Challenges of measuring and linking patient outcomes to nursing interventions in acute care settings

Measuring and linking patient outcomes to nursing intervention is an important task that has professional, financial and political ramifications. The importance and complexity of measuring patient outcomes accurately should not be overlooked, as there are a number of emergent factors that influence this process. These include the turbulent context of practise, variations in care due to the large number of health professionals, individual patient characteristics impacting on outcomes, determining appropriate nursing outcome measures, nursing's lack of autonomy within the system and difficulties experienced while trying to link patient outcomes to nursing interventions. So that the results reflect reality, it is important for researchers in the field to take note and consider these factors when measuring patient outcomes. The present article aimed to examine and discuss a number of these factors as they relate to the evaluation of patient care.

An effective non-parametric method for globally clustering genes from expression profiles

Clustering is widely used in bioinformatics to find gene correlation patterns. Although many algorithms have been proposed, these are usually confronted with difficulties in meeting the requirements of both automation and high quality. In this paper, we propose a novel algorithm for clustering genes from their expression profiles. The unique features of the proposed algorithm are twofold: it takes into consideration global, rather than local, gene correlation information in clustering processes; and it incorporates clustering quality measurement into the clustering processes to implement non-parametric, automatic and global optimal gene clustering. The evaluation on simulated and real gene data sets demonstrates the effectiveness of the algorithm.

Ferals, nomads, drifters, gypsies, vagrants, blow-ins, thieves, troublemakers, tricksters and terrorists : creative writing, from creative industries to creative ecologies

In this paper I consider some issues that I, as a creative writer and academic, find with the concept and current understandings of the term creative industries. The subject of creative industries is not one that has been adequately teased out in relation to creative writing, even though the creative industries model has been a strong force in cultural policymaking internationally since the late 1990s. It influences policies that in turn may affect writers, especially those applying for state or national funds to resource their writing, and also writers working within the academy and attempting to gain recognition and funding for creative work there. The issues relating to creative industries are also particularly pertinent at this time in Australian universities, as the new system of research quality measurement is negotiated, and creative arts scholars, including those in creative writing, struggle to define their work in terms of those negotiations. I will argue that the recent work of Paul Carter looks towards ways in which creative industries may be more inclusive and useful for the creative arts, including creative writing, and suggest that a reclaimed term, creative ecologies, indicates a good way of taking creative industries into the future.

Análise da influência da qualidade em um ciclo de serviços na satisfação do cliente: estudo de caso em uma instituição de ensino.

With the increasing offer of education services in Brazil, it is necessary to evaluate the quality of service in education, especially in those institutions for vocational education which have a greater interaction with the labor market, in order to form qualified professionals and meet the growing demand that the country has today[A1] . In Brazil, the evaluation of the quality of library services has influenced the assessment of educational institutions and in this context, there needs to be a process to monitor the quality of services provided by libraries. However, the service is not done in a single moment and thus to a more detailed assessment it needs to be measured and evaluated each different time the customer uses it. Therefore, the aim of this work consists in measuring the quality in every moment of truth of a cycle of library services to assess which are the most relevant moments in the client's perspective at the library of the Federal Institute of Education, Science and Technology of Rio Grande do Norte (IFRN) Campus João Câmara in building the overall quality of service. In the literature review, internal secondary sources were used, from the database of the institution studied, and also external sources, through literature in books, articles, dissertations, theses and journals on compost quality, service quality, cycle services, measuring quality, satisfaction, teaching activities, and on library services specifically. We applied a questionnaire to students in the library based on models of quality measurement SERVPERF and SERVQUAL and its variations such as SERVQUAL pondered and SERVPERF pondered . Through analysis based on concepts of reliability and validity of measuring instruments, it was found that the SERVPERF model is the instrument that most closely matches the dimensions of quality assessed in the library with customer satisfaction measured by the questionnaire. From there, the search results as measured by statistical techniques of analysis, indicated that the initial and final moments of truth of the cycle of service quality had the greatest influence on overall customer satisfaction with the library service

Comparative Analysis of Objective Distortion Measures for Speech Signals Degraded by Noise

Speech signals degraded by additive noise can affects different applications in telecommunication. The noise may degrades the intelligibility of the speech signals and its waveforms as well. In some applications such as speech coding, both intelligibility and waveform quality are important but only intelligibility has been focused lastly. So, modern speech quality measurement techniques such as PESQ (Perceptual Evaluation of Speech Quality) have been used and classical distortion measurement techniques such as Cepstral Distance are becoming unused. In this paper it is shown that some classical distortion measures are still important in applications where speech corrupted by additive noise has to be evaluated.

Inequality and academic achievement in Chile

Includes bibliography

O Ministério Público estadual e a justiciabilidade do direito à qualidade do ensino fundamental público no Brasil: funções e interpretações

Pós-graduação em Educação - FCT

Moisture content and its influence on the roughness and noise emission during wood machining

Numerous factors influencing the surface quality of wood after machining, among them we highlight the machining parameters and the properties of the wood. In the analysis of the influence of these factors on machining and in determining the quality measurement systems are used to obtain surface characteristics, these systems are divided into methods of contact and non-contact. The method for mechanical contact performed with the aid of the surface roughness tester is the most valued in the measurement of roughness of wood, however, aiming at a greater agility in these measurements, there is a need to seek alternatives for evaluation of surface quality, and one of these options is to use the forms of indirect measurements of this quality, as for example, the use of noise emission during the machining process. With this, the aim was to analyze the influence of the moisture content of the wood, at different levels, on surface quality of the species Pinus elliottii, determined by the method of mechanical probing move and relate this roughness with the sound emission issued for each class of humidity, during machining. The planning of experiments and statistical analyses were performed with the help of Taguchi method. The specimens were conditioned in greenhouses climatizadoras automatics for obtaining three classes of humidity. Machining tests of wooden pieces were performed on a machining center specific for this type of material. The roughness values were measured by a roughness verifier and the noise emission values were measured by for a measurer sound pressure level. Statistically significant differences were observed, the significance level of 10 %, on roughness and noise emission between the three levels of moisture. It was observed that with the increase in the moisture content occurred an increase of roughness and a reduction in noise emission. Monitoring of surface quality through noise level is an interesting alternative to the method of mechanical contact.

Vortex dynamics in the high-temperature superconductors YBa 2 Cu 3 O 7 and Bi 2 Sr 2 CaCu 2 O 8 + delta in low- and high-dissipative transport measurements

This thesis investigates phenomena of vortex dynamics in type II superconductors depending on the dimensionality of the flux-line system and the strength of the driving force. In the low dissipative regime of Bi_2Sr_2CaCu_2O_{8+delta} (BSCCO) the influence of oxygen stoichiometry on flux-line tension was examined. An entanglement crossover of the vortex system at low magnetic fields was identified and a comprehensive B-T phase diagram of solid and fluid phases derived.In YBa_2Cu_3O_7 (YBCO) extremely long (>100 mm) high-quality measurement bridges allowed to extend the electric-field window in transport measurements by up to three orders of magnitude. Complementing analyses of the data conclusively produced dynamic exponents of the glass transition z~9 considerably higher than theoretically predicted and previously reported. In high-dissipative measurements a voltage instability appearing in the current-voltage characteristics of type II superconductors was observed for the first time in BSCCO and shown to result from a Larkin-Ovchinnikov flux-flow vortex instability under the influence of quasi-particle heating. However, in an analogous investigation of YBCO the instability was found to appear only in the temperature and magnetic-field regime of the vortex-glass state. Rapid-pulse measurements fully confirmed this correlation of vortex glass and instability in YBCO and revealed a constant rise time (~µs).

An Integrated approach to street canyon pollution modelling.

An integrated method for the prediction of the spatial pollution distribution within a street canyon directly from a microscopic traffic simulation model is outlined. The traffic simulation package Paramics is used to model the flow of vehicles in realistic traffic conditions on a real road network. This produces details of the amount of pollutant produced by each vehicle at any given time. The authors calculate the dispersion of the pollutant using a particle tracking diffusion method which is superimposed on a known velocity and turbulence field. This paper shows how these individual components may be integrated to provide a practical street canyon pollution model. The resulting street canyon pollution model provides isoconcentrations of pollutant within the road topography.

Revisiting the conceptualization and measurement of service quality

Since the 1980s, industries and researchers have sought to better understand the quality of services due to the rise in their importance (Brogowicz, Delene and Lyth 1990). More recent developments with online services, coupled with growing recognition of service quality (SQ) as a key contributor to national economies and as an increasingly important competitive differentiator, amplify the need to revisit our understanding of SQ and its measurement. Although ‘SQ’ can be broadly defined as “a global overarching judgment or attitude relating to the overall excellence or superiority of a service” (Parasuraman, Berry and Zeithaml 1988), the term has many interpretations. There has been considerable progress on how to measure SQ perceptions, but little consensus has been achieved on what should be measured. There is agreement that SQ is multi-dimensional, but little agreement as to the nature or content of these dimensions (Brady and Cronin 2001). For example, within the banking sector, there exist multiple SQ models, each consisting of varying dimensions. The existence of multiple conceptions and the lack of a unifying theory bring the credibility of existing conceptions into question, and beg the question of whether it is possible at some higher level to define SQ broadly such that it spans all service types and industries. This research aims to explore the viability of a universal conception of SQ, primarily through a careful re-visitation of the services and SQ literature. The study analyses the strengths and weaknesses of the highly regarded and widely used global SQ model (SERVQUAL) which reflects a single-level approach to SQ measurement. The SERVQUAL model states that customers evaluate SQ (of each service encounter) based on five dimensions namely reliability, assurance, tangibles, empathy and responsibility. SERVQUAL, however, failed to address what needs to be reliable, assured, tangible, empathetic and responsible. This research also addresses a more recent global SQ model from Brady and Cronin (2001); the B&C (2001) model, that has potential to be the successor of SERVQUAL in that it encompasses other global SQ models and addresses the ‘what’ questions that SERVQUAL didn’t. The B&C (2001) model conceives SQ as being multidimensional and multi-level; this hierarchical approach to SQ measurement better reflecting human perceptions. In-line with the initial intention of SERVQUAL, which was developed to be generalizable across industries and service types, this research aims to develop a conceptual understanding of SQ, via literature and reflection, that encompasses the content/nature of factors related to SQ; and addresses the benefits and weaknesses of various SQ measurement approaches (i.e. disconfirmation versus perceptions-only). Such understanding of SQ seeks to transcend industries and service types with the intention of extending our knowledge of SQ and assisting practitioners in understanding and evaluating SQ. The candidate’s research has been conducted within, and seeks to contribute to, the ‘IS-Impact’ research track of the IT Professional Services (ITPS) Research Program at QUT. The vision of the track is “to develop the most widely employed model for benchmarking Information Systems in organizations for the joint benefit of research and practice.” The ‘IS-Impact’ research track has developed an Information Systems (IS) success measurement model, the IS-Impact Model (Gable, Sedera and Chan 2008), which seeks to fulfill the track’s vision. Results of this study will help future researchers in the ‘IS-Impact’ research track address questions such as: • Is SQ an antecedent or consequence of the IS-Impact model or both? • Has SQ already been addressed by existing measures of the IS-Impact model? • Is SQ a separate, new dimension of the IS-Impact model? • Is SQ an alternative conception of the IS? Results from the candidate’s research suggest that SQ dimensions can be classified at a higher level which is encompassed by the B&C (2001) model’s 3 primary dimensions (interaction, physical environment and outcome). The candidate also notes that it might be viable to re-word the ‘physical environment quality’ primary dimension to ‘environment quality’ so as to better encompass both physical and virtual scenarios (E.g: web sites). The candidate does not rule out the global feasibility of the B&C (2001) model’s nine sub-dimensions, however, acknowledges that more work has to be done to better define the sub-dimensions. The candidate observes that the ‘expertise’, ‘design’ and ‘valence’ sub-dimensions are supportive representations of the ‘interaction’, physical environment’ and ‘outcome’ primary dimensions respectively. The latter statement suggests that customers evaluate each primary dimension (or each higher level of SQ classification) namely ‘interaction’, physical environment’ and ‘outcome’ based on the ‘expertise’, ‘design’ and ‘valence’ sub-dimensions respectively. The ability to classify SQ dimensions at a higher level coupled with support for the measures that make up this higher level, leads the candidate to propose the B&C (2001) model as a unifying theory that acts as a starting point to measuring SQ and the SQ of IS. The candidate also notes, in parallel with the continuing validation and generalization of the IS-Impact model, that there is value in alternatively conceptualizing the IS as a ‘service’ and ultimately triangulating measures of IS SQ with the IS-Impact model. These further efforts are beyond the scope of the candidate’s study. Results from the candidate’s research also suggest that both the disconfirmation and perceptions-only approaches have their merits and the choice of approach would depend on the objective(s) of the study. Should the objective(s) be an overall evaluation of SQ, the perceptions-only approached is more appropriate as this approach is more straightforward and reduces administrative overheads in the process. However, should the objective(s) be to identify SQ gaps (shortfalls), the (measured) disconfirmation approach is more appropriate as this approach has the ability to identify areas that need improvement.

Quality of child abuse information for measurement and surveillance : linking hospital and child welfare data

National estimates of the prevalence of child abuse-related injuries are obtained from a variety of sectors including welfare, justice, and health resulting in inconsistent estimates across sectors. The International Classification of Diseases (ICD) is used as the international standard for categorising health data and aggregating data for statistical purposes, though there has been limited validation of the quality, completeness or concordance of these data with other sectors. This research study examined the quality of documentation and coding of child abuse recorded in hospital records in Queensland and the concordance of these data with child welfare records. A retrospective medical record review was used to examine the clinical documentation of over 1000 hospitalised injured children from 20 hospitals in Queensland. A data linkage methodology was used to link these records with records in the child welfare database. Cases were sampled from three sub-groups according to the presence of target ICD codes: Definite abuse, Possible abuse, unintentional injury. Less than 2% of cases coded as being unintentional were recoded after review as being possible abuse, and only 5% of cases coded as possible abuse cases were reclassified as unintentional, though there was greater variation in the classification of cases as definite abuse compared to possible abuse. Concordance of health data with child welfare data varied across patient subgroups. This study will inform the development of strategies to improve the quality, consistency and concordance of information between health and welfare agencies to ensure adequate system responses to children at risk of abuse.

Service quality and performance measurement : evidence from the Indian Water Sector

The conventional measures of benchmarking focus mainly on the water produced or water delivered, and ignore the service quality, and as a result the 'low-cost and low-quality' utilities are rated as efficient units. Benchmarking must credit utilities for improvements in service delivery. This study measures the performance of 20 urban water utilities using data from an Asian Development Bank survey of Indian water utilities in 2005. It applies data envelopment analysis to measure the performance of utilities. The results reveal that incorporation of a quality dimension into the analysis significantly increases the average performance of utilities. The difference between conventional quantity-based measures and quality-adjusted estimates implies that there are significant opportunity costs of maintaining the quality of services in water delivery.