Quality Movement Research Articles

FUNCTIONAL MOVEMENT SCREEN AND LOWER LIMB STRENGTH ASYMMETRY IN PROFESSIONAL SOCCER PLAYERS

BackgroundThe Functional Movement Screen (FMS) protocol consists of 7 tests (Cook & Burton, 2014). At higher values mean higher quality of movement execution. Lower limb functional asymmetry (FA) is monitored...

Key enabling factors for organizational ambidexterity in the public sector

PurposeThe capability of an organization to perform not only incremental quality improvements to the existing processes and products but also innovative or radical improvements that explore new opportunities is referred to as organizational ambidexterity. Research indicates that the long-term success of organizations demands a dynamic balancing of and excelling at both perspectives. However, there is considerably less clarity as regards how this can be achieved. The purpose of this paper is to empirically explore enabling factors for organizational ambidexterity in the public sector.Design/methodology/approachThis study is a qualitative study based on interviews with managers at two public organizations in Sweden. The analysis is conducted using a soft system methodology.FindingsNine enabling factors for organizational ambidexterity are identified and presented in two pictures inspired by the Soft System Methodology. The study indicates that it above all is important to create leeway for exploration to achieve organizational ambidexterity in the public sector. The study strengthens the belief that some quality movement values and tools can be considered important, whereas others can counteract the ability to achieve organizational ambidexterity in public administration.Practical implicationsPractitioners and scholars can use the identified enablers and the Soft System Methodology presented in this study to examine and develop the organizational ambidexterity of other public organizations.Originality/valueThis study explores empirically the concept of ambidexterity in the public sector, a perspective that few previous scholars have studied.

El movimiento de la Calidad en Colombia 1930-2010. Una mirada desde las políticas públicas

El interés por adelantar esta investigación, nace de la ausencia de información centralizada que permita observar cuál ha sido el proceso, que ha permitido la incorporación de las estrategias propias de la calidad en Colombia, tanto desde estudios propios de la gestión de la calidad, como desde aquellos construidos a partir de la historia económica o empresarial. El concepto de “movimiento” es tomado de las teorías de la cultura, porque la implementación de la calidad en los sectores industriales, trajo cambios en los modos, usos y formas de enfrentar el sistema productivo. Esta investigación presenta entonces, los principales momentos que ha influido en la adopción del movimiento de la calidad, haciendo un análisis sobre las políticas públicas (económicas y de gestión estatal, principalmente) y su posible influencia, en el avance de la infraestructura técnica y la adopción de la calidad en Colombia. Donde el papel del Estado desde la vigilancia, hasta la promoción de la calidad, parece evolucionar a la par de los cambios y estrategias presentes en los mercados cada vez más globalizados.

Evaluating outer segment length as a surrogate measure of peak foveal cone density

Adaptive optics (AO) imaging tools enable direct visualization of the cone photoreceptor mosaic, which facilitates quantitative measurements such as cone density. However, in many individuals, low image quality or excessive eye movements precludes making such measures. As foveal cone specialization is associated with both increased density and outer segment (OS) elongation, we sought to examine whether OS length could be used as a surrogate measure of foveal cone density. The retinas of 43 subjects (23 normal and 20 albinism; aged 6–67years) were examined. Peak foveal cone density was measured using confocal adaptive optics scanning light ophthalmoscopy (AOSLO), and OS length was measured using optical coherence tomography (OCT) and longitudinal reflectivity profile-based approach. Peak cone density ranged from 29,200 to 214,000cones/mm2 (111,700±46,300cones/mm2); OS length ranged from 26.3 to 54.5μm (40.5±7.7μm). Density was significantly correlated with OS length in albinism (p<0.0001), but not normals (p=0.99). A cubic model of density as a function of OS length was created based on histology and optimized to fit the albinism data. The model includes triangular cone packing, a cylindrical OS with a fixed volume of 136.6μm3, and a ratio of OS to inner segment width that increased linearly with increasing OS length (R2=0.72). Normal subjects showed no apparent relationship between cone density and OS length. In the absence of adequate AOSLO imagery, OS length may be used to estimate cone density in patients with albinism. Whether this relationship exists in other patient populations with foveal hypoplasia (e.g., premature birth, aniridia, isolated foveal hypoplasia) remains to be seen.

An Accelerometer-Assisted Transmission Power Control Solution for Energy-Efficient Communications in WBAN

Energy efficiency is a key issue in wireless body area networks (WBANs). A number of transmission power control (TPC) schemes have been developed to improve the efficiency of transmission, which is one of the most energy consuming operations in WBAN. To save energy, these schemes only probe the link quality from the received data packets. However, due to large intervals between data packets and fast dynamic on-body link characteristics in WBAN, the obtained link information is usually outdated. In this case, the performance of the current TPC scheme is poor. This paper proposes an accelerometer-assisted TPC (AA-TPC) scheme, which exploits the periodic fluctuations of link qualities to improve the transmission energy efficiency. Consider the relationship between link quality and body movement, AA-TPC makes transmissions at ideal channel points that are identified by using the local accelerometer. We first conduct experiments to investigate the correlation between periodic movements and link quality. Then, we propose an algorithm to locate the time point in each period with the best link quality to transmit packets. The specific transmission power is then determined by the feedback information from the receiver. Finally, we evaluate the energy efficiency of AA-TPC based on a CC2420 platform in both a periodic scenario (without any aperiodic movement to break the periodicity) and a realistic scenario (which has aperiodic movements 20% of the time). The results show that about 26.4% and 18% of total energy consumption can be saved on average in the periodic and realistic scenarios, respectively.

Kinesthetic Feedback During 2DOF Wrist Movements via a Novel MR-Compatible Robot

We demonstrate the interaction control capabilities of the MR-SoftWrist, a novel MR-compatible robot capable of applying accurate kinesthetic feedback to wrist pointing movements executed during fMRI. The MR-SoftWrist, based on a novel design that combines parallel piezoelectric actuation with compliant force feedback, is capable of delivering 1.5 N [Formula: see text] of torque to the wrist of an interacting subject about the flexion/extension and radial/ulnar deviation axes. The robot workspace, defined by admissible wrist rotation angles, fully includes a circle with a 20 deg radius. Via dynamic characterization, we demonstrate capability for transparent operation with low (10% of maximum torque output) backdrivability torques at nominal speeds. Moreover, we demonstrate a 5.5 Hz stiffness control bandwidth for a 14 dB range of virtual stiffness values, corresponding to 25%-125% of the device's physical reflected stiffness in the nominal configuration. We finally validate the possibility of operation during fMRI via a case study involving one healthy subject. Our validation experiment demonstrates the capability of the device to apply kinesthetic feedback to elicit distinguishable kinetic and neural responses without significant degradation of image quality or task-induced head movements. With this study, we demonstrate the feasibility of MR-compatible devices like the MR-SoftWrist to be used in support of motor control experiments investigating wrist pointing under robot-applied force fields. Such future studies may elucidate fundamental neural mechanisms enabling robot-assisted motor skill learning, which is crucial for robot-aided neurorehabilitation.

The Interplay between Quality Movement, Reputation and Funding on Private Students' Choice of Universities in Uganda

The current study purpose to analyse the influence of the quality movement on private students’ choice of universities in Uganda. First, the paper points out the fact that there is a quality movement in Uganda’s higher education sub-sector. Second, it was found that quality movement have a significant relationship with the reputation of a university [r (392) =.629, p<0.01]. Third, there was a significant relationship between reputation and funding [r (392) =. 596, p<0.01]. Fourth, there was a significant relationship between funding and choice [r (392) =.512, p<0.01]. Fifth, there was a significant relationship between quality and choice of a university by private students [r (392) =.636, p<0.01]. It was concluded that quality influenced students’ choices of universities in Uganda.

Automatic basal slice detection for cardiac analysis.

Identification of the basal slice in cardiac imaging is a key step to measuring the ejection fraction of the left ventricle. Despite all the effort placed on automatic cardiac segmentation, basal slice identification is routinely performed manually. Manual identification, however, suffers from high interobserver variability. As a result, an automatic algorithm for basal slice identification is required. Guidelines published in 2013 identify the basal slice based on the percentage of myocardium surrounding the blood cavity in the short-axis view. Existing methods, however, assume that the basal slice is the first short-axis view slice below the mitral valve and are consequently at times identifying the incorrect short-axis slice. Correct identification of the basal slice under the Society for Cardiovascular Magnetic Resonance guidelines is challenging due to the poor image quality and blood movement during image acquisition. This paper proposes an automatic tool that utilizes the two-chamber view to determine the basal slice while following the guidelines. To this end, an active shape model is trained to segment the two-chamber view and create temporal binary profiles from which the basal slice is identified. From the 51 tested cases, our method obtains 92% and 84% accurate basal slice detection for the end-systole and the end-diastole, respectively.

Quality Measurement and Accountability in Cardiovascular Medicine: An Incomplete Revolution.

The rise of quality measurement and the proliferation of programs that require accountability for quality are among the most dramatic developments in cardiovascular medicine in the past 2 decades. The quality revolution now affects the daily practice of virtually every cardiovascular clinician and has influenced national health policy. Over time, however, both the successes and limitations of the quality movement have become apparent. As is often the case with revolutionary changes, quality measurement and the uses of these measures merit reflection and consideration of further change. For years, quality measurement played an insignificant role in medicine. This changed with a growing appreciation of substantial unexplained variation in healthcare practice in parallel with seemingly unrestrained increases in care costs. The actions of the Health Care Financing Administration, now the Centers for Medicare & Medicaid Services, are illustrative of this evolution. Having employed the ineffectual approach of performing individual case review (quality assurance) of negative outliers, the Health Care Financing Administration adopted the relatively radical approach of measuring quality nationally in the hopes of stimulating improvement for all institutions and providers in the early 1990s.1 The Health Care Financing Administration’s Cooperative Cardiovascular Project measured the quality of care for acute myocardial infarction; subsequent efforts expanded to other high-impact conditions, including heart failure. Although these programs focused entirely on measuring processes of care (eg, rates of use of evidence-based therapies for acute myocardial infarction and heart failure) and did not address strategies for quality improvement, they introduced clinicians and hospitals to formal …

Korean quality – past, present, and future

The article discusses the key activities in the process of enhancing quality to attain excellence in Korea by investigating the key issues addressed by both government and scholars over the past 60 years. The key quality initiatives were classified by decade and presented customer needs, government policies, and objectives at each of the six decades. A thorough counting process using the research articles published in Korea was also conducted to delineate the main research themes. The current strengths and weaknesses of Korean quality were summarised according to MBQ (Motivation-based Quality), SBQ (System-based Quality), and KBQ (Knowledge-based Quality). Finally, a set of strategic issues were identified and converted into five long-term tasks required to create a new slope for the future of Korean quality. We regard this study as unique in that it summarises Korea’s long-term quality initiatives of the past 60 years and proposes new strategic issues for the future of Korean quality. The results of this study are expected to provide policy-makers and scholars with a new understanding of Korea’s quality movement from the Past to the Present and the Future.

Spermatozoa Motility Parameters of the Pumpkinseed (Lepomis gibbosus) in a Standardized Solution and Ambient Water.

The sunfish are classified as an invasive species after their introduction into a new habitat. Milt quality and spermatozoa movement in several sunfish were described. The aim of this study was to determine the basic milt characteristics and spermatozoa motility parameters in pumpkinseed males after using ambient water and a standardized solution to examine the parameters in mimicked natural conditions and in controlled conditions allowing interspecies data comparisons. Nine spermatozoa motility parameters were traced using computer-assisted sperm analysis (CASA) after activation with 30 mM NaCl and ambient water at 20°C. Spermatozoa motility parameters on activation, except for ALH, differed after using saline solution and ambient water. The CASA parameters were higher in the first medium. On the other hand, spermatozoa motility was high in both media, with an average of 89.6 and 85.2% in saline solution and ambient water, respectively. In the media, initial spermatozoa motility was characterized by a mean curvilinear velocity of 122.4 and 108.5 μm s-1, and a linearity of 79.7 and 67.1%, respectively. The active motility phase in the saline solution was approx. 8 min was longer than that measured in ambient water (mean 3 min). The pumpkinseed spermatozoa reveal good motility parameters, especially the high percentage of motile sperm, linearity, long duration of spermatozoa movement, as well as good velocity. It can be assumed that apart from reproductive strategy, spermatozoa motility parameters are valuable features of the male reproductive biology which may contribute to reproductive success.

Evolution and implementation of quality management practices in the manufacturing sector in Eastern Europe after the end of communism

Purpose – The purpose of this paper is to answer the following three questions: what influence has the centrally planned economy and Soviet-style manufacturing had on the evolution and implementation of quality management practices in Bulgaria’s manufacturing sector since the end of the communism; have Bulgaria and its businesses been able to embrace modern quality management philosophies such as TQM, which at times preach the exact opposite philosophies of the Soviet-style manufacturing; and if so, how advanced is the quality mindset of Bulgarian manufacturing businesses today – 24 years after the end of communism? Design/methodology/approach – The paper relies mainly on qualitative research methods. The authors have opted for exploratory approach. Besides an array of articles from scholarly journals, books, and conference proceedings, the authors have relied on five in-depth, semi-structured interviews and one case study in the form of plant visit and observations. The authors have used a framed analytical approach for interpreting the empirical data. Findings – The paper argues that the slow and painful transition from a centrally planned to market economy has impeded the evolution and implementation of QM practices in Bulgaria. More precisely, haphazard reforms in education, lack of highly qualified individuals due to the brain drain in the early 1990s, and the workers’ strong resistance to change have been among the main obstacles in the case of the quality movement. Research limitations/implications – The work presented in this paper is just the beginning of a series of studies on the quality management initiatives in Bulgaria. To go deeper into the topic, the authors realize that further research in a number of different directions is required. The first direction is related to the degree of relevance of Management Sovieticus in the twenty-first century, which somehow has been completely neglected as a research topic in the last decade. The second direction lies in the aspect of the attributes of Bulgarian managers and their perception toward the importance of the role of quality today. Practical implications – Countries with similar, political, economic, and social backgrounds – former Eastern Bloc members – can profit a great deal from the authors’ work. More than 20 years since the end of communism, both researchers and entrepreneurs, especially those from the West, have been neglecting the legacy of the centrally planned economy, which has been a major reason for the great number of business failures in the region. The authors’ work seeks to awaken those who still believe that two decades are sufficient to eradicate fully the unfortunate legacy of the command economy. Originality/value – Little, not to say incremental, research on the quality initiatives in Eastern Europe (*except for Russia) has been conducted so far. As to Bulgaria, the investigation reveals no significant studies on quality management, especially ones published in English. Hence, the authors’ work is the first international study on the evolution and implementation of QM practices in Bulgaria.

Soil spreading of liquid olive mill processing wastes impacts leaching of adsorbed terbuthylazine

Olive mill waste water (OMWW) is a major byproduct of the three phase olive oil production process. OMWW has high acidity (pH ∼ 4–5), high salt content (EC ∼ 5–10 mS cm−1), extremely high biological and chemical oxygen demand (BOD and COD up to 100,000 and 220,000 mg L−1, respectively), and also high concentrations of organic compounds such as phenols and polyphenols. As a result, OMWW cannot be freely discharged into domestic wastewater treatment plants, but on-site treatment is very expensive and not sufficiently effective. Uses for OMWW such as agricultural recycling and co-composting were found to be impractical or expensive. Thus, OMWW is frequently spread on agricultural land for disposal. However, excessive or uncontrolled spreading of such organic-rich and saline wastewater could have many deleterious effects on soil quality, including salinization, phytotoxicity, or contaminant movement. The impact of OMWW on the leaching of adsorbed terbuthylazine, a soil-applied herbicide, was tested in four soils of varying physical and chemical properties. Although terbuthylazine solubility in OMWW is significantly higher than in water, leaching of adsorbed terbuthylazine from OMWW-treated soils was less than from control treatments. Low soil organic carbon and clay contents were major factors that contributed to reduced terbuthylazine leaching after soil treatment with OMWW.

Does Money Really Talk? A Resident-Driven Pay-for-Performance Pilot.

I n this issue of the Journal of Graduate Medical Education, an article entitled ‘‘Successful resident engagement in quality improvement: the Detroit Medical Center story’’ by Hussain et al presents an interesting foray into the world of payfor-performance. The authors focused on a residentdriven pay-for-performance initiative that targeted venous thromboembolism (VTE) prevention and stroke care in a large urban academic medical center. In addition to being predominantly resident-driven, the intervention is unique, in that it successfully obtained full institutional support of an educational endeavor. It thus serves as an excellent example of what can be achieved when educational and institutional goals are aligned. The article also highlights the importance of adopting adjunctive software that augments established electronic health record systems to improve the quality of care delivered to a target population. In the pilot described by the authors, a decision support tool was utilized that tailored evidence-based recommendations for VTE prevention and stroke care to the patients being evaluated. The study offers a first look into whether resident behavior can be modified by the use of financial incentives. We know from earlier research that physicians’ performance can be changed, for better or for worse, based on financial incentives. The most illustrative example of financially motivated behavioral changes comes from a 2004 United Kingdom (UK) experiment. Family medicine physicians were incentivized to adhere to 136 clinically based core measures, known collectively as the Quality and Outcomes Framework. As we now know, the results were astounding, in that the payouts reached 83.4% of available incentive payments within the first year of the program and increased to 97.8% by 2007. Hussain et al have shown that resident behavior can similarly be altered by financial motivations. As educators, it is encouraging to know that an educational program can achieve results of this magnitude across multiple disciplines and at the same time be completely self-policed and self-maintained. Not only does this exemplify the importance of institutional buy-in, but it also demonstrates the success that can be achieved through engagement of front-line staff rather than through blanket edicts. To date, most residency programs have predominately payed lip service to the quality movement, asking trainees to understand the relevance of quality metrics and pay-for-performance by using hypothetical scenarios rather than real life situations. While this program demonstrated resounding success in achieving the designated performance measures, a number of concerns spring to light related to the integrity of the pay-for-performance concept. The performance metrics used in the authors’ study were process measures, chosen for their ease of measurement and the ease with which they can define success. The reader is left with the age-old question of whether achieving these measures had an impact on clinically relevant outcomes, and if so, were the outcomes such that the financial input necessary to achieve them was reasonable. We know that to implement such a broad and far-reaching residentrun program using additional electronic health record decision support, a $250,000 startup cost was required. It would be interesting to know whether the hospital realized equivalent cost savings as a result of this initiative. Similar to questions raised by the UK experiment, with the intervention described by Hussain et al there are issues to be considered on a local level. The achievement gap discussed in this article was extremely narrow, with compliance rates for VTE performance measures increasing from 88.5% at baseline, to 94.2% at 6 months, and an astounding 100% at 12 months. Similarly, the performance measures for stroke care improved from a baseline of 88%, to 96.6% in 6 months, to 100% compliance at 12 months. While impressive, one could argue that with the preimplementation baseline being so high, such improvements have little practical meaning in terms of both cost savings and patient outcome benefits. Readers also should be wary any time a performance indicator achieves and maintains longterm sustainability at 100% compliance. While we revel in these outcomes, ‘‘to err is human,’’ even with decision support programs. The 100% success rates compel us to ask: Were there patients who were inappropriately excluded from the denominator DOI: http://dx.doi.org/10.4300/JGME-D-16-00105.1

An Improved Decision-Making Model for Multimedia Teaching and College Students’ Physical Health: an Empirical Analysis of Wushu Education

Multimedia teaching is a new kind of teaching mode, it makes multimedia computer as the core, and includes sound, images, text and animation. In multimedia teaching, teaching is always the main body, and multimedia is to cooperate with the teaching. In this paper, we make empirical analysis of performance evaluation of the multimedia teaching, the study subjects is martial arts courses in colleges. The result shows that after experiment, the students’ psychological quality and body movement quality have very significant increase, Body function and body form has improved. At the same time, college students give a better evaluation of the multimedia class, so multimedia teaching is worth promoting.

Quality of Work Life and Organizational Performance

Background The quality movement in health care has recognized better quality of work life (QWL) of employees as an important rubric for a health care organization’s performance. Health care employees are the front lines of the health care delivery system. However, studies on the QWL of private health care unit’s employees are limited. Methodology This research investigates the relationship between QWL, organizational performance (OP) and employee commitment (EC). A self-designed questionnaire was distributed to 300 health care employees. Out of which only 205 valid responses were received resulting in a response rate of 68 per cent from the survey. The data were analyzed using SPSS 20. Results The findings show that EC acts as a partial and a significant mediator in the relationship between QWL and OP. Mediation analysis was also conducted for each dimension of QWL, EC and OP to reinforce the results. Conclusions and Recommendations Findings can be used by health care units’ managers and policy makers to design and implement appropriate initiatives to improve QWL. Better QWL is the key to attract and retain qualified and motivated employees and can possibly lead to enhanced quality of services in health care organizations.

Quality and Safety in Health Care, Part I: Five Pioneers in Quality.

Five pioneers had a huge impact on the quality movement in health care in the United States. Ernest Codman contributed in many ways, including his focus on outcome analysis. Avidis Donabedian is known for his focus on the 3 domains of structure, process, and outcome in health care. Walter Shewhart is known especially for the control chart and early work on what W. Edwards Deming made into the PDSA cycle. Deming is also known for other contributions, including his 14 points of management, correcting system problems rather than blaming the workers, and his System of Profound Knowledge. Juran is known for the Pareto principle and his emphasis on customer satisfaction and addressing the human, not just statistical side, of quality improvement.

Why should and how can hospitals improve their organizational health literacy?

In late modern "multi-option" and "health" societies, health literacy (HL), understood as a specific competence, is considered necessary to successfully deal with the multitude of health relevant decisions and tasks to be taken every day. The concept has been used in the US, primarily in healthcare, to research the consequences of HL on the outcome of treatment specifically in patients with limited HL. In this context, it became evident that HL has to be understood as a relational or contextual concept. That is, the adequacy of HL does not only depend on personal HL, but equally on the demands organizations put on their users. This understanding of HL opened the road to measure not only individual HL, but also the HL sensitivity of organizations, i.e. organizational HL, and to use targeted measures to improve it. The ten attributes of a health-literate healthcare organization, as defined by the US Institute of Medicine, are a first systematic attempt to use this strategy in healthcare. In the meantime, the strategy has been used in other settings as well. Using experiences from health-promoting hospitals and the quality movement in healthcare, the authors develop this approach further into the comprehensive Vienna concept of the health-literate hospital, which considers all stakeholders and tasks of the hospital which are relevant for HL. A self-assessment tool was developed and tested as a basic instrument for developing a health-literate hospital. By doing so, hospitals are empowered to make a contribution to the promotion of HL as an important societal task.

3D Transient CFD Simulation of Scroll Compressors with the Tip Seal

A new template simulation tool is developed for scroll compressors/expanders capable of modelling tip seal leakages. This scroll template generates a high quality 3D multiblock structured mesh from user-input stationary and orbiting scroll surfaces. The mesh movement is then automatically calculated to account for every position of the orbiting scroll, maintaining good grid quality and smooth movement throughout the whole revolution. A state- of-the-art efficient CFD solver is used to solve Navier-Stokes equations, capable of simulation with both real gas and ideal gas. A case study is presented for a generic scroll compressor with refrigerant R410A. The case was run with and without the tip seal volumes. Comparisons are made to show the impact of tip seals on the compressor performance.

The paradigm shift to Business Excellence 2.0

Purpose – This paper aims to contribute to the debate on business excellence by comparing the business excellence models of Malcolm Baldrige, European Foundation for Quality Management and Swedish Institute for Quality. By assessing these in relation to today’s new business landscape, the authors suggest that emphasising issues such as stakeholder co-creation of value, stakeholder dialogue, service innovation, service logic, business ethics and different views on resource integration can alter the view of quality improvement from economic, social and environmental perspectives, in turn, leading to Business Excellence 2.0. Design/methodology/approach – This study examines three business excellence models and compares their adoption of the concepts of today’s new business landscape. The study focuses on whether the models’ fundamental principles and concepts are aligned with the views on sustainability, stakeholder co-creation and service innovation. Findings – The examined business excellence models do not fully respond to the requirements of today’s business landscape. To gain relevance in the private sector, the fundamental ideas of the models in terms of concepts, criteria and evaluation processes must be rethought. Such an opportunity enables the quality movement and service logic research to come together to develop new business excellence models that incorporate the challenges of today’s business landscape. Research limitations/implications – This paper illustrates the need to develop business excellence models to address the perspectives of today’s new business landscape. Practical implications – By incorporating strategies in sustainability, stakeholder co-creation and service innovation in business excellence models, organisations can deliver sustainable business growth. Originality/value – The paper sheds new light on how business excellence models can incorporate aspects of the new business landscape. It also shows how the quality movement and the ongoing service logic research can come together to develop a new business excellence model that addresses the challenges in the new business landscape.