The impact of leadership and quality climate on hospital performance

Objective. To explore the relationship between leadership effectiveness and health-care trust performance, taking into account external quality measures and the number of patient complaints; also, to examine the role of care quality climate as a mediator. Design. We developed scales for rating leadership effectiveness and care quality climate. We then drew upon UK national indices of health-care trust performance—Commission for Health Improvement star ratings, Clinical Governance Review ratings and the number of patient complaints per thousand. We conducted statistical analysis to examine any significant relationships between predictor and outcome variables. Setting. The study is based on 86 hospital trusts run by the National Health Service (NHS) in the UK. The data collection is part of an annual staff survey commissioned by the NHS to explore the quality of working life. Participants. A total of 17 949 employees were randomly surveyed (41% of the total sample). Results. Leadership effectiveness is associated with higher Clinical Governance Review ratings and Commission for Health Improvement star ratings for our sample (ß = 0.42, P < 0.05; ß = 0.37, P < 0.05, respectively), and lower patient complaints (ß = –0.57, P < 0.05). In addition, 98% of the relationship between leadership and patient complaints is explained by care quality climate. Conclusions. Results offer insight into how non-clinical leadership may foster performance outcomes for health-care organizations. A frequently neglected area—patient complaints—may be a valid measure to consider when assessing leadership and quality in a health-care context.

Parental information needs in chronic renal failure and diabetes mellitus

The information needs of parents of children with end stage renal failure (ESRF) or with insulin dependent diabetes mellitus (IDDM) were assessed by questionnaires over a 2-year period. Questionnaires were posted on seven occasions at 4-monthly intervals and were sent to both mothers and fathers. Most information needs were reported to be for detailed test results, for new information about the condition and about the child's future social development. Questions responsible for the three highest scores were concerned with the future: the child's fertility; their social, career and marriage prospects; and the hope for a new improved treatment. For the IDDM mothers, scores were significantly different depending on age of the child (P = 0.02). Change in treatment mode had no significant effect on the information needs of parents of children with ESRF (P = 0.81). Occupation was significantly associated with the mean general information needs scores for parents, with occupations of a lower socioeconomic status associated with higher information needs scores. There were no significant differences between the reported mean general information needs scores of parents of children with ESRF and of parents of children with IDDM (P = 0.69) or between mothers and fathers mean general information needs scores (P = 0.58). CONCLUSION: Multidisciplinary team members need to tailor information to the needs of the individual families and be sensitive to socioeconomic factors and communication issues.

Expression of the ubiquitin-proteasome pathway and muscle loss in experimental cancer cachexia

Muscle protein degradation is thought to play a major role in muscle atrophy in cancer cachexia. To investigate the importance of the ubiquitin-proteasome pathway, which has been suggested to be the main degradative pathway mediating progressive protein loss in cachexia, the expression of mRNA for proteasome subunits C2 and C5 as well as the ubiquitin-conjugating enzyme, E2(14k), has been determined in gastrocnemius and pectoral muscles of mice bearing the MAC16 adenocarcinoma, using competitive quantitative reverse transcriptase polymerase chain reaction. Protein levels of proteasome subunits and E2(14k) were determined by immunoblotting, to ensure changes in mRNA were reflected in changes in protein expression. Muscle weights correlated linearly with weight loss during the course of the study. There was a good correlation between expression of C2 and E2(14k) mRNA and protein levels in gastrocnemius muscle with increases of 6-8-fold for C2 and two-fold for E2(14k) between 12 and 20% weight loss, followed by a decrease in expression at weight losses of 25-27%, although loss of muscle protein continued. In contrast, expression of C5 mRNA only increased two-fold and was elevated similarly at all weight losses between 7.5 and 27%. Both proteasome functional activity, and proteasome-specific tyrosine release as a measure of total protein degradation was also maximal at 18-20% weight loss and decreased at higher weight loss. Proteasome expression in pectoral muscle followed a different pattern with increases in C2 and C5 and E2(14k) mRNA only being seen at weight losses above 17%, although muscle loss increased progressively with increasing weight loss. These results suggest that activation of the ubiquitin-proteasome pathway plays a major role in protein loss in gastrocnemius muscle, up to 20% weight loss, but that other factors such as depression in protein synthesis may play a more important role at higher weight loss. © 2005 Cancer Research.

Translation and quality

This volume deals with the translation quality assessment from the perspective of a functionalist approach to translation. This approach is illustrated by examples from real translation assignments, and it is argued that quality in translation is something to be negotiated between the client and the translator. Consequences of such understanding for translator training are critically reflected upon.

Delay of light in an optical bottle resonator with nanoscale radius variation : dispersionless, broadband, and low-loss

It is shown theoretically that an optical bottle resonator with a nanoscale radius variation can perform a multinanosecond long dispersionless delay of light in a nanometer-order bandwidth with minimal losses. Experimentally, a 3 mm long resonator with a 2.8 nm deep semiparabolic radius variation is fabricated from a 19??µm radius silica fiber with a subangstrom precision. In excellent agreement with theory, the resonator exhibits the impedance-matched 2.58 ns (3 bytes) delay of 100 ps pulses with 0.44??dB/ns intrinsic loss. This is a miniature slow light delay line with the record large delay time, record small transmission loss, dispersion, and effective speed of light.

Process improvement and quality management systems in the financial services industry:the case for the OPEX quality management system and framework

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

Professionalism and quality in European business courses:utilising research to enhance student learning and promote employability - a pan-European study

This..paper provides a comparative analysis of Quality Management and standards in four European countries, (the UK, Austria, Slovenia and Romania) and in doing so addresses the gap in academic knowledge about how the introduction and implementation of Quality Management Strategies can both facilitate and enhance student learning within Universities.

Delay of light in an optical bottle resonator with nanoscale radius variation:dispersionless, broadband, and low-loss

It is shown theoretically that an optical bottle resonator with a nanoscale radius variation can perform a multinanosecond long dispersionless delay of light in a nanometer-order bandwidth with minimal losses. Experimentally, a 3 mm long resonator with a 2.8 nm deep semiparabolic radius variation is fabricated from a 19??µm radius silica fiber with a subangstrom precision. In excellent agreement with theory, the resonator exhibits the impedance-matched 2.58 ns (3 bytes) delay of 100 ps pulses with 0.44??dB/ns intrinsic loss. This is a miniature slow light delay line with the record large delay time, record small transmission loss, dispersion, and effective speed of light.

Record small and low loss slow light delay lines and dispersion compensators

Record small and low loss slow light optical signal processing devices are proposed and demonstrated using the recently invented Surface Nanoscale Axial Photonics (SNAP) technology.