The relationship between quality of work life and turnover intention of primary health care nurses in Saudi Arabia

Background Quality of work life (QWL) has been found to influence the commitment of health professionals including nurses. However, reliable information on the QWL and turnover intention of primary health care (PHC) nurses is limited. The aim of this study was to examine the relationship between QWL and turnover intention of PHC nurses in Saudi Arabia. Methods A cross-sectional survey was used in this study. Data were collected using Brooks’ survey of Quality of Nursing Work life (QNWL), the Anticipated Turnover Scale and demographic data questions. A total of 508 PHC nurses in the Jazan region, Saudi Arabia completed the questionnaire (RR = 87%). Descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression (SMR), and hierarchical multiple regression (HMR) were applied for analysis using SPSS v17 for Windows. Results Findings suggested that the respondents were dissatisfied with their work life, with almost 40% indicating a turnover intention from their current PHC centres. Turnover intention was significantly related to QWL. Using SMR, 26% of the variance in turnover intention was explained by the QWL, p < 0.001, with R² = .263. Further analysis using HMR found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, p < 0.001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables. Conclusions Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes.

Examining the health related quality of life of people with end stage kidney disease living in Hanoi, Vietnam

Background: The prevalence of end-stage kidney disease (ESKD) patients is increasing in Vietnam; however, the impact of ESKD and its treatment on a person’s quality of life (QOL) is not well understood. Objective: This research sought to examine the association between monthly income, comorbidity, length of time on dialysis, social support and health-related quality of life (HRQOL) among Vietnamese ESKD patients. Method: Using a descriptive design, 95 patients who were receiving haemodialysis (HD) and peritoneal dialysis (PD) from one hospital in Hanoi, were conveniently sampled. Results: ESKD patients reported having a moderate level of HRQOL. Factors associated with QOL were social support (r= .268, p<.05), comorbid health conditions (r= –.185, p<.05), and length of time on dialysis (r= .182, p<.05). However, monthly income was not significantly related to HRQOL (p>.05). Conclusion: The results seem to indicate that ESKD patients in Vietnam have a high level of support from family members, friends and significant others. There was also a negative impact of comorbid conditions on the QOL of these patients. Based on the results of this study, nurses ought to develop nursing interventions which will lead to a better QOL for patients, and further research into the QOL for ESKD patients in Vietnam is warranted.

A distributional analysis of the native-immigrant wage gap : the importance of employment discrimination

It is well documented that immigrants earn less than natives in the United States, and various attempts have been made to determine whether these earnings differentials reflect underlying differences in skill or ethnic discrimination in the labor market. The earnings of immigrants and ethnic minorities is an extensively studied area focusing on the economic integration of immigrants (e.g., Chiswick (1978), Lalonde and Topel (1993), Borjas (1995)). Yet, the role of occupational segregation as a mechanism for discrimination is yet to be addressed (to our knowledge). Discrimination can be effective at either of two stages in the earnings process – in the assignment of earnings to people within occupational groups (henceforth referred to as wage discrimination) or in the allocation of people to occupations (henceforth referred to as employment discrimination). While it would be premature to attribute the underlying cause to discriminatory hiring policies of employers, it would be of social-political and economic interest to investigate the possibility.

Comparing the availability, price, variety and quality of fruits and vegetables across retail outlets and by area level socioeconomic position

Abstract Objective: To explore whether area-level socioeconomic position or the form of retail stream (conventional versus farmers’ market) are associated with differences in the price, availability, variety and quality of a range of fresh fruit and vegetables. Design: A multi-site cross-sectional pilot study of farmers’ markets, supermarkets and independent fruit and vegetable retailers. Each was surveyed to assess the price, availability, variety and quality of 15 fruit and 18 vegetable items. Setting: Retail outlets were located in South-East Queensland. Subjects: Fifteen retail outlets were surveyed (five of each retail stream). Results: Average basket prices were not significantly different across the socioeconomic spectrum however prices in low socioeconomic areas were cheapest. Availability, variety, and quality did not differ across levels of socioeconomic position however the areas with the most socioeconomic disadvantage scored poorest for quality and variety. Supermarkets had significantly better fruit and vegetable availability than farmers’ markets however price, variety and quality scores were not different across retail streams. Results demonstrate a trend to fruit and vegetable prices being more expensive at farmers’ markets, with the price of the Fruit basket being significantly greater at the organic farmer’s market compared with the non-organic farmers’ markets. Conclusions: Neither area-level socioeconomic position nor the form of retail stream was significantly associated with differences in the availability, price, variety and quality of fruit and vegetables, except for availability which was higher in supermarkets than farmers’ markets. Further research is needed to determine what role farmers’ markets can play in affecting fruit and vegetable intake.

Will the application of spatial multi criteria evaluation technique enhance the quality of decision-making to resolve boundary conflicts in the Philippines?

Systematic studies that evaluate the quality of decision-making processes are relatively rare. Using the literature on decision quality, this research develops a framework to assess the quality of decision-making processes for resolving boundary conflicts in the Philippines. The evaluation framework breaks down the decision-making process into three components (the decision procedure, the decision method, and the decision unit) and is applied to two ex-post (one resolved and one unresolved) and one ex-ante cases. The evaluation results from the resolved and the unresolved cases show that the choice of decision method plays a minor role in resolving boundary conflicts whereas the choice of decision procedure is more influential. In the end, a decision unit can choose a simple method to resolve the conflict. The ex-ante case presents a follow-up intended to resolve the unresolved case for a changing decision-making process in which the associated decision unit plans to apply the spatial multi criteria evaluation (SMCE) tool as a decision method. The evaluation results from the ex-ante case confirm that the SMCE has the potential to enhance the decision quality because: a) it provides high quality as a decision method in this changing process, and b) the weaknesses associated with the decision unit and the decision procedure of the unresolved case were found to be eliminated in this process.

The effect of Tai Chi on health related quality of life in people with elevated blood glucose or diabetes : a randomized controlled trial

Purpose The aim was to assess the effects of a Tai Chi based program on health related quality of life (HR-QOL) in people with elevated blood glucose or diabetes who were not on medication for glucose control. Method 41 participants were randomly allocated to either a Tai Chi intervention group (N = 20) or a usual medical care control group (N = 21). The Tai Chi group involved 3 x 1.5 hour supervised and group-based training sessions per week for 12 weeks. Indicators of HR-QOL were assessed by self-report survey immediately prior to and after the intervention. Results There were significant improvements in favour of the Tai Chi group for the SF36 subscales of physical functioning (mean difference = 5.46, 95% CI = 1.35-9.57, P < 0.05), role physical (mean difference = 18.60, 95% CI = 2.16-35.05, P < 0.05), bodily pain (mean difference = 9.88, 95%CI = 2.06-17.69, P < 0.05) and vitality (mean difference = 9.96, 95% CI = 0.77-19.15, P < 0.05). Conclusions The findings show that this Tai Chi program improved indicators of HR-QOL including physical functioning, role physical, bodily pain and vitality in people with elevated blood glucose or diabetes who were not on diabetes medication.

Appraisal of the quality of care of older people with cognitive impairment presenting to emergency departments

The medical records of 273 patients 75 years and older were reviewed to evaluate quality of emergency department (ED) care through the use of quality indicators. One hundred fifty records contained evidence of an attempt to carry out a cognitive assessment. Documented evidence of cognitive impairment (CI) was reported in 54 cases. Of these patients, 30 had no documented evidence of an acute change in cognitive function from baseline; of 26 patients discharged home with preexisting CI (i.e., no acute change from baseline), 15 had no documented evidence of previous consideration of this issue by a health care provider; and 12 of 21 discharged patients who screened positive for cognitive issues for the first time were not referred for outpatient evaluation. These findings suggest that the majority of older adults in the ED are not receiving a formal cognitive assessment, and more than half with CI do not receive quality of care according to the quality indicators for geriatric emergency care. Recommendations for improvement are discussed.

Immigrant wage differentials and the role of self-employment in Australia

Immigration has played an important role in the historical development of Australia. Thus, it is no surprise that a large body of empirical work has developed, which focuses upon how migrants fare in the land of opportunity. Much of the literature is comparatively recent, i.e. the last ten years or so, encouraged by the advent of public availability of Australian crosssection micro data. Several different aspects of migrant welfare have been addressed, with major emphasis being placed upon earnings and unemployment experience. For recent examples see Haig (1980), Stromback (1984), Chiswick and Miller (1985), Tran-Nam and Nevile (1988) and Beggs and Chapman (1988). The present paper contributes to the literature by providing additional empirical evidence on the native/migrant earnings differential. The data utilised are from the rather neglected Australian Bureau of Statistics, ABS Special Supplementary Survey No.4. 1982, otherwise known as the Family Survey. The paper also examines the importance of distinguishing between the wage and salary sector and the self-employment sector when discussing native/migrant differentials. Separate earnings equations for the two labour market groups are estimated and the native/migrant earnings differential is broken down by employment status. This is a novel application in the Australian context and provides some insight into the earnings of the selfemployed, a group that despite its size (around 20 per cent of the labour force) is frequently ignored by economic research. Most previous empirical research fails to examine the effect of employment status on earnings. Stromback (1984) includes a dummy variable representing self-employment status in an earnings equation estimated over a pooled sample of paid and self-employed workers. The variable is found to be highly significant, which leads Stromback to question the efficacy of including the self-employed in the estimation sample. The suggestion is that part of self-employed earnings represent a return to non-human capital investment, i.e. investments in machinery, buildings etc, the structural determinants of earnings differ significantly from those for paid employees. Tran-Nam and Nevile (1988) deal with differences between paid employees and the selfemployed by deleting the latter from their sample. However, deleting the self-employed from the estimation sample may lead to bias in the OLS estimation method (see Heckman 1979). The desirable properties of OLS are dependent upon estimation on a random sample. Thus, the 'Ran-Nam and Nevile results are likely to suffer from bias unless individuals are randomly allocated between self-employment and paid employment. The current analysis extends Tran-Nam and Nevile (1988) by explicitly treating the choice of paid employment versus self-employment as being endogenously determined. This allows an explicit test for the appropriateness of deleting self-employed workers from the sample. Earnings equations that are corrected for sample selection are estimated for both natives and migrants in the paid employee sector. The Heckman (1979) two-step estimator is employed. The paper is divided into five major sections. The next section presents the econometric model incorporating the specification of the earnings generating process together with an explicit model determining an individual's employment status. In Section 111 the data are described. Section IV draws together the main econometric results of the paper. First, the probit estimates of the labour market status equation are documented. This is followed by presentation and discussion of the Heckman two-stage estimates of the earnings specification for both native and migrant Australians. Separate earnings equations are estimated for paid employees and the self-employed. Section V documents estimates of the nativelmigrant earnings differential for both categories of employees. To aid comparison with earlier work, the Oaxaca decomposition of the earnings differential for paid-employees is carried out for both the simple OLS regression results as well as the parameter estimates corrected for sample selection effects. These differentials are interpreted and compared with previous Australian findings. A short section concludes the paper.

Asset specificity and behavioral uncertainty as moderators of the sales growth-employment growth relationship in emerging ventures

New venture growth is a central topic in entrepreneurship research. Although sales growth is emerging as the most commonly used measure of growth for emerging ventures, employment growth has also been used frequently. However, empirical research demonstrates that there are only very low to moderately sized correlations between the two (Delmar et aL, 2003; Weinzimmer, et al., 1998). In addition) sales growth and employment growth respond differently to a wide variety of criteria (Baum et al., 2001; Delmar et al., 2003). In this study we use transaction cost economics (Williamson, 1996) as a theoretical base to examine transaction cost influences on the addition of new employees as emerging ventures experience sales growth. \\le theorize that transaction cost economics variables will moderate the relationship between sales growth and employment growth. W'e develop and test hypotheses related to asset specificity, behavioral uncertainty, and the influence of resource munificence on the strength of the sales growth/ employment growth relationship. Asset specificity is theorized to be a positive moderator of the relationship between sales growth and employment growth. When the behavioral uncertainty associated with adding new employees is greater than that of outsourcing or subcontracting, it is hypothesized to be a negative moderator of the sales growth/employment growth relationship. We also hypothesize that resource scarcity will strengthen those relationships.

Is quality more important if you’re quirky? A review of the literature on differential susceptibility to childcare environments

Evidence concerning the impact of child care on child development suggests that higher-quality environments, particularly those that are more responsive, predict more favourable social and behavioural outcomes. However, the extent of this effect is not as great as might be expected. Impacts on child outcomes are, at best, modest. One recent explanation emerging from a new theoretical perspective of development, differential susceptibility theory, is that a minority of children are more reactive to both positive and negative environments, while the majority are relatively unaffected. These 'quirky' children have temperamental traits that are more extreme, and are often described in research studies as having 'difficult temperaments'. This paper reviews the literature on such children and argues for the need for further research to identify components of childcare environments that optimise the potential of these more sensitive, quirky individuals.

Narrative, education policy and the newsprint media : A critical discourse analysis of the construction of young people's participation in education or employment

This thesis used Critical Discourse Analysis to investigate how a government policy and the newsprint media constructed discussion about young people’s participation in education or employment. The study found that a continuous narrative across both sites about government as a noble agent taking action to redress the social disruption caused by young people’s disengagement. Unlike the education policy, the newsprint media blamed young people who were disengaged and failed to recognise the barriers they often face. The study points to possibilities for utilising the power of narrative to build a more fair and rigorous discussion of issues in the public sphere.

Not all systematic reviews are systematic : a meta-review of the quality of systematic reviews for non-invasive remote monitoring in heart failure

Remote monitoring for heart failure has been evaluated in numerous systematic reviews. The aim of this meta-review was to appraise their quality and synthesise results. We electronically searched online databases, performed a forward citation search and hand-searched bibliographies. Systematic reviews of remote monitoring interventions that were used for surveillance of heart failure patients were included. Seven (41%) systematic reviews pooled results for meta-analysis. Eight (47%) considered all non-invasive remote monitoring strategies. Five (29%) focused on telemonitoring. Four (24%) included both non-invasive and invasive technologies. According to AMSTAR criteria, ten (58%) systematic reviews were of poor methodological quality. In high quality reviews, the relative risk of mortality in patients who received remote monitoring ranged from 0.53 (95% CI=0.29-0.96) to 0.88 (95% CI=0.76-1.01). High quality reviews also reported that remote monitoring reduced the relative risk of all-cause (0.52; 95% CI=0.28-0.96 to 0.96; 95% CI=0.90–1.03) and heart failure-related hospitalizations (0.72; 95% CI=0.64–0.81 to RR 0.79; 95% CI=0.67-0.94) and, as a consequence, healthcare costs. As the high quality reviews reported that remote monitoring reduced hospitalizations, mortality and healthcare costs, research efforts should now be directed towards optimising these interventions in preparation for more widespread implementation.

Not all systematic reviews are systematic : a meta-review of the quality of current systematic reviews and meta-analyses for remote monitoring in heart failure

Background/aims: Remote monitoring for heart failure has not only been evaluated in a large number of randomised controlled trials, but also in many systematic reviews and meta-analyses. The aim of this meta-review was to identify, appraise and synthesise existing systematic reviews that have evaluated the effects of remote monitoring in heart failure. Methods: Using a Cochrane methodology, we electronically searched all relevant online databases and search engines, performed a forward citation search as well as hand-searched bibliographies. Only fully published systematic reviews of invasive and/or non-invasive remote monitoring interventions were included. Two reviewers independently extracted data. Results: Sixty-five publications from 3333 citations were identified. Seventeen fulfilled the inclusion and exclusion criteria. Quality varied with A Measurement Tool to Assess Systematic Reviews (AMSTAR scores) ranging from 2 to 11 (mean 5.88). Seven reviews (41%) pooled results from individual studies for meta-analysis. Eight (47%) considered all non-invasive remote monitoring strategies. Four (24%) focused specifically on telemonitoring. Four (24%) included studies investigating both non-invasive and invasive technologies. Population characteristics of the included studies were not reported consistently. Mortality and hospitalisations were the most frequently reported outcomes 12 (70%). Only five reviews (29%) reported healthcare costs and compliance. A high degree of heterogeneity was reported in many of the meta-analyses. Conclusions: These results should be considered in context of two negative RCTs of remote monitoring for heart failure that have been published since the meta-analyses (TIM-HF and Tele-HF). However, high quality reviews demonstrated improved mortality, quality of life, reduction in hospitalisations and healthcare costs.

Improving the quality of fourth year civil engineering research projects through bibliographic instruction

Faculty and reference librarians at the Queensland University of Technology have collaborated in an attempt to improve the quality of literature reviews in civil engineering final -year research projects. This article describes the instructional program devised and the level of faculty support for the librarians' contribution, and presents survey results revealing how students could most benefit from BI and how the classroom collaboration affected student project work. The authors offer some observations about the possible impact of 81 in general, and on engineers in particular, which may provide a focus for future research.