Quality in disability service - whose indicators?

The study identified indicators of disability service quality used by three stakeholder groups (service users, providers and managers) in order to develop an explanatory schema regarding stakeholders' perceptions of quality and its indicators. The different perspectives were identified and the emerging quality indicator framework had a complex socio-ecological basis.

Companion animal visitation and its effectiveness with stroke patients

The study employed a randomised controlled trial design to determine whether a companion animal intervention had any effect on wellbeing and quality of life in patients who were admitted to hospital after suffering a stroke. The study found significant benefits for their wellbeing and improvements in quality of life.

Use of poverty indicators and the poverty pyramid for agricultural and rural development in the smallholder sector in Sri Lanka

Based on official micro-level poverty studies for agricultural and rural development in the smallholder sector of Sri Lanka. The Poverty Pyramid was found to be a powerful tool for poverty analysis and the design of poverty alleviation strategies that are targeted at sustained poverty alleviation. Identification of the correct target groups by factors that prevent them from being more productive in their income generation activities is crucial to the formulation of rural development programs that benefit poor people first and most.

The resident assessment instrument-minimum data set 2.0 quality indicators : a systematic review

Background
The Resident Assessment Instrument-Minimum Data Set (RAI-MDS) 2.0 is designed to collect the minimum amount of data to guide care planning and monitoring for residents in long-term care settings. These data have been used to compute indicators of care quality. Use of the quality indicators to inform quality improvement initiatives is contingent upon the validity and reliability of the indicators. The purpose of this review was to systematically examine published and grey research reports in order to assess the state of the science regarding the validity and reliability of the RAI-MDS 2.0 Quality Indicators (QIs).

Methods
We systematically reviewed the evidence for the validity and reliability of the RAI-MDS 2.0 QIs. A comprehensive literature search identified relevant original research published, in English, prior to December 2008. Fourteen articles and one report examining the validity and/or reliability of the RAI-MDS 2.0 QIs were included.

Results
The studies fell into two broad categories, those that examined individual quality indicators and those that examined multiple indicators. All studies were conducted in the United States and included from one to a total of 209 facilities. The number of residents included in the studies ranged from 109 to 5758. One study conducted under research conditions examined 38 chronic care QIs, of which strong evidence for the validity of 12 of the QIs was found. In response to these findings, the 12 QIs were recommended for public reporting purposes. However, a number of observational studies (n=13), conducted in "real world" conditions, have tested the validity and/or reliability of individual QIs, with mixed results. Ten QIs have been studied in this manner, including falls, depression, depression without treatment, urinary incontinence, urinary tract infections, weight loss, bedfast, restraint, pressure ulcer, and pain. These studies have revealed the potential for systematic bias in reporting, with under-reporting of some indicators and over-reporting of others.

Conclusion
Evidence for the reliability and validity of the RAI-MDS QIs remains inconclusive. The QIs provide a useful tool for quality monitoring and to inform quality improvement programs and initiatives. However, caution should be exercised when interpreting the QI results and other sources of evidence of the quality of care processes should be considered in conjunction with QI results.