Quality Integrity Research Articles

Quality ofIntegration ofAir Force Trauma Surgeons Within the Center forSustainment ofTrauma andReadiness Skills, Cincinnati: A Pilot Study.

While previous studies have analyzed military surgeon experience within military-civilian partnerships (MCPs), there has never been an assessment of how well military providers are integrated within an MCP. The Center for Sustainment of Trauma and Readiness Skills, Cincinnati supports the Critical Care Air Transport Advanced Course and maintains the clinical skills of its staff by embedding them within the University of Cincinnati Medical Center. We hypothesized that military trauma surgeons are well integrated within University of Cincinnati Medical Center and that they are exposed to a similar range of complex surgical pathophysiology as their civilian partners. After Institutional Review Board approval, Current Procedural Terminology (CPT) codes were abstracted from billing data for trauma surgeons covering University of Cincinnati Hospitals in 2019. The number of trauma resuscitations and patient acuity metrics were abstracted from the Trauma Registry and surgeon Knowledge, Skills, and Abilities clinical activity (KSA-CA) scores were calculated using their CPT codes. Finally, surgeon case distributions were studied by sorting their CPT codes into 23 categories based on procedure type and anatomic location. Appropriate, chi-squared or Mann-Whitney U-tests were used to compare these metrics between the military and civilian surgeon groups and the metrics were normalized by the group's full-time equivalent (FTE) to adjust for varying weeks on service between groups. Data were available for two active duty military and nine civilian staff. The FTEs were significantly lower in the military group: military 0.583-0.583 (median 0.583) vs. civilian 0.625-1.165 (median 1.0), P = 0.04. Per median FTE and surgeon number, both groups performed a similar number of trauma resuscitations (civilian 214 ± 54 vs. military 280 ± 13, P = 0.146) and KSA-CA points (civilian 55,629 ± 25,104 vs. military 36,286 ± 11,267; P = 0.582). Although the civilian surgeons had a higher proportion of hernia repairs (P < 0.001) and laparoscopic procedures (P = 0.006), the CPT code categories most relevant to combat surgery (those relating to solid organ, hollow viscus, cardiac, thoracic, abdominal, and tissue debridement procedures) were similar between the surgeon groups. Finally, patient acuity metrics were similar between groups. This is the first assessment of U.S. Air Force trauma surgeon integration relative to their civilian partners within an MCP. Normalized by FTE, there was no difference between the two groups' trauma experience to include patient acuity metrics and KSA-CA scores. The proportion of CPT codes that was most relevant to expeditionary surgery was similar between the military and civilian partners, thus optimizing the surgical experience for the military trauma surgeons within University of Cincinnati Medical Center. The methods used within this pilot study can be generalized to any American College of Surgeons verified Trauma Center MCP, as standard databases were used.

Exploring the PhD supervisor/candidate relationship for a ‘publication-based thesis’: a metaphor-driven approach

ABSTRACT In this paper, we use metaphors to capture the experiences of a group of five PhD supervisors (who have supervised) and three PhD graduates (who have completed) a Publication-Based Thesis (P-BT) within the Information Systems (IS) discipline. Our analysis leads to the emergence of five themes referred to as ART-IQ (Ambidexterity, Responsibility, Trust, Integrity, Quality). These five themes shine a light on the PhD supervisor/candidate relationship dynamic and are also core in theorising PhD supervision (in a P-BT context) as a sustainable leadership practice. Overall, we argue that viewing PhD supervision as sustainable leadership (in a P-BT context) suggests that the IQ (Integrity, Quality) is only achievable if the ART (Ambidexterity, Responsibility, Trust) elements are present.

Integration quality, value co-creation and resilience in logistics service supply chains: moderating role of digital technology

PurposeUsing the logistics service supply chain (LSSC) as a research object, this study focuses on the relationship between integration quality (IQ), value co-creation (VCC), and LSSC resilience. Moreover, it discusses the moderating role of digital technology (DT).Design/methodology/approachBased on data about China, this study used the structural equation model to test the research hypothesis. To verify the validity of each construct, this study used various established scales in the literature to conduct exploratory and confirmatory analysis.FindingsThe results show that IQ is an essential antecedent variable that promotes VCC and LSSC resilience. Moreover, this study confirms that DT has a positive moderating effect on the relationship between IQ, VCC, and resilience.Originality/valueThis study constructs a research framework to examine LSSC resilience and expands the theoretical research on the VCC theory in the supply chain literature. Moreover, this paper studies supply chain integration from a new perspective, that is, IQ, which is more in line with the reality of LSSC.

Omni-channel banking integration quality and perceived value as drivers of consumers’ satisfaction and loyalty

Purpose This research aims to enrich the literature related to the emerging topic of omni-channel. The purpose of this paper is to empirically investigate the relationship between omni-channel integration quality (IQ), omni-channel perceived value (PV), customer satisfaction and loyalty in the banking context. Design/methodology/approach A quantitative study was conducted to collect data. A web-based questionnaire was sent by an e-mail to a sample of 395 bank customers. Exploratory factor analysis and structural equation modelling were used for the statistical analysis of the data. Findings The results reveal that a high quality of omni-channel banking integration increases the PV of the omni-channel by the customer. There is also a positive relationship between PV and customer satisfaction, as well as customer loyalty, in the omni-channel banking context. A positive relationship between omni-channel IQ and customer satisfaction was also highlighted. Furthermore, customer loyalty can be increased through enhancing customer satisfaction within omni-channel banking. Practical implications Bank managers should provide a consistent omni-channel integration of their omni-channels, as it leads to a higher level of customers’ perception of value and it increases their satisfaction. A high IQ and PV of omni-channel could also be an efficient tool to promote customers’ long-term relationships, as it enhances satisfaction and loyalty towards the bank. Originality/value After being studied in a multi-channel context, this study extends the use of the concepts of IQ and PV on omni-channel. This research is among the few studies that empirically test nearly all the relationships of the research model in an omni-channel environment, in general, and in omni-channel banking, in particular. Furthermore, this research offers a comprehension of the omni-channel system from customer’s point of view, which is an insufficiently explored topic.

Abstract 2438: Rapid fluorescence based assessment of RNA integrity quality using machine learning

Abstract Much attention has been focused on RNA transcript bias. The quality of isolated mRNA used for RNA-seq and other downstream analyses can contribute to sample specific bias of transcript abundance. If the library is prepared from polyA enrichment of degraded RNA or with reverse transcriptase using oligo dT priming then 3′ positional bias must be considered (Irizarry 2016). Isolated total RNA is routinely examined for its quality prior to committing to costly gene expression analysis. Since total RNA consists of ~85% rRNA, analysis primarily reflects rRNA quality and the mRNA quality is inferred. Typically, measurements consist of 260/280 nm ratio, 28S/18S rRNA ratio and capillary electrophoresis fragment analysis or gel-based separation and imaging methods. These methods which have become industry standards of quality generate an RNA score such as RNA integrity number (RIN) between 0-10 with &amp;gt;8 being acceptable for RNA-seq. Generating RIN score requires experienced technical ability, specialized equipment, as well as additional cost and time prior to committing to the next step of building the library for sequencing. In this presentation we examine the integrity of the RNA using a combination of nucleic acid specific fluorescent dyes which display different binding specificity depending on the primary and secondary structure of the RNA. Fluorescence signal is analyzed using machine learning based algorithm. For machine learning, a training data set of data was generated, followed by a test set of data used to determine accuracy. Data depicting the actual vs. predicted class are reported in a confusion matrix. Variable of importance analysis was used to determine the factors most important for predicting accurate RNA integrity quality (IQ). With machine learning the initial determination of accuracy using the test data, ranged between 92.7 - 95.7% over the entire range depending on the algorithm. With further refinement of the machine learning approach, RNA IQ had an accuracy of ±0.65 and ± 0.39 standard deviation (SD) for IQ range 0 - 10 using the test data set. The accurate and low SD generated using nucleic acid binding dyes makes for a quick, simple and easy to use assessment of isolated RNA. The dye binding and fluorescent measurement is rapid and requires only a few minutes to generate. Comparison of the dye/RNA based fluorescence based determination of RNA IQ was benchmarked against the industry standards using the BioAnalyzer system (Agilent) to generate a RIN score and other gel analysis methods to determine concordance and utility of this method. Technical ability, cost and time investment are minimal allowing for rapid sample characterization prior to further analysis and commitment to downstream sequencing steps. Citation Format: Scott T. Clarke, Dylan Poulsen, Chris Vonnegut, Debra Gale, Kathy Free. Rapid fluorescence based assessment of RNA integrity quality using machine learning [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2438.

Opportunistic legitimisation and de-Europeanisation as a reverse effect of Europeanisation

This paper will look at the concept of de-Europeanisation through the prism of the official relations between the EU representatives and the political elites in two countries – Bulgaria and Serbia. Here de-Europeanisation is defined as a process of deterioration of the quality of integration or more simply as 'it is worse than it was'. The article begins with a critical overview of the dominant theoretical approaches to enlargement Europeanisation. Then, from a theoretical perspective, the article explores the role of EU legitimisation for national political elites. While distinguishing between revolutionary and opportunistic legitimisation, the paper highlights the former, based on Bulgaria and Serbia. Going beyond the liberal political narrative of democratic backsliding in Central Europe, the article will approach critically the dominant Europeanisation assumption of the unequivocally positive effect of European integration on national political elites. Particularly, it will examine the relevance of the argument that in the case of rule of law and human rights, the existing formal Europeanisation not only does not lead to informal Europeanisation of the states, but it can also have a reverse effect through the preservation of pathological political practices and their infusion into the process of European integration. The research will use a qualitative method of analysis to juxtapose the official EU/nation state political elites' rhetoric with political practices at the national level in the context of rule of law and human rights. Based on the findings, the paper argues that the EU oriented institutionalised perspective of Europeanisation omits important interactions on a micro-level that lead to the accommodation of political practices contradictory to EU's fundamental political values. While these practices survive in the peripheries of the integration process, they have the potential to multiply and eviscerate the fundamental political practices and thus the EU's political system.

Application of the Rasch rating scale model to the assessment of quality of life of persons with intellectual disability

Background Most instruments that assess quality of life have been validated by means of the classical test theory (CTT). However, CTT limitations have resulted in the development of alternative models, such as the Rasch rating scale model (RSM). The main goal of this paper is testing and improving the psychometric properties of the INTEGRAL Quality of Life Scale (i.e., fit statistics, person and item reliability coefficients) with RSM.Method The sample comprised 271 Spanish adults with intellectual disability.Results The results showed that the data fitted the model, point-biserial correlations were adequate, items showed precision, reliability of items (.98) and persons (.89) were adequate, and the response categories were suitable (thresholds were ordered). However, one item (“I feel excluded from society”) did not fit the model and a few items were too easy for participants to achieve.Conclusions Although it seems necessary to include more difficult items and to delete one, the INTEGRAL Scale is a useful instrument with evidence of validity.