Quality Attributes Research Articles

Beyond Empathy: Examining the Complexities of Outpatient Satisfaction in a Resource-Constrained Setting

Patient satisfaction is a critical indicator of healthcare quality, particularly in resource-constrained settings where efficient and effective care is paramount. This study aimed to explore the multifaceted nature of outpatient satisfaction at a private Indonesian hospital, moving beyond the traditional focus on empathy to understand the interplay of various service quality dimensions. A mixed-methods sequential explanatory design was employed. The quantitative phase involved a survey of 400 outpatients, measuring their satisfaction with five service quality dimensions: tangibles, reliability, responsiveness, empathy, and assurance. Data were analyzed using descriptive statistics, Importance-Performance Analysis (IPA), and gap analysis (suitability index). The qualitative phase utilized in-depth interviews and focus group discussions with patients, staff, and management to provide context and depth to the quantitative findings. While overall patient satisfaction was 82.9%, a gap analysis revealed substantial discrepancies between patient expectations and perceptions across several service quality dimensions. Tangibles, reliability, and responsiveness emerged as key areas requiring improvement. Qualitative findings highlighted extended wait times, inconsistent staff communication, and concerns about the physical environment as significant contributors to patient dissatisfaction. Achieving high levels of patient satisfaction in resource-constrained environments necessitates a comprehensive approach that addresses systemic inefficiencies and communication gaps alongside interpersonal factors like empathy. These findings underscore the need for targeted interventions to optimize resource allocation, streamline processes, and enhance staff communication skills to improve the patient experience.

What is the relationship between the volume and type of appointments in general practice and patient experience? An observational study of general practice in England.

Background Patient satisfaction is a significant dimension of quality in general practice and has notably declined post-COVID. Understanding the dynamics between practice activities, practice characteristics and patient experience is vital for improving care quality. Aim This study investigates the relationship between the volume, modality (telephone or face-to-face) and practitioner type of general practice appointments and patient experience. Design and Setting An observational study of general practices in England. Method Data from the General Practice Patient Survey (GPPS) were merged with NHS Digital's practice level appointment data, covering August 2022 to March 2023. We estimate ordinary least squares regressions of patient satisfaction with access, general satisfaction, preference for a specific GP, and support for managing long-term conditions (dependent variables) against appointment volume, modality (telephone or face-to-face), and practitioner type. Results Analysis of 5,278 practices showed that a higher volume of appointments, especially face-to-face with GPs, was significantly (p<0.001) associated with increased patient satisfaction. Practices having a greater proportion of same-day appointments was significantly correlated with lower patient satisfaction. Conclusion Patient satisfaction and ability to have health needs met is associated with face-to-face access to GPs as well as the total volume of appointments available. The results suggest that patients' perceptions of access involve more than immediate availability of appointments or that patients may struggle to get appointments at practices offering more same day appointments. Initiatives to improve access to and satisfaction with general practice should prioritise expanding face-to-face GP appointments.

Postharvest application of sodium nitroprusside improves the quality of ‘Umran’ ber fruit under cold storage conditions by regulating enzyme activities

ABSTRACT Ber fruit is highly perishable, with a storage life of only 3–5 days under ambient conditions, which makes it difficult to transport the fruit even to domestic markets. An experiment was conducted to study the effect of postharvest treatment with sodium nitroprusside (50, 100 and 150 µM) on the storage life, quality attributes, bioactive composition and antioxidant enzyme contents of ‘Umran’ ber fruit. The treated fruit were stored for 28 days to investigate the effects of sodium nitroprusside after 7 days of cold storage at 7.5°C and 90–95% RH. It was found that fruit treated with 100 μM sodium nitroprusside experienced lower fruit weight loss and spoilage, maintained fruit firmness, and had a higher sensory quality, phenolic content, carotenoid content, soluble solids content, sugar content, ascorbic acid and antioxidant activity than the control. Furthermore, the activities of the cell wall degrading enzymes polygalacturonase, polyphenol oxidase, pectin methyl esterase and catalase were lower, while the activities of superoxide dismutase and peroxidase enzymes were higher in the treated fruit. Therefore, treatment with 100 μM sodium nitroprusside shows high potential for improving the storage life and maintaining the quality attributes of ber fruit for up to 21 days under cold storage.

Polyphenol and Quality Attributes from Some Potato Cultivars and it's Affected by Date of Planting and Salicylic Acid Treatments

Polyphenol and Quality Attributes from Some Potato Cultivars and it's Affected by Date of Planting and Salicylic Acid Treatments

Two-Staged Technology for CoCr Stent Production by SLM.

Additive manufacturing of porous materials with a specific macrostructure and tunable mechanical properties is a state-of-the-art area of material science. Additive technologies are widely used in industry due to numerous advantages, including automation, reproducibility, and freedom of design. Selective laser melting (SLM) is one of the advanced techniques among 3D fabrication methods. It is widely used to produce various medical implants and devices including stents. It should be noticed that there is a lack of information on its application in stent production. The paper presents the technological aspects of CoCr stent SLM fabrication, including design of stents and development of regimes for their manufacturing. Physical, chemical, and technological properties of CoCr powder were initially determined. Parametric design of mesh stent models was adopted. A two-stage approach was developed to ensure dimensional accuracy and quality of stents. The first stage involves a development of the single-track fusion process. The second stage includes the stent manufacturing according to determined technological regimes. The single-track fusion process was simulated to assign laser synthesis parameters for stent fabrication. Melting bath temperature and laser regimes providing such conditions were determined. Twenty-seven SLM manufacturing regimes were realized. Dependence of single-tracks width and height on the laser power, exposition time, and point distance was revealed. The qualitative characteristics of tracks imitating the geometry of the stent struts as well as favorable and unfavorable fusion regimes were determined. The results of surface roughness regulating of the stents' structural elements by various methods were analyzed. Thus, this two-staged approach can be considered as a fundamental approach for CoCr stent SLM fabrication.

Impact of Shelf life on the Quality of Cocoa Butter Extracted by Screw Press

Aims: To evaluate the changes in the quality of cocoa butter during storage extracted using the developed screw press-type cocoa butter extractor. Study Design: Statistical analysis was done using t-test. Place and Duration of Study: The study was conducted at Processing and Food Engineering lab, Kelappaji College of Agricultural Engineering and Food Technology, Tavanur under ICAR-AICRP on Post-Harvest Engineering and Technology Scheme for 3 months. Methodology: Shelf life study of the cocoa butter extracted at optimized condition (100ºC barrel temperature, 50 rpm screw speed, 2 kg/hr feed rate) was done in polyethylene pouch of 80 micron thickness and stored under ambient temperature (25±5°C) for a period of 3 months. Various quality parameters viz., free fatty acid, iodine number, peroxide number, moisture content and water activity of stored butter were determined at regular intervals of 30 days for 3 months. Results: Statistical analysis (t-test) showed that, there was no significant changes in the quality of cocoa butter during storage. The quality parameters of cocoa butter viz.,free fatty acid (1.28%), iodine number (34.74), peroxide value (1.685), moisture content (0.15%) and water activity (0.645) were within the allowable limits recommended by CODEX standards even after 3 months of storage. Conclusion: During the course of storage, all quality parameters viz., free fatty acid, peroxide value, iodine number, moisture content and water activity were found to be increased. However, all the quality parameters of cocoa butter stored under ambient temperature were within the acceptable limit prescribed by CODEX standards till 90 days with constant quality attributes.

Effect of Citric Acid and Tromethamine on the Stability of Eyedrops Containing Lifitegrast

Background/Objectives: Lifitegrast is an effective treatment for dry eye disease, reducing inflammation and improving the ocular surface condition. Owing to its high sensitivity to oxidation and hydrolysis, formulation studies are required to maintain the physicochemical stability of lifitegrast. This study aimed to overcome the instability of lifitegrast by developing a more stable eyedrop formulation by using citric acid and tromethamine to prevent the degradation of lifitegrast. Methods: Based on the Design of Experiment (DoE) approach, formulations were prepared at various concentrations of two stabilizers, citric acid and tromethamine. The stabilizers were carefully controlled to reduce the generation of degradation products. The eyedrops were stored under accelerated test conditions, and parameters such as appearance, pH, drug content, and impurities were evaluated. Results: The results showed that all critical quality attributes (CQAs) including appearance, pH, drug content, and impurities were maintained at stable levels under accelerated conditions, meeting established criteria. In addition, it was suggested that citric acid provided protection against oxidative stress, while tromethamine prevented hydrolysis caused by pH fluctuations. Conclusions: Consequently, it was concluded that the developed lifitegrast-containing eyedrop formulation exhibited improved physicochemical stability, validated through statistical analyses. These findings contribute to the development of stable eyedrops and provide a foundation for commercial production and clinical applications.

Sustaining Economic Growth: E-Service Quality’s Role in Fostering Customer Loyalty in Nigeria SMEs

The aim of this study is to investigate the impact of e-service quality on customer loyalty with customer satisfaction as a mediator in the small and medium-sized business sector in Nigeria. The dimensions investigated in this study are reliability, web design, trust, empathy, convenience, and cultural inclusion. To the best of the researchers’ knowledge, there has not been any research done on this subject investigating the above dimensions among Nigerian SMEs across various cultural groups. Therefore, this study fills this gap by investigating the impact of culture, web design, trust, empathy, convenience, and reliability on SMEs. A questionnaire was used for the purpose of the study to collect primary data. Four hundred and ninety-two responses were obtained from the respondents, who were age 20 and above. The survey was carried out online across the four major poles of Nigeria (east, west, north, and south) because of their varying and distinct cultural background. The data collected were analyzed using SPSS 28, Smart PLS 4 and AMOS 29 for descriptive analysis and structural equation modeling to test the research model. The results showed that the service quality dimensions have a positive significant impact on customer satisfaction and also show that customer loyalty is positively impacted by customer satisfaction.

Study on the Carcass Traits, Meat Quality, and Nutritional Attributes of Six Kinds of Jiangxi Local Breeds Cattle.

The purpose of this study is to explore the carcass traits, meat quality, and nutritional attributes of local yellow cattle (Guangfeng, Ji'an, and Jinjiang) and buffalo (Poyanghu, Xiajiang, and Xinfeng mountain) in Jiangxi Province, and compare the differences among different breeds. The results showed that the dressing percentage, net meat percentage, and meat-bone ratio of Jinjiang cattle were highest, and that Jinjiang cattle had the best meat production performance. Regarding meat quality, the pH24h value of all breeds was at normal level, and no dark-cutting beef was produced. Poyanghu buffalo and Xinfeng mountain buffalo had higher redness (a*) values, and Guangfeng cattle had the best water retention and tenderness. The intermuscular fat of yellow cattle breeds was higher than that of buffalo breeds; Poyanghu buffalo had the highest crude protein content. The composition of amino acids and fatty acids was different among breeds, and the composition of Jiangxi breeds was healthy. The muscle fibers of buffalo breeds are generally smaller and denser than those of yellow cattle breeds. The MyHC-Ⅰ, MyHC-Ⅱa, and MyHC-Ⅱx were the main types of muscle fibers of Jiangxi local breeds, and the proportion varied with different breeds. This work elucidated the carcass characteristics, meat quality, and nutritional attributes of Jiangxi breed cattle to provide a theoretical basis for optimizing the development of beef cattle industry.

Re-imagining educational quality. The need for a multidimensional approach in evaluating educational quality through TIMSS data

In recent years, international assessments have significantly impacted the discourse pivoting educational quality, often simplifying it to a single achievement continuum. With literature emphasizing quality’s multidimensional nature, this unidimensional view challenges the concept’s complexity. Although research with international datasets has identified multiple dimensions of educational quality, they are often considered in isolation. This paper seeks to expand current state of research by advocating a multidimensional approach using cluster analysis. Employing TIMSS data, six distinct clusters are portrayed, representing diverse quality configurations across global educational systems. This nuanced evaluation enhances our understanding of quality patterns and informs recommendations for future research.

Kualitas Pelayanan pada Berbagai Bidang Jasa di Kota Serang melalui Kajian Pustaka

One topic that is often discussed in marketing management is service quality. Service quality is an indicator of the service provided by the service provider to the service recipient. Service quality is also an early indicator of customer satisfaction. The aim of this research is to find out what types of service sectors have been researched in the marketing sector, especially service quality in Serang City. This service quality research method uses qualitative methods originating from journals that have been previously researched with research questions including year of publication, field of service studied, dimensions of service quality used, and research methods. It is hoped that the results of this research can intensify research in Serang City, especially service quality related to marketing management. Considering the limited data available and the breadth of the service quality sector for the size of Serang City.

Identifying central dimensions of quality of life including life-related values, preferences and functional health in older patients with cancer: a scoping review protocol.

Older patients with cancer already represent the largest proportion of cancer survivors which will further increase in the upcoming years. However, older patients are highly underrepresented in clinical research, leading to a detrimental knowledge gap. Research on important aspects of quality of life (QoL) and associated factors for older patients with cancer is insufficient to date. The objective of this scoping review therefore is to investigate the dimensions of QoL including functional health, life-relevant values and preferences in older adults with cancer across all tumor entities and health care settings. It will further identify medical, sociodemographic, psychosocial and geriatric aspects associated with QoL in the elderly and compare these with younger cancer patients and older non-cancer cases. Published articles investigating QoL dimensions and associated factors in older patients with cancer, i.e., exclusively patients ≥65 years or mean/median age ≥ 70 years for age-mixed samples, or that compare results of older with younger cancer patients or with older non-cancer cases will be considered for this scoping review. Older patients with cancer across all tumor entities, disease stages and health care setting will be included. PubMed and PsychINFO databases will be searched for relevant articles. Abstracts and titles will be screened for basic inclusion, and two independent reviewers will conduct a full text screening to evaluate the age criteria and decide on the final inclusion of the study. Data on study and participant characteristics, QoL dimensions and geriatric factors will be extracted using a data extraction sheet. Results will be summarized descriptively to address the objectives of this review. The findings of this scoping review will provide valuable insights into central dimensions of QoL, including values, preferences and functional health in older adults with cancer, and help to improve targeted interventions and healthcare planning.

Multimass Analysis of Adeno-Associated Virus Vectors by Orbitrap-Based Charge Detection Mass Spectrometry.

Adeno-associated virus (AAV) vectors have attracted significant attention as the main platform for gene therapy. To ensure the safety and efficacy of AAV vectors when used as gene therapy drugs, it is essential to assess their critical quality attributes (CQAs). These CQAs include the genome packaging status, the size of the genome encapsidated within the AAV capsid, and the stoichiometry of viral proteins (VPs) that constitute the AAV capsids. Analytical methods have been established for evaluating CQAs, such as analytical ultracentrifugation, capillary gel electrophoresis with laser-induced fluorescence detection, and capillary gel electrophoresis using sodium dodecyl sulfate with UV detection. Here, we present a multimass analysis of AAV vectors using orbitrap-based charge detection mass spectrometry (CDMS), a single-ion mass spectrometry. Orbitrap-based CDMS facilitates the quantitative evaluation of the genome packaging status based on the mass distribution of empty and full particles. Additionally, we established a novel method to analyze the encapsidated genome directly without pretreatment, such as protein digestion or heat treatment, and to estimate the stoichiometric variation of VP for the capsid based on the mass distribution constituted by the single peak corresponding to AAV particles. Orbitrap-based CDMS is a distinctive method that allows multiple mass characterizations of AAV vectors with a small sample volume of 20 μL for 1013 cp/mL in a short time (30 min), and it holds the potential to become a new standard method in the assessment of CQAs for AAV vectors.

Grain quality attributes of an on-farm Thailand's highland rice germplasm directly beneficial to the farming households

Rice (Oryza sativa) from the highlands of Northern Thailand where the crop is predominantly planted with local varieties was examined for grain quality features having direct benefits for the local population. Un-husked rice seed provided by farmers of 10 minority groups had large grains, in contrast to the slender grain type found in the lowlands. The highland-grown rice directly benefits the local population by providing a higher dietary intake of Fe but not of Zn. The highlands have been identified as a rich source of pigmented rice with a high anthocyanin content and an environment favouring the production of premium quality rice. On-farm experiments confirmed the effects of genotype (G) and environment (E) and the G × E interaction on grain quality. The local rice with high grain Zn exhibited higher concentrations under the upland conditions, while the high anthocyanin variety produced greater levels under wetland conditions. The pigmented rice had a higher anthocyanin content at high altitudes than at lower altitudes. The information concerning the value of local rice germplasm benefits the local population and should facilitate more sustainable on-farm conservation efforts than rewards offered to the farmers from external funding sources.

Understanding Test Convention Consistency as a Dimension of Test Quality

Unit tests must be readable to help developers understand and evolve production code. Most existing test quality metrics assess test code's ability to detect bugs. Few metrics focus on test code's readability. One standard approach to improve readability is the consistent application of conventions. We investigated test convention consistency as a dimension of test quality. We formalized test suite consistency as the extent to which alternatives are used within a code base and introduce two complementary metrics to capture this extent. We elaborated a catalog of over 30 test conventions for the Java language organized in 10 convention classes that group mutual alternatives. We developed tool support to detect occurrences of conventions, compute consistency metrics over a test suite, and view occurrences of conventions in the corresponding code. We applied our tools to study the consistency of the test suites of 20 large open-source Java projects. The study validates the design of the test convention classes, provides descriptive statistics on the range of consistency values for ten different convention classes, and enables us to link observed changes in consistency values to specific events in the change history of our target systems, thus providing evidence of the construct validity of the metrics. We conclude that analyzing test suite consistency via static analysis shows promise as a practical approach to help improve test suite quality.

Comparative analysis of the wear behaviour of TiN/TiAlN, TiAlVN, and TiAlYN coated tools in milling operations of Inconel 718

Abstract Milling is widely used in the aeronautical and aerospace industries, due to the possibility of producing parts with good dimensional stability and surface quality. Because of its exceptional mechanical qualities and limited thermal conductivity, Inconel 718 is a nickel superalloy that is regarded as a challenging material to process. Due to the flexibility of milling, this is the most commonly used process for machining INCONEL alloys. However, high levels of tool wear can be observed. Coatings can be deposited on the cutting tools to improve process performance. Nonetheless, doping elements such as yttrium and vanadium when added to TiAlN-based coatings can increase the coating's resistance. Furthermore, multilayer coatings tend to be very promising resistance to crack propagation. Thus, this work intends to compare three coatings deposited via PVD, in terms of the quality of the machined surface and wear resulting from the process: TiAlVN, TiAlYN, and TiN/TiAlN. The cutting speed (Vc), feed per tooth (fz), and cutting length (Lcut) were varied. It was possible to verify that the multilayer coating had better results, in terms of average roughness (Ra) and in measuring wear (VB3) and its characterisation. On the other hand, the TiAlVN coating showed the worst results. It was concluded that due to the TiN layer, the TiN/TiAlN coating has better resistance to crack propagation, as its adhesion to the substrate is good and there is no delamination.

Not all about the money: Service quality information improves consumer decision-making

Information asymmetries are pervasive in many industries and can result in large losses in consumer welfare. Does providing product quality information result in improved consumer decision-making? We study this question in a market where quality is notoriously hard to determine ex ante: the residential energy market. Using a discrete choice experiment (N = 1,002), we document a substantial willingness-to-pay (37–45 % of the median bill) for four service quality attributes (transparency, agency, authenticity, and convenience). In an incentivized search task (N = 432), we show that how quality information is presented matters: consumers who view information in the form of ratings and stamps of approval are (i) 4 % more likely to opt in to the search task, and (ii) 20 % more likely to correctly identify given levels of quality, relative to consumers who are provided with bar graphs, pie charts, and text. Finally, using a decision experiment (N = 510) with real company names familiar to our participants, we find that the provision of quality information increases choices of the best-rated company more than 20-fold, relative to the control scenario where quality information is absent, in which consumers select companies predominantly on price and brand awareness. Our findings are applicable to other markets in which information asymmetries are present, where policymakers should consider interventions that promote transparency and quality information provision.

Intrinsic data quality dimensions: expanding on Wand and Wang’s data quality model

PurposeStudies show that data quality (DQ) issues are extremely costly for companies. To address such issues, as a starting point, there is a need to understand what DQ is. In his context, the 1996 paper “Anchoring data quality dimensions ontological foundations” by Wand and Wang has been highly influential on the understanding of DQ. However, the present study demonstrates that some of the assumptions made in their paper can be challenged. On this basis, this study seeks to develop clearer definitions.Design/methodology/approachThe assumptions behind Wand and Wang’s DQ classification are discussed, on which basis three counter-propositions are formulated. These are investigated through a representation theoretical approach involving analyses of deficient mappings between real-world and information system states. On this basis, an intrinsic DQ classification is derived. A case study is conducted to investigate the value of the developed DQ classification.FindingsThe representation theoretical analysis and the case study support the three propositions. These give rise to the development of a DQ classification that includes three primary intrinsic DQ dimensions (accuracy, completeness and conciseness), which are associated with six primary value-level DQ deficiencies (inaccuracy, incorrectness, meaninglessness, incompleteness, absence and redundancy). The case study supports the value of extending Wand and Wang’s DQ classification with the three additional data deficiencies.Research limitations/implicationsBy improving the conceptual clarity of DQ, this study provides future research with an improved basis for studies and discussions of DQ.Originality/valueThe study advances the understanding of DQ by providing additional clarity.

Investigating quality service and student satisfaction: evidence from College of Business & Economics, University of Gondar, Ethiopia

Providing quality service is the major concern of many public organizations. However, the way to provide immediate service (responsiveness), the capacity to deliver on promises of accurate and consistent service (reliability), the degree of trust and confidence of students in the service provided by the college (assurance), the physical appearances of the service that the college offers (tangibility) and understanding the needs of students in the college are not as such potential. Thus, the study aims to investigate the effect of a quality service system on student satisfaction in Business and Economics College, University of Gondar. An explanatory research design with a quantitative research approach was employed to address the specified objectives. The population of the study was 6323 and out of these, 376 samples were drawn through stratified random sampling technique. Of 376 self-administer questionnaires, 263 were valuable for this analysis. One of the objectives of the study was to understand the dominant service quality dimension. The finding of the mean score of SERVQUAL dimensions portrays that students are less satisfied with dimension responsiveness (M = 2.31), which implies that the way students get an immediate response for their need showed very low followed by dimension empathy (M = 2.63) i.e., the willingness of staff to support or help students, spontaneous care and concern of staff to student’s needs, is lower, whereas with tangibles, assurance, and reliability are better. The PLS-SEM analysis result confirmed that tangibility and assurance has a significant effect but other service quality dimensions are not.

Study on Mass Transfer and Physicochemical Properties of Avocado During Osmotic Dehydration

A previous study found that mass transfer occurring during the osmotic dehydration (OD) process. This phenomena is possible causing modification in physicochemical properties; therefore, understanding the OD effect on quality attributes is important. This research aimed to study the impact of sucrose concentration and immersion time on the kinetics of mass transfer and the physicochemical properties of avocado (Persea americana var. Miki) during the OD process. The samples were immersed in a sucrose solution (45, 55 and 65 ° Brix) for up to 300 min, then the mass transfer parameter and physicochemical properties were evaluated. The results showed that the highest rate of water removal (WR) was –0.037 g.g–1.h–1 using the 55 ° Brix solution, which also led to an increase in the soluble solid gain (SSG) value to 0.0126 g.g–1.h–1, while the highest WR/SSG ratio was obtained after 180 min of immersion using 65 ° Brix (2.451). A 2nd-order polynomial model accurately describes avocado mass transfer kinetics and their relationship to physicochemical properties. The model showed the best adjustment for WR, SSG, and weight loss (WL), as pointed out by R2 = 0.9671, 0.8968 and 0.9573, respectively. WR has a negative effect on firmness (R2 = 0.9278), vitamin C (R2 = 0.9349), and total fat (R2 = 0.8954). The uptake of sucrose correlated with decrease of vitamin C (R2 = 0.9391), whereas WL also affected the loss of total fat (R2 = 0.8288). The OD process modified the chroma of the avocado by reducing lightness, increasing greenness and yellowness, and yet protecting the flesh from the browning effect. Overall, this study provides insights into the relationship between mass transfer and physicochemical properties, and it is useful to predict the final condition of the osmo-avocado before subsequent processes. HIGHLIGHTS Immersing the avocado in a 55 ° Brix solution resulted in the highest rate of water removal (WR) and soluble solid gain (SSG). The highest ratio of WR and soluble solid gain (WR/SSG) was obtained at 180 min of immersion using a 65 ° Brix solution. The 2nd-order polynomial model fits the mass transfer parameters (WR, SSG, and weight loss/WL). WR contributed to a softened texture, color contrast, degradation of vitamin C, and total fat content. The combination of mass transfer and physicochemical property models is useful for designing the OD process and predicting the final condition of osmo-avocado. GRAPHICAL ABSTRACT