Equity indicators: measures of socio-economic status at an Australian university

After reviewing relevant literature on socio-economic status (SES) and the ways in which it is used for higher education institutional research and policy, a detailed data analysis of Victoria University (Australia) student data was undertaken. Between 10,000 and 15,000 domestic student addresses were ‘geocoded’ to Australian Bureau of Statistics (ABS) collection district level. A survey of individual reenrolling 2001 students that included parental occupation and education data was also analysed. The most important findings were: (1) The debate for practical reasons tends to focus on area versus individual measures, but SES is a richer and more complex subject and must be acknowledged as such. (2) It is apparent that VU’s student catchment is on average of lower SES than the Melbourne average, using various area measures of SES, including the DEST-Martin indicators. (3) There is only a very small difference between average area SES measures at the collection district and the postcode level. In practical terms this means that the postcode method is adequate, as well as being cheaper and more efficiently obtained, for analyses at an aggregated (or average) level. (4) Individual surveys of students do not prima facie add to the quality of aggregated institution level SES results delivered by area analyses. This again suggests that the postcode method is best for practical reasons.

Assessment of wilderness quality using the analytic hierarchy process

Wilderness is a unique environmental resource that provides a multitude of use and non-use benefits. The use and management of wilderness depend on the assessment of wilderness quality. Current wilderness assessment in Australia is based on two broad criteria, the remoteness and naturalness of the wilderness, determined using geographic information systems. This paper discusses a complementary assessment method using the Analytic Hierarchy Process (AHP). The AHP can be used to incorporate additional criteria, such as social and cultural criteria, to improve the quality of wilderness assessment. It provides a flexible and compatible method for large-scale wilderness assessments with multiple criteria. The weighting factors for the different criteria can be obtained from expert panels and focus groups.

An index of diet and eating patterns is a valid measure of diet quality in an Australian population

Diet indices represent an integrated approach to assessing eating patterns and behaviors. The aim of this study was to develop a comprehensive food-based dietary index to reflect adherence to healthy eating recommendations, evaluate the construct validity of the index using nutrient intakes, and evaluate this index in relation to sociodemographic factors, health behaviors, risk factors, and self-assessed health status. Data were analyzed from adult participants of the Australian National Nutrition Survey who completed a 108-item FFQ and a food habits questionnaire (n = 8220). The dietary guideline index (DGI) consisted of 15 items reflecting the dietary guidelines, including dietary indicators of vegetables and legumes, fruit, total cereals, meat and alternatives, total dairy, beverages, sodium, saturated fat, alcoholic beverages, and added sugars. Diet quality was incorporated using indicators relating to whole-grain cereals, lean meat, reduced/low fat dairy, and dietary variety. We investigated associations between the DGI score, sociodemographic factors, health behaviors, chronic disease risk factors, and nutrient intakes. We found associations between the DGI scores and sex, age, income, area-level socioeconomic disadvantage, smoking, physical activity, waist:hip ratio, systolic blood pressure (males only), and self-assessed health status (females only) (all P < 0.05). Higher DGI scores were associated with lower intakes of energy, total fat, and saturated fat and higher intakes of fiber, β-carotene, vitamin C, folate, calcium, and iron (P < 0.05). This food-based dietary index is able to discriminate across a variety of sociodemographic factors, health behaviors, and self-assessed health and reflects intakes of key nutrients.

Generation of statements for the development of clinical indicators for mental heath nursing in New Zealand : achieving a bicultural focus

Aim : In this paper, the first of 4 stages of a large study aiming to develop culturally and clinically valid clinical indicators to flag the achievement of mental health nursing standards of practice in New Zealand are described.

Methods : A bicultural design was employed throughout the research project to ensure that nurses' views of practice and the cultural differences between New Zealand's indigenous Maori and non-Maori peoples could be identified. Accordingly, separate focus groups of Maori- and non-Maori-experienced mental health nurses were asked to develop lists of statementd reflective of the Australian and New Zealand College of Mental Health Nurses' Standards of Practice in New Zealand.

Results : The focus group participants produces 473 statements, which were synthesized into 190 clinical indicator statements. In keeping with the bicultural research design, Maori and non-Maori data were analysed separately until the data were merged to provide a single set of indicator statements. Although both Maori and non-Maori groups wrote statements relevant to clinical practice, there was a difference in the way the 2 groups addressed cultural issues. The Maori focus group wrote statements about cultural issues for 4 of the 6 Standards of Practice, whereas the non-Maori focus group participants wrote statements about cultural issues for only the Standard focusing on cultural safety.

Conclusion : The research design of this project in mental health nursing was unique in that it sought the perspectives of both indigenous and non-indigenous nurses about quality mental health nursing practice related to the professional standards of practice. The involvement of Maori and non-Maori mental health nurses enhanced the cultural and clinical validity of the study and the obtained from it. The bicultural approach adopted for the study highlights the need for more mental health nursing research involving indigenous partners.

New Zealand development and trial of mental health nursing clinical indicators - a bicultural study

This paper describes the development and validation of bicultural clinical indicators that measure achievement of mental health nursing practice standards in New Zealand (ANZMCHN, 1995, Standards of practice for mental health nursing in New Zealand. ANZCMHN, Greenacres). A four-stage research design was utilised including focus groups, Delphi surveys, a pilot, and a national field study, with mental health nurses and consumers as participants. During the national field study, consumer files (n=327) from 11 District Health Boards, and registered nurses (n=422) completed an attitude questionnaire regarding the regularity of specific nursing and service activities. Results revealed a variation in the mean occurrence of the clinical indicators in consumer case notes of 18.5–89.9%. Five factors with good internal consistency, encompassing domains of mental health nursing required for best practice, were derived from analysis of the questionnaire. This study presents a research framework for developing culturally and clinically valid, reliable measures of clinical practice.

Nutritional and functional status indicators in residents of a long-term care facility

In a cross-sectional study, we determined whether results from the Mini Nutritional Assessment (MNA), Geriatric Depression Scale (GDS), and Katz Activities of Daily Living (ADL), were associated with nutritional status and mobility in long-term care residents. One hundred and fifteen study participants (mean [SD] age: 80.2 [10.6]) provided informed consent. Fifty eight percent (n = 66) responded to all three questionnaires: 12 were assessed as malnourished (MNA < 17) and 28 were depressed (GDS ≥ 6). Higher levels of depression were associated with lower serum zinc (n = 71, r = -.356, p = .001) and associated with a slower Timed Up and Go test (TUG, n = 38, r = .301, p = .030). MNA was also associated with serum zinc (n = 44, r = .307, P = .021). Non responders to questionnaires (n = 36) had a lower BMI (mean difference: -2.5 ± 1.0 kg/m², p = .013) and serum 25(OH)D (-8.7 ± 3.8 nmol/l, p = .023) vs. responders. The GDS, in addition to the MNA, is useful in identifying poor nutritional status in residential care. Intervention programs that target depression and poor nutritional status could potentially improve overall quality of life, but it is not clear if depression is leading to poor nutritional status or if poor nutrition is leading to depression.

How do we compare? - Applying UK pay for performance indicators to an Australian general practice

BACKGROUND United Kingdom general practitioners receive payment based on their performance in multiple clinical indicators. We set out to apply the same indicators in an Australian general practice to benchmark our performance and to see how much work was required to obtain the data.

METHODS Clinical indicators for the 2008–2009 UK Quality and Outcomes Framework (QOF) cycle were examined and achievement levels measured in a large rural Australian general practice, mainly by computer searching of the clinical database.

RESULTS Outcome measures were obtainable for 79 out of 80 indicators. Manual perusal of computer records was required for 16 indicators. Data collection takes approximately 130 hours. The Australian general practice achieved 66% of available pay for performance points compared to the UK average of 97%.

DISCUSSION United Kingdom QOF clinical data is obtainable relatively easily in a well computerised Australian rural general practice. The exercise identified significant areas in which clinical performance could be improved.

Quality as the criterion for delivered information systems effectiveness

One of the major challenges of MIS activities is the difficulty in measuring the effectiveness of delivered systems. The principal purpose of my research is to explore this field in order to develop an instrument by which to measure such effectiveness. Conceptualisation of Information System (IS) Effectiveness has been substantially framed by DeLone and McLean's (1992) Success; Model. But with the innovation in Information Technology (IT) over the past decade, and the constant pressure in IT to improve performance, there is merit in undertaking a fresh appraisal of the issue. This study built on the model of IS Success developed by DeLone and MeLean, but was broadened to include related research from the domains of IS, Management and Marketing. This analysis found that an effective IS function is built on three pillars: the systems implemented; the information held and delivered by these systems; and, the service provided in support of the IS function. A common foundation for these pillars is the concept of stakeholder needs. In seeking to appreciate the effectiveness: of delivered IS applications in relation to the job performance of stakeholders, this research developed an understanding of what quality means in an IT context I argue that quality is a more useful criterion for effectiveness than the more customary measures of use and user satisfaction. Respecification of the IS Success Model was then proposed. The second phase of the research was to test this model empirically through judgment panels, focus groups and interviews. Results consistently supported the structure and components of the respecified model. Quality was determined as a multi-dimensional construct, with the key dimensions for the quality of delivered IS differing from those used in the research from other disciplines. Empirical work indicated that end-user stakeholders derived their evaluations of quality by internally evaluating perceived performance of delivered IS in relation to their expectations for such performance. A short trial explored whether, when overt measurement of expectations was concurrent with the measurement of perceptions, a more revealing appraisal of delivered IS quality was provided than when perceptions alone were measured. Results revealed a difference between the two measures. Using the New IS Success Model as the foundation, and drawing upon the related theoretical and empirical research, an instrument was developed to measure the quality/effectiveness of delivered IS applications. Four trials of this instrument, QUALIT, are documented. Analysis of results from preliminary trials indicates promise in terms of business value: the instrument is simple to administer and has the capacity to pinpoint areas of weakness. The research related to the respecification of the New IS Success Model and the associated empirical studies, including the development of QTJALIT, have both contributed to the development of theory about IS Effectiveness. More precisely, my research has reviewed the components of an information system, the dimensions comprising these components and the indicators of each, and based upon these findings, formulated an instrument by which to measure the effectiveness of a delivered IS.

Empowering audiences to measure quality

This paper addresses four indicators of the audience experience in the performing arts: knowledge, risk, authenticity and collective engagement, and argues that these provide a measure of the audience's experience of the quality of a performance. Qualitative interviews with four performing arts companies
demonstrated a range of strategies for gathering audience feedback. In particular, the paper addresses systems for gathering "deep feedback" by audiences, and argues that these are a means of collecting information about the quality of the audience experience. "Deep feedback" is a critical mechanism by which performing arts organisations can engage in audience development and audiences are empowered to measure quality.

The quality and outcomes framework reduces disparities in health outcomes for cardiovascular disease

Jamie Robinson, the Berkeley health economist, famously remarked in 2001 that ‘the three worst ways to pay doctors are salary, capitation and fee-for-service.’ Different financial incentives produce different clinical and service outcomes, sometimes perversely.1 In 2004, the UK government introduced pay for performance (P4P) for general practitioners, the Quality and Outcomes Framework (QOF). Its introduction was associated with the general trend in the National Health Service away from placing implicit trust in doctors and more active monitoring of their performance. One-quarter of GP pay can be earned from achieving scores on 147 indicators.2 These indicators were acceptable to doctors because the majority are evidence-based clinical outcome measures for 10 chronic diseases. Others relate to patient access and satisfaction, and practice organisation.

Quality nephrology nursing care : beyond Kt/V

Ask nephrology nurses about the care in their hemodialysis units and they will probably say that high quality care is provided. This perception may reflect a genuine pride in their own and their colleagues' hemodialysis services, however, the meaning of high quality dialysis care remains unclear. Quality is often framed in terms of the high percentage of patients receiving a Kt/V of greater than 1.2 or 1.4. The unfortunate inference here is that high quality hemodialysis care is defined as the waste clearing service of the urea molecule. Defining quality in this narrow way conflicts with the caring and compassionate nursing ethic. Furthermore, it places a high value on a single mathematically derived formula that ignores many other indicators of quality dialysis care. In this article, the authors examine some historical, political, and technical features of Kt/V and use the metaphor of a hangover to illustrate the overuse of Kt/V, arguing that nurses have embraced Kt/V at the expense of other core elements of dialysis nursing care.

The quality-of-relationship construct in IT outsourcing

This paper reports on the conceptualization and measurement of an important management controllable factor affecting the success of an information technology outsourcing (ITO) arrangement, namely Quality of Relationship (QoR). Attributes of the construct were identified from an analysis of the literature, and key attributes selected based on interviews with 29 managers in four pairs of client and supplier organizations. Construct validity of the resultant measure is assessed through comparison with qualitative interview data, and through tests of association between our measure and perceived overall ITO success. The results suggest that the ten indicators identified in the paper provide a valid measure of the quality of relationship that can be used by both client and supplier managers, and researchers, in assessing the health of an ITO relationship.

A critical evaluation and comparison of two formative measures of system quality using criterion variables

Evaluating the validity of formative variables has presented ongoing challenges for researchers. In this paper we use global criterion measures to compare and critically evaluate two alternative formative measures of System Quality. One model is based on the ISO-9126 software quality standard, and the other is based on a leading information systems research model. We find that despite both models having a strong provenance, many of the items appear to be non-significant in our study. We examine the implications of this by evaluating the quality of the criterion variables we used, and the performance of PLS when evaluating formative models with a large number of items. We find that our respondents had difficulty distinguishing between global criterion variables measuring different aspects of overall System Quality. Also, because formative indicators “compete with one another” in PLS, it may be difficult to develop a set of measures which are all significant for a complex formative construct with a broad scope and a large number of items. Overall, we suggest that there is cautious evidence that both sets of measures are valid and largely equivalent, although questions still remain about the measures, the use of criterion variables, and the use of PLS for this type of model evaluation.

Urban growth in arid environments : developing water sustainability indicators for Abu Dhabi (UAE)

The United Arab Emirates (UAE) face a serious water problem. It has a very dry climate, high evaporation rate, combined with large water consumption from fast growing population, economic activities and uncontrolled uses of water for irrigation. Currently, UAE has one of the largest water footprints in the world. Groundwater is overexploited. Waste water is increasingly being treated to supply non-drinking water, but it still cover a small proportion of the demand. Desalination of sea water is the main source of potable water in UAE, but the high economic cost of desalination, its intensive energy demand and the adverse effects of its effluents on the marine life are a major concern. Other factors contributing to the problem are the focus of water management policies on keep supplying the growing demand for water, the increase of the per capita water consumption, and the free water charge for most of population. This research goal is to develop a water sustainability set of indicators for the challenging context of UAE. This paper presents the first stage of the research. Based on a review of the literature, the proposed framework involves 19 indicators, divided into four categories: water availability; water quality; water use efficiency; and policy and governance. Using an integrated cause-effect approach (DSR - Driving force, State, Response), the indicators were related in terms of their interdependencies, with a holistic view of the city water cycle. A preliminary test of the indicators to Abu Dhabi as a case study allowed an evaluation of the main 'Driving force' on the system, such as the scarcity of water due to natural constraints of the region, and increasing water consumption patterns of modern society; an assessment of the current 'state', which is under serious water stress. Also it indicated some potential 'responses', such as implementing policies for increasing efficient use.

Distribution and abundance of human-specific Bacteroides and relation to traditional indicators in an urban tropical catchment

The study goals were to determine the relationship between faecal indicator bacteria (FIB), the HF183 marker and land use, and the phylogenetic diversity of HF183 marker sequences in a tropical urban watershed