% upper limits of absolute differences were determined for the respective parameters. Both, acquisition and interpretation, independently and sizably contributed to IOV. As such, separate assessment of AcV and InV is likely to aid in echocardiography training and quality-assurance. Our results further suggest to routinely determine IOV in clinical trials as a comprehensive measure of imaging quality. The derived 95, 90, 85, and 80% upper limits of absolute differences are suggested as reproducibility targets of future studies, thus contributing to the international efforts of standardization in quality-assurance.

Service quality from the perspective of myocardial infarction patients.

Service quality (SQ) generally refers to the nonclinical aspects of health services and primarily focuses on the relationship between the care provider and the customers, and the environment in which care services are delivered. The aim of this study was to assess the SQ provided for myocardial infarction (MI) from the patients' perspective. A cross-sectional study was conducted with 164 patients with MI at the Tabriz Shahid Madani cardiology clinic. Study participants were selected using convenience sampling. SQ was measured using a validated Comprehensive Quality Measurement in Healthcare SQ questionnaire. The reliability was confirmed based on Cronbach's alpha coefficient (α=0.81). SQ was calculated using the formula SQ=10- (importance × performance), based on the importance and performance of non-health-related aspects from the customers' perspective. Importance scores ranged from 1 to 10 and performance was scored between 0 and 1. Of 164 participants, about 75% were men and almost 44% were between 51 and 65 years of age. From the customers' perspective, the total SQ score was 6.80 (0-10 scale), and the individual scores for all SQ aspects were below an acceptable level. Confidentiality, dignity and continuity were given the highest scores, while availability of support groups had the lowest score. The study findings revealed an opportunity to improve SQ. Patient and provider participation in quality improvement activities could be an effective strategy to improve the aspects of health care quality that were most important to the customers and those with low scores, such as availability of support groups.

A Worldwide Measure of Societal Quality of Life

This paper proposes a comprehensive new measure of societal quality of life (QOL) at the national level. Focusing on livability, the environmental, external factors that constitute a society’s QOL this measure derives from a novel and multifaceted analysis of subjective wellbeing data. In determining what people actually value, the measure allows for a comprehensive cross-country comparison of QOL that complements normative objective-list or capabilities approaches. The analysis supports the five broad categories of Community and Relationships, Freedom and Opportunity, Health and Environment, Living Standard, and Peace and Security as antecedents to QOL. Current measures overlook or deemphasize aspects of these elements. This paper explains the methodology used to construct the index and, provides complete country rankings of QOL for 143 countries since 2000.