High-quality Rate Research Articles

PROTECT: a novel psychotherapy for late-life depression in elder abuse victims.

Elder abuse is prevalent, and victims have high rates of depression and low quality of life. We established an academic-community partnership to test the feasibility, acceptability, and impact of a brief psychotherapy for depression (PROTECT) among elder abuse victims with capacity to make decisions. Elder abuse service providers referred depressed (Patient Health Questionnaire-9 [PHQ-9] ≥ 10) older victims (age ≥ 55 years) for potential pilot study participation. Forty eligible victims who consented were randomized to PROTECT psychotherapy (N = 25) or a Usual Care (N = 15) condition involving a community psychotherapy referral. Follow-up research assessments were conducted at 6 weeks (mid-treatment) and 9 weeks (end of treatment) after study initial assessment. We used mixed-effects regression models to examine treatment effects on depression severity and quality of life over time. Most victims (75%) reported two or more types of abuse. The a priori acceptability benchmark was met at the end of PROTECT therapy. All PROTECT participants initiated therapy; this engagement rate is greater than the a priori 75% standard set for feasibility. We found a significant reduction in depression severity (Montgomery-Åsberg Depression Rating Scale [MADRS]), with PROTECT leading to greater benefits compared to Usual Care. Both study groups had a similar improvement in quality of life. The pilot project results found that PROTECT psychotherapy is feasible, acceptable, and effective in reducing depression. With the support of our partnership, we found that PROTECT could be delivered alongside elder abuse services with victims willing to initiate therapy that leads to meaningful treatment effects.

Big data management capabilities in the hospitality sector: Service innovation and customer generated online quality ratings

Despite the wide usage of big data in tourism and the hospitality sector, little research has been done to understand the role of organizations’ capability of managing big data in value creation. This study bridges this gap by investigating how big data management capabilities lead to service innovation and high online quality ratings. Instead of treating big data management as a whole, we access big data management capabilities at the strategic and operational level. Using a sample of 202 hotels in Pakistan, we collected the primary data for big data capabilities, knowledge creation and service innovation; the secondary data about quality rating were collected from Booking.com. Structural equation modelling through SmartPLS was used for data analysis. The results indicated that big data management capabilities lead to high online quality ratings through the mediation of knowledge creation and service innovation. We contribute to the current literature by empirically testing how strategic level big data capabilities enable the firm to add value in innovativeness and positive online quality ratings through acquiring, contextualizing, experimenting and applying big data.

Effects of chronic pain on sleep quality and depression: A cross-sectional study.

Objectives:To examined the impacts of chronic pain on depression and poor sleep quality dimensions as well as the mediating function of poor sleep quality in the pathway between chronic pain and depression.Methods:Between March 2019 and February 2020, we conducted a cross-sectional study on 233 chronic pain patients in 2 tertiary hospitals in Riyadh, Saudi Arabia.Results:Of the 233 patients, 36% had depression, while 66.1% had poor sleep quality. Chronic pain intensity and pain disability significantly explained 10.9% of depressed affect variance, 4.9% of anhedonia variance, 17.3% of somatic complaint variance, 4.5% of interpersonal difficulty variance, 7.4% of sleep efficiency variance, and 15% of perceived sleep quality variance. The result also showed a positive, direct effect of chronic pain on poor sleep quality, which in turn positively and directly affect depression. However, chronic pain had only indirect effect on depression.Conclusions:Among chronic pain patients, the high rates of poor sleep quality and depression requires a special attention. Chronic pain intensity and disability predict depression and sleep quality dimensions differently. The result underlines the need of managing poor sleep quality to address depression in the context of chronic pain.

Quality in Inclusive and Non-Inclusive Infant and Toddler Classrooms: What Are the Trends After 15 Years?

ABSTRACT It is beneficial to keep the information concerning quality of care offered to infants and toddlers current to maximize children’s outcomes. This study analyzed the data collected from 2016 to 2018 in order to examine the current status of quality of care for infants/toddlers in licensed child-care centers in North Carolina and compared findings with results reported from data collected in 2003-04. The current data (N = 1053 classrooms) revealed the percent of infants/toddler classrooms serving children with disabilities (N = 162, 15.38%) slightly increased from the 2003–04 data collection (N = 64, 13.6%), while the overall quality slightly decreased to 4.76 from 4.94. Further, there were no differences in quality (based on the Infant/Toddler Environment Rating Scale-Revised) between inclusive and non-inclusive infant and toddler classrooms regardless of disability severity. The researchers examined which structural and process characteristics affected quality scores. Classroom quality differed by age groups. Further, teacher education, ratios, and teachers’ length of time in the classroom were still associated with higher quality ratings. The data on low-scoring items were similar in 2003–4 and 2016–18, with programs continuing to struggle with Personal Care Routines.

Pareto Frontier of the Arm Energy Ripple and the Conduction Losses of a Modular Multilevel Converter

Modular multilevel converters can achieve high power quality and voltage ratings, becoming a good alternative for high-voltage direct-current applications. However, the circulating current and capacitor voltage ripple remain significant drawbacks, mainly due to the impact on efficiency and power density. In this work, a stationary operation of a modular multilevel converter is optimized by calculating the Pareto frontier of the arm energy ripple and the conduction losses for different operating conditions. From the set of optimal solutions, the best trade-off between energy ripple and power losses can be chosen depending on the application requirements. Therefore, an optimal operating point regarding capacitor voltage ripple and circulating current was found, optimizing efficiency and allowing a reduction of capacitance, hence size and cost. The theoretical analysis and results are validated experimentally on a prototype test-bench.

An Ecological Analysis of Quality Ratings and Inspections Associated with COVID-19 Outbreaks in Skilled Nursing Homes

Objectives: As COVID-19 spread across the United States, and most rapidly in skilled nursing homes, public health departments developed policies to mitigate the spread. Concerns grew over whether this spread linked to nursing home quality. Design: We collected data on nursing home quality, staffing, and COVID-19 cases from the Centers of Medicare and Medicaid Services. Demographic data was sourced from Long Term Care Focus. Settings and Participants: The analysis used cross-sectional data from 1,025 California skilled nursing homes including quality ratings and confirmed COVID-19 cases between May 17, 2020 and August 23, 2020. Methods: The dependent variable was confirmed COVID-19 cases among residents. The primary independent variables were Overall Rating and Health Inspection Rating, while also including nursing home beds, patient race composition, ownership and geographic classification. Results: 5-Star Overall Rating, 5-Star Health Inspection Rating, and a lower count of health inspection deficiencies each predicted a lower likelihood of having a confirmed COVID resident case (p<.05). Conclusions and Implications: Skilled nursing homes with higher quality ratings and fewer health inspection deficiencies were less likely to have a confirmed case of COVID-19 among residents.

Deep Transfer Learning for Improved Product Quality Prediction: A Case Study of Aluminum Gravity Die Casting

High product quality and low rejection rates are decisive for the competitiveness of manufacturing systems. Hence, manufacturing shifts towards digitalization for predicting and controlling product quality. In order to implement data-driven approaches in manufacturing successfully, sufficient model performances are necessary. Especially metal casting comes with several hurdles for data-driven approaches, like sparse and imbalanced data, a relatively high human interaction and frequent mounting events. This often leads to hardly generalizable and weak models. Within this paper, transfer learning is investigated for the quality prediction of aluminum gravity die casting to try to overcome these hurdles and create robust, accurate and data-efficient models.

The Public Procurement and the Quality of Services: The Case of Moscow Hospitals

The work is devoted to the search for answers to the question: “Are there any differences in the public procurement of customers who provide services of different quality?”. The article identifies the stages of the hospital procurement process in the contract system and highlights the main customer strategies used in the auction. The results of an independent quality assessment are examined and comparative hospital characteristics with low and high quality rating are conducted. The hospital needs according to the types of purchases and their annual volumes of contracts are analyzed. The advantages of competitive procedures are determined and the key factors affecting the level of competition with possible risks of unreliable execution of contracts are identified. The empirical study is based on the database which includes 5390 contracts of 2 hospitals in Moscow for years of 2011–2017. Using the methods of econometric analysis, in particular, the method of least squares and the difference in the average, the hypothesis is tested the high competition has a positive effect on the quality of medical services. The constructed regression models show that the customer providing high quality services has low competition and small rebates at the auction. At the same time there are more contract terms, delays in the supply of goods and services as compared with the customer providing low quality services. Thus it was found that the underestimation of competition at the auction indicates the desire of the hospital to guarantee a higher quality of medical services to patients while as aggressive bids of participants lead to the supply of poor purchases. The results of the study may be useful for the competent authorities in the development of legal acts for the participants of the contract system in the field of health procurement.

How do People with Disabilities Evaluate the Quality of Social Services?

In this article we analyse the quality of social services from the perspective of people with disabilities and we analyse other social services quality studies that use the EQUASS system or the SERVQUAL model. We show the contrast between the high quality ratings reported by social workers and unmet expectations of the services’ recipients. It is argued that the difference may be due to methodological errors in choosing one or another research method, and the phenomenon of social workers’ conformism, which can be supported also by the peculiarities of Lithuania’s long-term social policy. It is proposed that the SERWQUAL model be used for the study of the quality of social services, which is flexible with regards to the needs of service users. Triangulation of research methods was used to analyse the data. We show evaluation of the quality of social services according to the 5 dimensions of the SERWQUAL model: tangibles, reliability, responsiveness, assurance (certainty) and sensitivity (empathy).

German-Language Websites Containing Information About Rare Diseases Lack Quality Indicators

A Review of: Pauer, F., Litzkendorf, S., Göbel, J., Storf, H., Zeidler, J., & Graf von der Schulenburg, J.-M. (2017). Rare diseases on the Internet: An assessment of the quality of online information. Journal of Medical Internet Research, 19(1), e23. https://doi.org/10.2196/jmir.7056 Abstract Objective – To evaluate the quality of the information contained in websites about rare diseases and to determine if quality varies based on the supplier category of the website. Design – Questionnaire and content analysis. Setting – Germany Subjects – 693 German-language websites Methods – Websites were identified through a Google search: All 8,000 rare diseases (as listed on Orphanet) and their synonyms were entered into Google; the first 20 results for each disease were scanned for sites written in German. A questionnaire designed to measure the quality of information found on the websites was mailed to each identified website provider. For those who did not respond, the survey was completed by the authors using information from the site. A t test was used to examine differences in the quality of information among the types of information providers. Main Results – A total of 693 information suppliers were identified. The suppliers completed 17.7% of the surveys; the other 82.3% were completed by the authors. The majority of information providers were patient organizations/support groups (38.8%) followed by medical institutions (26.8%). Information provided by individuals had the lowest quality rating. There were no statistically significant differences between the quality of information supplied by patient support groups and medical institutions. The highest quality rating was provided by associations/sponsoring bodies. Conclusion – There is not much information available on the Internet regarding rare diseases. Patient support groups and organizations are the largest provider of information. The overall quality rating of information on rare disease websites was found to be low, particularly in areas of accessibility. Website providers should be made aware of how to produce websites of higher quality with greater accessibility.

How People Evaluate Anti-Corona Measures for Their Social Spheres: Attitude, Subjective Norm, and Perceived Behavioral Control.

Restrictions on outdoor activities, tips for hygiene, and tips for mental health are among the most common initiatives to counter the COVID-19 pandemic. These measures aim to protect people’s health and, at the same time, impact their social lives. So far, it is little known how people evaluate those anti-Corona measures with regard to their social spheres (close family, wider family and friends, colleagues, and society). Furthermore, it is plausible that the subjective evaluation of attitudinal objects and especially severe events, like the COVID-19 pandemic and the related counter-measures, is multidimensional. Against this background, we combine the social spheres with the elements of the Theory of Planned Behavior. On the methodological basis of the Means-End Theory of Complex Cognitive Structures, we determine the perceived relevance and quality of the attitude, subjective norm, perceived behavioral control, and social spheres regarding anti-Corona measures. Furthermore, the applied methodology allows the deduction of norm strategies to define the priority of securing or increasing the effectiveness of elements of anti-Corona measures. Based on the answers of 663 participants, we found that the protection from COVID-19 and its consequences (attitude) are more important to people than the practicability of anti-Corona measures in their social lives (perceived behavioral control), which, again, has a higher subjective relevance than the willingness to fulfill the expectations of others (subjective norm). Additionally, people distinguish between their close family (higher subjective relevance) and their other social spheres (lower subjective relevance). The people attribute the highest quality to the tips on hygiene, followed by the restrictions on outdoor activities and the tips for mental health. The protection and practicability of the anti-Corona measures have higher quality ratings than the willingness to fulfill the expectations of others. Based on the norm strategies, policymakers should secure the effectiveness of the current anti-Corona measures with a high priority by focusing on the protection and practicability with regard to close and wider family and friends. Increasing the effectiveness of the protection and practicability of anti-Corona measures in work and society also has a high priority. Focusing on the subjective norm should be of lower priority.

Linking Patient Safety Culture to Quality Ratings in the Nursing Home Setting.

There is limited evidence on the associations between patient safety culture and measures of health care quality in nursing homes. This study examines the relationship between scores on the Agency for Healthcare Research and Quality (AHRQ) Surveys on Patient Safety Culture™ (SOPS®) Nursing Home Survey (NH SOPS) and Centers for Medicare and Medicaid Services Nursing Home Five-Star Quality Ratings. Using data from 186 nursing homes, we conducted multiple regression analyses predicting the Five-Star Quality Ratings from the NH SOPS survey measures. Five NH SOPS measures were related to the Overall, Health Inspections, and Quality Five-Star Ratings. Four NH SOPS measures were related to at least two of the four Five-Star Quality Ratings and three SOPS measures were related to one Five-Star Rating. None of the NH SOPS measures were significantly associated with the Staffing Five-Star Rating. Findings generally indicated that stronger patient safety culture is associated with higher quality ratings.

Outcomes at five to eight years of age for children with Hirschsprung’s disease

ObjectiveThis study describes core outcomes of Hirschsprung’s disease (HD) in a UK-wide cohort of primary school-aged children.DesignA prospective cohort study conducted from 1 October 2010 to 30 September 2012. Outcomes...

Effect of milling parameters on HSLA steel parts produced by Wire and Arc Additive Manufacturing (WAAM)

Abstract Additive manufacturing is considered a motivator for the development of the industrial world. Recent advances show that Wire and Arc Additive Manufacturing (WAAM) has the potential to become a relevant method for the fabrication of large complex-shaped metallic components. In this study, we address one of the most important post-processing methods for WAAM parts to be used in structural applications, milling. In this work, thin-walled high strength low alloy steel parts were manufactured by WAAM and their microstructure was characterized. Then, a milling strategy which considered the microstructure and local mechanical properties of each part was employed. The results show that the mechanical behavior of the as-built parts does not yield a significant influence on the milling process. Overall, it was ascertained that the quality of the milled surfaces improves, that is, has lower roughness, with the increase of cutting speed and with the decrease of feed per tooth. Nevertheless, we highlight the need for more attention to be dedicated on post-process machining operations after WAAM, to establish the best strategies aiming at decreasing tool wear, while maintaining both high surface quality and production rates.

Phenotyping the Association between Nocturia and Hypertension: A Systematic Review and Meta-Analysis.

The association between nocturia and hypertension has been widely reported yet remains poorly characterized, precluding a more refined understanding of blood pressure as it relates to the clinical urology setting. We synthesized current evidence on the relationship between nocturia and hypertension as a function of nocturia severity, age, gender, race, body mass index and diuretic use. We searched PubMed®, EMBASE® and Cochrane databases for studies published up to May 2020. Random effects meta-analyses were performed to identify pooled odds ratios for nocturia given the presence of hypertension. Meta-regression and subgroup analyses were performed to identify differences across study samples. Of 1,193 identified studies, 25 met the criteria for inclusion. The overall pooled OR for the association of nocturia with hypertension was 1.25 (95% CI 1.21-1.28, p <0.001). Pooled estimates were 1.20 (1.16-1.25, p <0.001) and 1.30 (1.25-1.36, p <0.001) using a 1-void and 2-void cutoff for nocturia, respectively (p <0.001 between cutoffs). The association was more robust in patient-based (1.74 [1.54-1.98], p <0.001) vs community-based (1.24 [1.24-1.29], p <0.001) study samples (p <0.001). The association was stronger in females compared to males (1.45 [1.32-1.58] vs 1.28 [1.22-1.35], p <0.001), and Black (1.56 [1.25-1.94]) and Asian (1.28 [1.23-1.33]) vs White subgroups (1.16 [1.08-1.24]; p <0.05 for both). No effect was observed for age or body mass index. Evidence on diuretics was limited. Hypertension is associated with a 1.2-fold to 1.3-fold higher risk of nocturia. This association is more robust at a higher nocturia cutoff, in patient-based study samples, among females and in Black and Asian patients, but unrelated to age or body mass index.

The effectiveness of test-driven development approach on software projects: A multi-case study

Over recent years, software teams and companies have made attempts to achieve higher productivity and efficiency and get more success in the competitive market by employing proper software methods and practices. Test-driven development (TDD) is one of these practices. The literature review shows that this practice can lead to the improvement of the software development process. Existing empirical studies on TDD report different conclusions about its effects on quality and productivity. The present study tried to briefly report the results from a comparative multiple-case study of two software development projects where the effect of TDD within an industrial environment. Method: We conducted an experiment in an industrial case with 18 professionals. We measured TDD effectiveness in terms of team productivity and code quality. We also measured mood metric and cyclomatic complexity to compare our results with the literature. We have found that the test cases written for a TDD task have higher defect detection ability than test cases written for an incremental NON-TDD development task. Additionally, discovering bugs and fixing them became easier. The results obtained showed the TDD developers develop software code with a higher quality rate, and it results in increasing team productivity than NON_TDD developers.

Which objective sleep elements predict children's perceptions of good sleep quality? A preliminary investigation based on polysomnography and actigraphy

ObjectivesObjective sleep elements that underlie child ratings of sleep quality are largely unknown. Child-based sleep recommendations, therefore, typically focus on duration. An expert panel recently provided specific recommendations regarding objective sleep parameters that correspond with higher quality sleep, but child-based studies from which to draw conclusions were notably limited. The present study used actigraphy and polysomnography to explore sleep continuity and architectural variables that correspond with higher ratings of sleep quality in a sample of school-aged children. MethodsFifty-two healthy, prepubertal children (aged 7–11 years) completed one night of unattended ambulatory polysomnography at home with concurrent actigraphy and provided sleep quality ratings the following morning. Associations between sleep variables and subjective ratings were examined using polynomial regression models to examine potential linear and nonlinear relationships. ResultsIn contrast to findings among adults, total sleep time, sleep onset latency, and sleep efficiency values were unrelated to child ratings of sleep quality. Wake after sleep onset (WASO) showed a curvilinear (reversed j-shaped) relationship such that perceptions of sleep quality were high when WASO values were less than approximately 30 minutes. For sleep architecture, N1% showed a significant quadratic association with sleep quality such that N1% between 2% and 6% corresponded with high sleep quality ratings. ConclusionsOur findings support expert recommendations regarding WASO values that predict high quality sleep in children, but also await replication. There is need for additional research aimed at understanding objective sleep elements and other influences of children's perceptions of sleep quality using linear and nonlinear models.

Older adults’ understanding of hypothetical community pharmacy quality report cards

BackgroundQuality ratings for health plans and health services have become increasingly available to patients. ObjectiveWe sought to explore older adults’ understanding of hypothetical community pharmacy report cards and the information they valued on the report card. MethodsWe recruited participants aged 50 years or older to complete a 59-question telephone survey. The participants reviewed 3 different pairs of report cards, which represented a hypothetical pharmacy, and each pair contained different quality metrics. The participants identified which pharmacy of the pair they preferred, and this served as the primary outcome. We asked the participants to rate the level of importance (4-point unidirectional scale, not at all to very important) of the star ratings, source of information, and quality metrics. We also gathered information about the participants personal experiences with medications and pharmacy services, their self-reported health, health literacy, health numeracy, and demographics. The frequency that the pharmacy with higher quality metrics was selected was reported. We used logistic regression to examine factors associated with correctly identifying the highest quality pharmacy for all 3 sets of report cards. ResultsMost participants (n = 152) correctly identified all 3 (n = 120, 79.0%) report cards for pharmacies with higher quality metrics. The source of the information, individual quality metrics, and star ratings were all perceived as moderately or very important by most participants. Ratings of importance were strongly correlated (r, 0.70–1.00). ConclusionMore than 75% were able to correctly identify all 3 report cards with higher quality ratings. Most participants believed that the source of the information, the individual quality metrics, and the star rating were all important. Research is needed to explore to what extent patients would use these types of quality metric report cards to make decisions about where to obtain their medications.

Decrease of Anticholinergic Drug Use in Nursing Home Residents in the United States, 2009 to 2017.

To investigate the time course of anticholinergic drug use in nursing home residents and assess if any temporal change in anticholinergic use varied by nursing home quality rating. Retrospective repeated cross-sectional analysis of Medicare enrollment, Parts A, B, and D, claims data linked to the Minimum Data Set from 2009 to 2017. Medicare-certified nursing homes. Long-term residents 65 years or older with nursing home stay of at least 100 consecutive days within a given calendar year. Estimates of anticholinergic drug prescription rates between 2009 and 2017 were based on a binary variable indicating whether a resident received a drug with high anticholinergic activity, as defined by the Anticholinergic Cognitive Burden scale, for at least 1 day during the initial 100 consecutive days of nursing home stay in a given calendar year. We used mixed effects logistic regression models to determine adjusted rates of anticholinergic use each year and test the interaction between nursing home quality rating and year, while adjusting for patient and nursing home characteristics. The cohort included 786,858 100-day nursing home stays (299,354 unique residents) in 6,703 nursing homes for the years 2009 to 2017. Prescription rates were stable at approximately 34% to 35% between 2009 and 2011, then gradually decreased to 24.3% in 2017 (P < .0001), with the decline being more pronounced in nursing homes having high quality ratings (P < .0001). Rates for anticholinergic drugs in nursing homes with 4 to 5 star quality rating (33.7% in 2011 to 23.3% in 2017) showed a steeper decline over time relative to nursing homes with 1 to 2 star quality rating (34.2% in 2011 to 25.2% in 2017) (P < .0001). The use of drugs with high anticholinergic activity has declined from 2009 to 2017, with a greater decline in higher-quality nursing homes.

Automated theoretical chemical kinetics: Predicting the kinetics for the initial stages of pyrolysis

Large scale implementation of high level computational theoretical chemical kinetics offers the prospect for dramatically improving the fidelity of combustion chemical modeling. To facilitate such efforts, we have developed a suite of codes, collectively referred to as AutoMech, that allow for the automatic prediction of the kinetics for large sets of reactions via ab initio transition-state-theory based master-equation calculations. The primary input is simply the mechanism, a dictionary relating chemically identifiable species descriptors (e.g., SMILES or InChIs) to species labels in the mechanism, and a specification of the electronic structure and transition state theory models to be implemented. Here we illustrate the current utility of AutoMech through a study of the initial stages of pyrolysis for 3 sets of fuels: sequences of alkanes, alcohols, and aldehydes. For simplicity, the analysis focuses on abstractions from the fuel by H, CH3, and OH, and the decomposition of the resulting radicals. Altogether, there are a total of 166 input channels in these sets (more than 363 forward reactions when expanded to the full set of elementary reactions). The code successfully produces high quality rate estimates (with apparent uncertainties less than a factor of two in limited comparisons with experiment) for >95% of these. For the radical decomposition reactions, the analysis includes predictions for the pressure dependence of the kinetics. This wide-ranging exploration illustrates (i) the effect of different levels of prediction on the expected accuracy, (ii) the branching between abstractions at different sites for different abstractors, (iii) the dependence of the rates on the chemical structure, and (iv) the variation in radical stabilities across chemical families. These results, as well as the demonstrated feasibility of the methodology, should find further utility in the development of accurate rate expressions for arbitrary fuels.