Is language a barrier for quality care in hospitals? A case series from an Emergency Department of a teaching hospital in Brisbane

Aim: The aim of this pilot study is to describe the use of an Emergency Department (ED) at a large metropolitan teaching hospital by patients who speak English or other languages at home. Methods: All data were retrieved from the Emergency Department Information System (EDIS) of this tertiary teaching hospital in Brisbane. Patients were divided into two groups based on the language spoken at home: patients who speak English only at home (SEO) and patients who do not speak English only or speak other language at home (NSEO). Modes of arrival, length of ED stay and the proportion of hospital admission were compared among the two groups of patients by using SPSS V18 software. Results: A total of 69,494 patients visited this hospital ED in 2009 with 67,727 (97.5%) being in the SEO group and 1,281 (1.80%) in the NSEO group. The proportion of ambulance utilisation in arrival mode was significantly higher among SEO 23,172 (34.2%) than NSEO 397 (31.0%), p <0.05. The NSEO patients had longer length of stay in the ED (M = 337.21, SD = 285.9) compared to SEO patients (M= 290.9, SD = 266.8), with 46.3 minutes (95%CI 62.1, 30.5, p <0.001) difference. The admission to the hospital among NSEO was 402 (31.9%) higher than SEO 17,652 (26.6%), p <0.001. Conclusion: The lower utilisation rates of ambulance services, longer length of ED stay and higher hospital admission rates in NSEO patients compared to SEO patients are consistent with other international studies and may be due to the language barriers.

The influence of service quality and trade show effectiveness on post-show purchase intention

Purpose The purpose of this paper is to develop and test an integrative services framework to investigate the role of perceived trade show effectiveness on overall trade show service outcome, conceptualised as the intention to purchase a related product after, rather than during, a show. Design/methodology/approach Drawing on the services marketing and trade show literature, the authors test a model of trade show effectiveness with data collected from 592 attendees at a major automotive trade show in a large metropolitan centre. Findings Results show that improving trade show visitors' perceived service quality positively affects visitor perceptions of trade show effectiveness. Furthermore, both trade show effectiveness and service quality directly influence future purchase intention. Research limitations/implications Employing a services theoretical framework to evaluate trade show visitor experiences provides an alternative to the traditional marketing communications approach. By viewing such visits as service encounters, managers must inevitably consider the effects of service quality and service outcomes in determining the likely success of their shows. The study primarily focuses on one large consumer show and therefore does not constitute a complete, nor necessarily representative, sample of the trade show industry. Originality/value The original contribution of the paper stems from the paucity of research conceptualising trade shows as services and the comparative lack of emphasis placed on visitors rather than exhibitors in the literature. The research not only has utility for trade show organisers but also provides necessary theory-based research in the trade show domain.

IS service quality as a multi-dimensional formative constuct

This study is motivated by, and proceeds from, a central interest in the importance of evaluating IS service quality and adopts the IS ZOT SERVQUAL instrument (Kettinger & Lee, 2005) as its core theory base. This study conceptualises IS service quality as a multidimensional formative construct and seeks to answer the main research questions: “Is the IS service quality construct valid as a 1st-order formative, 2nd-order formative multidimensional construct?” Additionally, with the aim of validating the IS service quality construct within its nomological net, as in prior service marketing work, Satisfaction was hypothesised as its immediate consequence. With the goal of testing the above research question, IS service quality and Satisfaction were operationalised in a quantitative survey instrument. Partial least squares (PLS), employing 219 valid responses, largely evidenced the validity of IS service quality as a multidimensional formative construct. The nomological validity of the IS service quality construct was also evidenced by demonstrating that 55% of Satisfaction was explained by the multidimensional formative IS service quality construct.

A formative measurement model of business process model quality

Business process management (BPM) is becoming the dominant management paradigm. Business process modelling is central to BPM, and the resultant business process model the core artefact guiding subsequent process change. Thus, model quality is at the centre, mediating between the modelling effort and related growing investment in ultimate process improvements. Nonetheless, though research interest in the properties that differentiate high quality process models is longstanding, there have been no past reports of a valid, operationalised, holistic measure of business process model quality. In attention to this gap, this paper reports validation of a Business Process Model Quality measurement model, conceptualised as a single-order, formative index. Such a measurement model has value as the dependent variable in rigorously researching the drivers of model quality; as antecedent of ultimate process improvements; and potentially as an economical comparator and diagnostic for practice.

Monocular amblyopia and higher order aberrations

This study compared the corneal and total higher order aberrations between the fellow eyes in monocular amblyopia. Nineteen amblyopic subjects (8 refractive and 11 strabismic) (mean age 30 ± 11 years) were recruited. A range of biometric and optical measurements were collected from the amblyopic and non-amblyopic eye including; axial length, corneal topography and total higher order aberrations. For a sub-group of eleven non-presbyopic subjects (6 refractive and 5 strabismic amblyopes, mean age 29 ± 10 years) total higher order aberrations were also measured during accommodation (2.5 D stimuli). Amblyopic eyes were significantly shorter and more hyperopic compared to non-amblyopic eyes and the interocular difference in axial length correlated with both the magnitude of anisometropia and amblyopia (both p < 0.01). Significant differences in higher order aberrations were observed between fellow eyes, which varied with the type of amblyopia. Refractive amblyopes displayed higher levels of 4th order corneal aberrations C(4, 0)(spherical aberration), C(4, 2)(secondary astigmatism 90°) and C(4, −2)(secondary astigmatism along 45°) in the amblyopic eye compared to the non-amblyopic eye. Strabismic amblyopes exhibited significantly higher levels of C(3, 3)(trefoil) in the amblyopic eye for both corneal and total higher order aberrations. During accommodation, the amblyopic eye displayed a significantly greater lag of accommodation compared to the non-amblyopic eye, while the changes in higher order aberrations were similar in magnitude between fellow eyes. Asymmetric visual experience during development appears to be associated with asymmetries in higher order aberrations, in some cases proportional to the magnitude of anisometropia and dependent upon the amblyogenic factor.

Impact of region-of-interest video coding on perceived quality in mobile video

Effective streaming of video can be achieved by providing more bits to the most important region in the frame at the cost of reduced bits in the less important regions. This strategy can be beneficial for delivering high quality videos in mobile devices, especially when the availability of bandwidth is usually low and limited. While the state-of-the-art video codecs such as H.264 may have been optimised for perceived quality, it is hypothesised that users will give more attention to interesting region/object when watching videos. Therefore, giving a higher quality to region of interest (ROI)while reducing quality of other areas may result in improving the overall perceived quality without necessarily increasing the bitrate. In this paper, the impact of ROI-based encoded video on perceived quality is investigated by conducting a user study for varous target bitrates. The results from the user study demonstrate that ROI-based video coding has superior perceived quality compared to normal encoded video at the same bitrate in the lower bitrate range.

The effectiveness of a four layer compression bandage system in comparison to Class 3 compression hosiery on healing and quality of life for patients with venous leg ulcers : a randomised controlled trial

There are an increasing number of compression systems available for treatment of venous leg ulcers and limited evidence on the relative effectiveness of these systems. The purpose of this study was to conduct a randomised controlled trial to compare the effectiveness of a 4-layer compression bandage system with Class 3 compression hosiery on healing and quality of life in patients with venous leg ulcers. Data were collected from 103 participants on demographics, health, ulcer status, treatments, pain, depression and quality of life for 24 weeks. After 24 weeks, 86% of the 4-layer bandage group and 77% of the hosiery group were healed (p=0.24). Median time to healing for the bandage group was 10 weeks, in comparison to 14 weeks for the hosiery group (p=0.018). Cox proportional hazards regression found participants in the 4-layer system were 2.1 times (95% CI 1.2–3.5) more likely to heal than those in hosiery, while longer ulcer duration, larger ulcer area and higher depression scores significantly delayed healing. No differences between groups were found in quality of life or pain measures. Findings indicate these systems were equally effective in healing patients by 24 weeks, however a 4-layer system may produce a more rapid response.

Multiple cameras for audio-visual speech recognition in an automotive environment

Audio-visualspeechrecognition, or the combination of visual lip-reading with traditional acoustic speechrecognition, has been previously shown to provide a considerable improvement over acoustic-only approaches in noisy environments, such as that present in an automotive cabin. The research presented in this paper will extend upon the established audio-visualspeechrecognition literature to show that further improvements in speechrecognition accuracy can be obtained when multiple frontal or near-frontal views of a speaker's face are available. A series of visualspeechrecognition experiments using a four-stream visual synchronous hidden Markov model (SHMM) are conducted on the four-camera AVICAR automotiveaudio-visualspeech database. We study the relative contribution between the side and central orientated cameras in improving visualspeechrecognition accuracy. Finally combination of the four visual streams with a single audio stream in a five-stream SHMM demonstrates a relative improvement of over 56% in word recognition accuracy when compared to the acoustic-only approach in the noisiest conditions of the AVICAR database.

Why the construction quality of design-build projects is not satisfactory : a Queensland study

Design-build (DB) system is well-known to be a popular and effective delivery method of construction work worldwide. It has been demonstrated as superior to the traditional delivery system in regards to time and cost performance. However, it suffers a major flaw, in that the performance of project quality cannot be guaranteed. This paper aims to investigate the underlying factors attributing to the poor quality performance of design-build projects in Queensland. Five major factors were first identified through a comprehensive literature review, which relate to (1) project briefing and scope definition, (2) client’s role and responsibility, (3) procurement selection, (4) contractor’s incentive, and (5) design document quality. A questionnaire survey with 127 DB professionals was conducted to determine how these factors affect various quality criteria, i.e. functional quality, architectural quality, technical quality, workmanship quality, client satisfaction and overall quality. With the architectural quality reduced greatly, the research findings reveal that the DB projects in Queensland have the reduced overall quality compared with traditional projects. The impacts of different factors on the quality performance of DB projects have been closely examined and summarized. The research findings will facilitate project stakeholder’s better understanding of the delivery process of the DB system and provide guidelines to improve the quality performance.