Dimensions of quality of life and psychosocial variables most salient to colorectal cancer patients

Colorectal cancer is one of the most common invasive cancers, and is responsible for considerable physical and psychosocial morbidity. Understanding the quality of life experienced by colorectal cancer patients is essential for evaluating the full impact of the disease on individuals, their families and their communities. Patient perspective is essential in establishing a proper understanding of the quality of life of colorectal cancer patients. Despite this, few studies have employed a qualitative methodology to explore quality of life issues for colorectal cancer patients. A review of the literature identified only seven qualitative studies pertaining to quality of life issues for colorectal cancer patients, a surprising finding given the prevalence of this cancer. Accordingly, this study sought to build on the findings of previous qualitative research by providing descriptive data on the quality of life and psychosocial variables most salient to colorectal cancer patients. Six core themes emerged from interview and focus group data: Satisfaction with diagnosis and treatment; support (including information provision); quality of life; benefits of diagnosis; making sense of the cancer experience; and coping strategies. The information derived from this study will help inform the development of supportive care services to address the needs of the increasing number of people diagnosed with colorectal cancer. Copyright (c) 2005 John Wiley & Sons, Ltd.

Analysis of quality in Brazilian e-commerce (B2C)

The business world has changed the way how people think and act on products and services. In this context, the most recent amendment of the scenarios of retail operations has been the use of technology in sales and distribution. The internet has revolutionized the way people communicate, and moreover as they purchase their goods and services. Thus, the e-commerce, specifically the relation business to customer, or simply B2C, has acted so convincingly in this change of paradigm, namely the purchases in the physical location for the virtual site. Quotes online, ease of payment, price, speed of delivery, have become real order winners of applications for companies that compete in this segment. With the focus on quality of services on e-commerce, the research examines the dimension related to the quality of services, and looks for what of these factors are winners of applications. © 2010 IFIP International Federation for Information Processing.

Dimensions of business processes quality (QoBP)

Conceptual modeling is an important tool for understanding and revealing weaknesses of business processes. Yet, the current practice in reengineering projects often considers simply the as-is process model as a brain-storming tool. This approach heavily relies on the intuition of the participants and misses a clear description of the quality requirements. Against this background, we identify four generic quality categories of business process quality, and populate them with quality requirements from related research. We refer to the resulting framework as the Quality of Business Process (QoBP) framework. Furthermore, we present the findings from applying the QoBP framework in a case study with a major Australian bank, showing that it helps to systematically fill the white space between as-is and to-be process modeling.

Marketing across cultures : an investigation into place specific dimensions of service quality in sport

Abstract The purpose of this study was to identify place-specific dimensions of service quality in spectator sport settings and determine if the importance of these dimensions differed across cultures. The study was limited to the soccer industry and involved the collection of responses from identified soccer spectators to a range of items presented in a survey instrument. The survey was distributed to respondents face-to-face on a match day of the club they supported, or mailed to their home address. Responses were obtained from spectators from two clubs from Australia (n=277), one club from the USA (n=199), one club from the Netherlands (n=245) and one federation from Malaysia (n= 100). Based on the findings of a number of authors, six categories of potential place-specific dimensions of service quality in spectator sport settings were created and the research instrument contained a number of items that could be categorised under one of these headings. These categories were Home, Religion, Social facilitation, Sensory, Uncertainty of outcome, and Personal attention. In this thesis it was assumed that place-specific service quality issues are similar for sport spectators of different cultures, although differences in degree of importance of these dimensions (etic approach) were likely to emerge. In other words, although it was expected dimensions per country to be similar, differences in degree of importance of these dimensions were expected. Given the lack of confirmatory statistical evidence pertaining to the specific country samples, it was concluded that differences per country are likely to be more than just differences in degree. Both the overall structure and structures per country could not be confirmed, and hence the conclusion was drawn that differences in nature between the countries were present. In other words, what is a dimension of place-specific service quality in one country is not necessarily a dimension in another country. The results of a content analysis of ‘core component’ structures per country compared with a (full sample) core component structure delivered six components (referred to as place-specific dimensions of service quality) that were defined as Home, Hedonist, Religious follower, Safe atmosphere, Hospitality and Personal Attention. It was found that in most cases the cultural orientation of soccer spectators reflects the cultural orientation of the country as a whole as proposed by Hofstede (1991). However, in line with Huntington (1997), it was also argued that grouping people based on their country of origin as a proxy for their cultural orientation, will increasingly lead to flawed and incomplete research findings. As noted by Yoo etal. (1999), the identification of a person's cultural orientation is likely to deliver more direct results when measured at the individual level In that regard it is concluded that it may seem prudent to view Hofstede's dimensions of culture with increased conceptual scrutiny. Although having been replicated in multiple studies, it becomes increasingly unlikely that Hofstede's dimensions cover the complete spectrum of an individual person's cultural orientation. In conclusion, this study identified that soccer spectators (from a number of clubs) from Australia, the USA, the Netherlands and to a lesser extent Malaysia, perceive a range of place-specific service quality dimensions in spectator spoil settings to be important when visiting a soccer match. Before research into satisfaction with and value of place-specific dimensions of the spectator sport service product is initiated, it is pertinent the identified dimensions are further explored and confirmed in different country (culture) settings. The confusion that still exists about the place of the value concept (in relation to quality and satisfaction), where Holbrook (1994) defines quality as a type of value and Chelladurai and Chang (2000) argue that value is a type of quality, further underpins this necessity. It needs to be clear what are the targets of service quality before this information is integrated in larger holistic research frameworks. In the final section of the thesis a conceptual model for international services marketing research in the sport industry was presented as a first attempt to integrate the findings of this research and other researchers.

Social control and smoking: Examining the moderating effects of different dimensions of relationship quality

A common form of social regulation of an individual’s health behavior is social control. The contextual model of social control assumes that higher relationship quality goes along with more beneficial effects of social control on health behavior. This study examined potential differential moderating effects of different dimensions of relationship quality on the associations between positive and negative social control and smoking behavior and hiding smoking. The sample consisted of 144 smokers (n = 72 women; mean age = 31.78, SD = 10.04) with a nonsmoking partner. Positive and negative social control, dimensions of relationship quality consensus, cohesion and satisfaction, numbers of cigarettes smoked (NCS), hiding smoking (HS), and control variables were assessed at baseline. Four weeks later NCS and HS were assessed again. Only for smokers with high consensus, but not cohesion and satisfaction, a negative association between positive control and NCS emerged. Moreover, smokers with high consensus tended to report more HS when being positively and negatively socially controlled. This also emerged for cohesion and positive control. Satisfaction with the relationship did not display any interaction effects. This study’s results emphasize the importance of differentiating not only between positive and negative social control but also between different dimensions of relationship quality in order to gain a comprehensive understanding of the dynamics in romantic dyads with regard to social regulation of behavioral change.

The heart of quality teaching : a values-based pedagogy for pre-service teacher education

In an ever changing world the adults of the future will be faced with many challenges. To cope with these challenges it seems apparent that values education will need to become paramount within a child.s education. A considerable number of research studies have indicated that values education is a critical component within education (Lovat & Toomey, 2007b). Building on this research Lovat (2006) claimed that values education was the missing link in quality teaching The concept of quality teaching had risen to the fore within educational research literature in the late 20th century with the claim that it is the teacher who makes the difference in schooling (Hattie, 2004). Thus, if teachers make such a difference to student learning, achievement and well-being, then it must hold true that pre-service teacher education programmes are vital in ensuring the development of quality teachers for our schools. The gap that this current research programme addressed was to link the fields of values education, quality teaching and pre-service teacher education. This research programme aimed to determine the impact of a values-based pedagogy on the development of quality teaching dimensions within pre-service teacher education. The values-based pedagogy that was investigated in this research programme was Philosophy in the Classroom. The research programme adopted a nested case study design based on the constructivist-interpretative paradigm in examining a unit within a pre-service teacher education programme at a Queensland university. The methodology utilised was qualitative where the main source of data was via interviews. In total, 43 pre-service teachers participated in three studies in order to determine if their involvement in a unit where the focus was on introducing pre-service teachers to an explicit values-based pedagogy impacted on their knowledge, skills and confidence in terms of quality teaching dimensions. The research programme was divided into three separate studies in order to address the two research questions: 1. In what ways do pre-service teachers perceive they are being prepared to become quality teachers? 2. Is there a connection between an explicit values-based pedagogy in pre-service teacher education and the development of pre-service teachers. understanding of quality teaching? Study One provided insight into 21 pre-service teachers. understandings of quality teaching. These 21 participants had not engaged in an explicit values-based pedagogy. Study Two involved the interviewing of 22 pre-service teachers at two separate points in time . prior to exposure to a unit that employed a values-explicit pedagogy and post this subject.s lecture content delivery. Study Three reported on and analysed individual case studies of five pre-service teachers who had participated in Study Two Time 1 and Time 2, as well as a third time following their field experience where they had practice in teaching the values explicit pedagogy. The results of the research demonstrate that an explicit values-based pedagogy introduced into a teacher education programme has a positive impact on the development of pre-service teachers. understanding of quality teaching skills and knowledge. The teaching and practice of a values-based pedagogy positively impacted on pre-service teachers with increases of knowledge, skills and confidence demonstrated on the quality teaching dimensions of intellectual quality, a supportive classroom environment, recognition of difference, connectedness and values. These findings were reinforced through the comparison of pre-service teachers who had participated in the explicit values-based pedagogical approach, with a sample of pre-service teachers who had not engaged in this same values-based pedagogical approach. A solid values-based pedagogy and practice can and does enhance pre-service teachers. understanding of quality teaching. These findings surrounding the use of a values-based pedagogy in pre-service teacher education to enhance quality teaching knowledge and skills has contributed theoretically to the field of educational research, as well having practical implications for teacher education institutions and teacher educators.

Dimensionality of quality from a customer perspective in the wood industry

The research analyzes product quality from a customer perspective in the case of the wood products industry. Of specific interest is to understand better how environmental quality is perceived from a customer perspective. The empirical material used comprises four data-sets from Finland, Germany and the UK, collected during 1992 2004. The methods consist of a set of quantitative statistical analyses. The results indicate that perceived quality from a customer perspective can be presented using a multidimensional and hierarchical construct with tangible and intangible dimensions, that is common to different markets and products. This applies in the case of wood products but also more generally at least for some other construction materials. For wood products, tangible product quality has two main sub-dimensions: technical quality and appearance. For product intangibles, a few main quality dimensions seem be detectable: Quality of intangibles related to the physical product, such as environmental issues and product-related information, supplier-related characteristics, and service and sales personnel behavior. Environmental quality and information are often perceived as being inter-related. Technical performance and appearance are the most important considerations for customers in the case of wood products. Organizational customers in particular also clearly consider certain intangible quality dimensions to be important, such as service and supplier reliability. The high technical quality may be considered as a license to operate , but product appearance and intangible quality provide potential for differentiation for attracting certain market segments. Intangible quality issues are those where Nordic suppliers underperform in comparison to their Central-European competitors on the important German markets. Environmental quality may not have been used to its full extent to attract customers. One possibility is to increase the availability of the environment-related information, or to develop environment-related product characteristics to also provide some individual benefits. Information technology provides clear potential to facilitate information-based quality improvements, which was clearly recognized by Finnish forest industry already in the early 1990s. The results indeed indicate that wood products markets are segmented with regard to quality demands

Dimensions of University Student Learning in Medicine and Pharmacy

Study orientations in higher education consist of various dimensions, such as approaches to learning, conceptions of learning and knowledge (i.e. epistemologies), self-regulation, and motivation. They have also been measured in different ways. The main orientations typically reported are reproducing and meaning orientations. The present study explored dimensions of study orientations, focusing in particular on pharmacy and medicine. New versions of self-report instruments were developed and tested in various contexts and in two countries. Furthermore, the linkages between study orientations and students epistemological development were explored. The context of problem-based (PBL) small groups was investigated in order to better understand how collaboration contributes to the quality of learning. The participants of Study I (n=66) were pharmacy students, who were followed during a three-year professionally oriented program in terms of their study orientations and epistemologies. A reproducing orientation to studying diminished during studying, whereas only a few students maintained their original level of meaning orientation. Dualism was found to be associated with a reproducing orientation. In Study II practices associated with deep and surface approaches to learning were measured in two differing ways, in order to better distinguish between what students believed to be useful in studying, and the extent to which they applied their beliefs to practice when preparing for examinations. Differences between domains were investigated by including a sample of Finnish and Swedish medical students (n=956) and a Finnish non-medical sample of university students (n=865). Memorizing and rote learning appeared as differing components of a surface approach to learning, while understanding, relating, and critical evaluation of knowledge emerged as aspects of a deep approach to learning. A structural model confirmed these results in both student samples. Study III explored a wide variety of dimensions of learning in medical education. Swedish medical students (n=280) answered the questionnaire. The deep approach to learning was strongly related to collaboration and reflective learning, whereas the surface approach was associated with novice-like views of knowledge and the valuing of certain and directly applicable knowledge. PBL students aimed at understanding, but also valued the role of memorization. Study IV investigated 12 PBL tutorial groups of students (n=116) studying microbiology and pharmacology in a medical school. The educational application was expected to support a deep approach to learning: Group members course grades in a final examination were related to the perceived functioning of the PBL tutorial groups. Further, the quality of cases that had been used as triggers for learning, was associated with the quality of small group functioning. New dimensions of study orientations were discovered. In particular, novel, finer distinctions were found within the deep approach component. In medicine, critical evaluation of knowledge appeared to be less valued than understanding and relating. Further, collaboration appeared to be closely related to the deep approach, and it was also important in terms of successful PBL studying. The results of the studies confirmed the previously found associations between approaches to learning and study success, but showed interesting context- and subgroup-related differences in this respect. Students ideas about the nature of knowledge and their approaches to learning were shown to be closely related. The present study expanded our understanding of the dimensions of study orientations, of their development, and their contextual variability in pharmacy and medicine.

The Cultural Dimensions of the Vietnamese Private Entrepreneurship

In this essay, we explore cultural impacts on the private entrepreneurship in the post-Doi Moi Vietnam. Some important aspects of the traditional cultural values of the Vietnamese society are explored in conjunction with the socio-economic changes over the past two decades. Traditional cultural values continue to have strong impacts on the Vietnamese society, and to a large extent to adversely affect the entrepreneurial spirit of the community. Typical constraints private entrepreneurs face may have roots in the cultural facet as legacy of the Confucian society, such as relationship-based bank credit. Low quality business education is both victim and culprit of the long-standing tradition that looks down on the role of private entrepreneurship in the country.

Formal caregivers' perceptions of quality of care for older people : associating factors

Background: Despite the growing number of studies concerning quality of care for older people, there is a lack of studies depicting factors associated with good quality of care from the formal caregivers' perspective. The aim was to describe formal caregivers' perceptions of quality of care for older people in the community and explore factors associated with these perceptions. In total, 70 nursing assistants, 163 enrolled nurses and 198 registered nurses from 14 communities in central Sweden participated in the study. They filled out the following questionnaires: a modified version of Quality from the Patient's Perspective, Creative Climate Questionnaire, Stress of Conscience Questionnaire, items regarding education and competence, Health Index and Sense of coherence questionnaire. The overall response rate was 57 % (n = 431). Results: In the perceived reality of quality of care respondents assessed the highest mean value in the dimension medical-technical competence and physical technical conditions and lower values in the dimensions; identity-oriented approach, socio-cultural atmosphere and in the context specific dimension. The caregivers estimated their competence and health rather high, had lower average values in sense of coherence and organizational climate and low values in stress of conscience. Conculsions: The PR of quality of care were estimated higher among NA/ENs compared to RNs. Occupation, organizational climate and stress of conscience were factors associated with quality of care that explained 42 % of the variance. Competence, general health and sense of coherence were not significantly associated to quality of care. The mentioned factors explaining quality of care might be intertwined and showed that formal caregivers' working conditions are of great importance for quality of care.

How cultural differences cause dimensions of tourism satisfaction

This paper develops a conceptual model of the relationship between different cultural values and how they influence consumer satisfaction in the tourism industry. It is hypothesized that cultural differences manifest themselves in different levels of importance being placed upon different aspects of service, and the differences between the levels of importance and the actual service received cause differences in the levels of satisfaction. These hypotheses are tested using 269 independent samples of levels of importance and 411 independent samples of satisfaction of tourists from four cultural groups (Australian, USA/Canadian, Japanese, Mandarin speakers) who visited Melbourne, Australia in the period May-September, 1996. The analysis develops dimensions of importance and satisfaction separately for each cultural grouping, and uses structural equation modeling (Amos 3.6) to develop the causal model measuring the way in which importance of service dimensions cause dimensions of satisfaction. Conclusions from the analysis show little evidence of a causal relationship between importance of service quality attributes and satisfaction. However, significant differences are found between cultures for different levels of satisfaction resulting indirectly from differences in the importance and actual levels of service received.

The health equity dimensions of urban food systems

There is increasing recognition that the nutrition transition sweeping the world’s cities is multifaceted. Urban food and nutrition systems are beginning to share similar features, including an increase in dietary diversity, a convergence toward “Western-style” diets rich in fat and refined carbohydrate and within-country bifurcation of food supplies and dietary conventions. Unequal access to the available dietary diversity, calories, and gastronomically satisfying eating experience leads to nutritional inequalities and diet-related health inequities in rich and poor cities alike. Understanding the determinants of inequalities in food security and nutritional quality is a precondition for developing preventive policy responses. Finding common solutions to under- and overnutrition is required, the first step of which is poverty eradication through creating livelihood strategies. In many cities, thousands of positions of paid employment could be created through the establishment of sustainable and self-sufficient local food systems, including urban agriculture and food processing initiatives, food distribution centers, healthy food market services, and urban planning that provides for multiple modes of transport to food outlets. Greater engagement with the food supply may dispel many of the food anxieties affluent consumers are experiencing.

Construction of the descriptive system for the assessment of quality of life AQoL-6D utility instrument

Background
Multi attribute utility (MAU) instruments are used to include the health related quality of life (HRQoL) in economic evaluations of health programs. Comparative studies suggest different MAU instruments measure related but different constructs. The objective of this paper is to describe the methods employed to achieve content validity in the descriptive system of the Assessment of Quality of Life (AQoL)-6D, MAU instrument.

Methods
The AQoL program introduced the use of psychometric methods in the construction of health related MAU instruments. To develop the AQoL-6D we selected 112 items from previous research, focus groups and expert judgment and administered them to 316 members of the public and 302 hospital patients. The search for content validity across a broad spectrum of health states required both formative and reflective modelling. We employed Exploratory Factor Analysis and Structural Equation Modelling (SEM) to meet these dual requirements.

Results and Discussion
The resulting instrument employs 20 items in a multi-tier descriptive system. Latent dimension variables achieve sensitive descriptions of 6 dimensions which, in turn, combine to form a single latent QoL variable. Diagnostic statistics from the SEM analysis are exceptionally good and confirm the hypothesised structure of the model.

Conclusions
The AQoL-6D descriptive system has good psychometric properties. They imply that the instrument has achieved construct validity and provides a sensitive description of HRQoL. This means that it may be used with confidence for measuring health related quality of life and that it is a suitable basis for modelling utilities for inclusion in the economic evaluation of health programs.